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Lv W, Wang X, Xu Q, Lu W. Mechanisms and Characteristics of Sulfonylureas and Glinides. Curr Top Med Chem 2020; 20:37-56. [PMID: 31884929 DOI: 10.2174/1568026620666191224141617] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 08/30/2019] [Accepted: 09/22/2019] [Indexed: 12/25/2022]
Abstract
BACKGROUND Type 2 diabetes mellitus is a complex progressive endocrine disease characterized by hyperglycemia and life-threatening complications. It is the most common disorder of pancreatic cell function that causes insulin deficiency. Sulfonylurea is a class of oral hypoglycemic drugs. Over the past half century, these drugs, together with the subsequent non-sulfonylureas (glinides), have been the main oral drugs for insulin secretion. OBJECTIVE Through in-depth study, the medical profession considers it as an important drug for improving blood sugar control. METHODS The mechanism, characteristics, efficacy and side effects of sulfonylureas and glinides were reviewed in detail. RESULTS Sulfonylureas and glinides not only stimulated the release of insulin from pancreatic cells, but also had many extrapanular hypoglycemic effect, such as reducing the clearance rate of insulin in liver, reducing the secretion of glucagon, and enhancing the sensitivity of peripheral tissues to insulin in type 2 diabetes mellitus. CONCLUSION Sulfonylureas and glinides are effective first-line drugs for the treatment of diabetes mellitus. Although they have the risk of hypoglycemia, weight gain and cardiovascular disease, their clinical practicability and safety can be guaranteed as long as they are reasonably used.
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Affiliation(s)
- Wei Lv
- School of Materials Science and Engineering, Shanghai University, Shanghai, China.,Shanghai Huayi Resins Co., Ltd., Shanghai, China
| | - Xianqing Wang
- Charles Institute of Dermatology, University College Dublin, Dublin D04 V1W8, Ireland
| | - Qian Xu
- Charles Institute of Dermatology, University College Dublin, Dublin D04 V1W8, Ireland
| | - Wencong Lu
- School of Materials Science and Engineering, Shanghai University, Shanghai, China
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Kalra S, Das AK, Baruah MP, Unnikrishnan AG, Dasgupta A, Shah P, Sahay R, Shukla R, Das S, Tiwaskar M, Vijayakumar G, Chawla M, Eliana F, Suastika K, Orabi A, Rahim AAA, Uloko A, Bahendeka S, Abdela AA, Mohammed F, Pathan F, Rahman MH, Afsana F, Selim S, Moosa M, Murad M, Shreshtha PK, Shreshtha D, Giri M, Hussain W, Al-Ani A, Ramaiya K, Singh S, Raza SA, Aye TT, Garusinghe C, Muthukuda D, Weerakkody M, Kahandawa S, Bavuma C, Ruder S, Vanny K, Khanolkar M, Czupryniak L. Glucocrinology of Modern Sulfonylureas: Clinical Evidence and Practice-Based Opinion from an International Expert Group. Diabetes Ther 2019; 10:1577-1593. [PMID: 31267358 PMCID: PMC6778594 DOI: 10.1007/s13300-019-0651-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Indexed: 12/16/2022] Open
Abstract
AIM The primary objective of this document is to develop practice-based expert group opinion on certain important but less discussed endocrine and metabolic effects of modern sulfonylureas (SUs) and their usage in the management of diabetes mellitus (DM). BACKGROUND Modern SUs may be considered a panacea in DM care with their beneficial extra-pancreatic, pleiotropic, and cardiovascular effects. Safe glycemic control with SUs could be achieved with appropriate patient selection, drug and dosage selection, and patient empowerment. Additionally, sulfonylureas also exhibit certain endocrine and metabolic effects, which could be considered beneficial in the management of DM. In this regard, a group of international clinical experts discussed the less known beneficial aspects of SUs and safe and smart prescription of modern SUs in DM care. RESULTS The concept of glucocrinology or the relationship of glycemia with the endocrine system was emphasized during the meetings. Clinical experts arrived at a consensus for the usage of modern SUs in the presence of other endocrine dysfunction and the impact of these drugs on endocrine health. The beneficial pleiotropic and cardiovascular effects of modern SUs were also discussed. The key discussion points were considered to develop clinical expert opinions for the use of modern SUs in persons with DM. Clinical expert opinions were developed for indications, pleiotropic benefits, cardiovascular outcomes, adherence, and safe use of modern SUs. CONCLUSIONS Appropriate clinical judgement coupled with a patient-centered approach is crucial to achieve the best outcome in persons with DM. Owing to their safety, efficacy, extra-pancreatic benefits including effects on endocrine and metabolic aspects, and low cost of therapy, modern SUs could be considered as drugs/agents of choice for the treatment of diabetes. FUNDING Sanofi India.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and BRIDE, Karnal, Haryana, India.
| | - A K Das
- Department of Endocrinology and Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - M P Baruah
- Department of Endocrinology, Excel Hospital, Guwahati, Assam, India
| | - A G Unnikrishnan
- Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, Maharashtra, India
| | - Arundhati Dasgupta
- Department of Endocrinology, Rudraksh Superspecialty Care, Siliguri, India
| | - Parag Shah
- Department of Endocrinology and Diabetes, Gujarat Endocrine Centre, Ahmedabad, India
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College, Hyderabad, India
| | - Rishi Shukla
- Department of Endocrinology, Regency Hospital Ltd., Kanpur, India
| | - Sambit Das
- Department of Endocrinology, Apollo Hospitals, Bhubaneswar, India
| | - Mangesh Tiwaskar
- Department of Diabetology, Shilpa Medical Research Centre, Mumbai, India
| | - G Vijayakumar
- Department of Diabetology, Apollo Hospitals, Chennai, India
| | - Manoj Chawla
- Department of Diabetology, Lina Diabetes Care and Mumbai Diabetes Research Centre, Mumbai, India
| | - Fatimah Eliana
- Department of Internal Medicine, Faculty of Medicine, YARSI University, Jakarta, Indonesia
| | - Ketut Suastika
- Indonesian Association of Endocrinology, Jakarta, Indonesia
| | - Abbas Orabi
- Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt
| | | | - Andrew Uloko
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Silver Bahendeka
- Department of Internal Medicine, Diabetes and Endocrinology, St. Francis Hospital, Nsambya, Kampala, Uganda
| | | | - Fariduddin Mohammed
- Department of Endocrinology of Bangabandhu Sheikh, Mujib Medical University, Dhaka, Bangladesh
| | - Faruque Pathan
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh
| | | | - Faria Afsana
- Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh
| | - Shajada Selim
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Muaz Moosa
- Department of Internal Medicine, Indira Gandhi Memorial Hospital, Malé, Maldives
| | - Moosa Murad
- Department of Internal Medicine, Indira Gandhi Memorial Hospital, Malé, Maldives
| | | | - Dina Shreshtha
- Department of Endocrinologist, Norvic International Hospital, Kathmandu, Nepal
| | - Mimi Giri
- Department of Endocrinology, Nepal Mediciti Hospital, Kathmandu, Nepal
| | - Wiam Hussain
- Department of Endocrinology and Diabetes, Dr Wiam Clinic, Royal Hospital, Awali Hospital, Awali, Bahrain
| | - Ahmed Al-Ani
- Department of Internal Medicine, Hamad Hospital, Doha, Qatar
| | - Kaushik Ramaiya
- Department of Diabetology, Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania
| | - Surender Singh
- Department of Internal Medicine, Aster Al Raffah Hospital, Muscat, Oman
| | - Syed Abbas Raza
- Department of Endocrinology, Shaukat Khanum Hospital and Research Center, Lahore, Pakistan
| | - Than Than Aye
- Myanmar Society of Endocrinology and Metabolism, Yangon, Myanmar
| | - Chaminda Garusinghe
- Department of Endocrinology, Colombo South Teaching Hospital, Colombo, Sri Lanka
| | - Dimuthu Muthukuda
- Department of Endocrinology, Sri Jayawardenepura General Hospital, Sri Jayawardenepura Kotte, Sri Lanka
| | - Muditha Weerakkody
- Department of Endocrinology, Teaching Hospital Karapitiya, Galle, Sri Lanka
| | | | - Charlotte Bavuma
- Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Rwanda
| | - Sundeep Ruder
- Department of Endocrinology and Metabolism, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Koy Vanny
- Department of Diabetes and Endocrinology, Dr Koy Vanny Diabetes and Endocrine Clinic, Phnom Penh, Cambodia
| | - Manish Khanolkar
- Department of Endocrinology and Diabetes, Waikato Hospital, Hamilton, New Zealand
| | - Leszek Czupryniak
- Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland
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Kalra S, Aamir AH, Raza A, Das AK, Azad Khan AK, Shrestha D, Qureshi MF, Md Fariduddin, Pathan MF, Jawad F, Bhattarai J, Tandon N, Somasundaram N, Katulanda P, Sahay R, Dhungel S, Bajaj S, Chowdhury S, Ghosh S, Madhu SV, Ahmed T, Bulughapitiya U. Place of sulfonylureas in the management of type 2 diabetes mellitus in South Asia: A consensus statement. Indian J Endocrinol Metab 2015; 19:577-96. [PMID: 26425465 PMCID: PMC4566336 DOI: 10.4103/2230-8210.163171] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Since their introduction in clinical practice in the 1950's, Sulfonylureas (SUs) have remained the main-stay of pharmacotherapy in the management of type 2 diabetes. Despite their well-established benefits, their place in therapy is inappropriately being overshadowed by newer therapies. Many of the clinical issues associated with the use of SUs are agent-specific, and do not pertain to the class as such. Modern SUs (glimepiride, gliclazide MR) are backed by a large body of evidence, experience, and most importantly, outcome data, which supports their role in managing patients with diabetes. Person-centred care, i.e., careful choice of SU, appropriate dosage, timing of administration, and adequate patient counseling, will ensure that deserving patients are not deprived of the advantages of this well-established class of anti-diabetic agents. Considering their efficacy, safety, pleiotropic benefits, and low cost of therapy, SUs should be considered as recommended therapy for the treatment of diabetes in South Asia. This initiative by SAFES aims to encourage rational, safe and smart prescription of SUs, and includes appropriate medication counseling.
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Affiliation(s)
- Sanjay Kalra
- Department of Endocrinology, Bharti Hospital and BRIDE, Karnal, Haryana, India
| | - A H Aamir
- Department of Endocrinology, Post Graduate Medical Institute Hayatabad Medical Complex, Peshawar, Pakistan
| | - Abbas Raza
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - A K Das
- Department of Endocrinology, Pondicherry Institute of Medical Sciences, Puducherry, India
| | - A K Azad Khan
- Department of Public Health, Bangladesh University of Health Sciences, Dhaka, Bangladesh
| | - Dina Shrestha
- Department of Endocrinology, Norvic International Hospital, Kathmandu, Nepal
| | - Md Faisal Qureshi
- Department of Endocrinology, Al-Khaliq Medicare Hospital, Dhaka, Bangladesh
| | - Md Fariduddin
- Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Shahbag, Dhaka, Bangladesh
| | | | - Fatema Jawad
- Department of Diabetology, Medilink Clinics, Karachi, Pakistan
| | - Jyoti Bhattarai
- Department of Medicine, Trivuvan University, Kathmandu, Nepal
| | - Nikhil Tandon
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Noel Somasundaram
- South Asian Federation of Endocrine Societies, National Hospital, Dhaka, Bangladesh
| | - Prasad Katulanda
- Department of Clinical Medicines, Diabetes Research Unit, University of Colombo, Colombo, Sri Lanka
| | - Rakesh Sahay
- Department of Endocrinology, Osmania Medical College, Hyderabad, Telangana, India
| | - Sanjib Dhungel
- Department of Medicine, Nepal Medical College Teaching Hospital, Kathmandu, Nepal
| | - Sarita Bajaj
- Department of Medicine, MLN Medical College, Allahabad, Uttar Pradesh, India
| | - Subhankar Chowdhury
- Department of Endocrinology, IPGMER and SSKM Hospital, Kolkata, West Bengal, India
| | - Sujoy Ghosh
- Department of Endocrinology and Metabolism, IPGMER, Kolkata, West Bengal, India
| | - S V Madhu
- Department of Medicine and Head, Centre for Diabetes, Endocrinology and Metabolism, UCMS-GTB Hospital, New Delhi, India
| | - Tofail Ahmed
- Department of Endocrinology, BIRDEM, Dhaka, Bangladesh
| | - Uditha Bulughapitiya
- Department of Endocrinology, Kalubowila South Teaching Hospital, Kalubowila, Sri Lanka
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Bennett N, Papich MG, Hoenig M, Fettman MJ, Lappin MR. Evaluation of transdermal application of glipizide in a pluronic lecithin gel to healthy cats. Am J Vet Res 2005; 66:581-8. [PMID: 15900936 DOI: 10.2460/ajvr.2005.66.581] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To evaluate plasma glipizide concentration and its relationship to plasma glucose and serum insulin concentrations in healthy cats administered glipizide orally or transdermally. ANIMALS-15 healthy adult laboratory-raised cats. PROCEDURE Cats were randomly assigned to 2 treatment groups (5 mg of glipizide, PO or transdermally) and a control group. Blood samples were collected 0, 10, 20, 30, 45, 60, 90, and 120 minutes and 4, 6, 10, 14, 18, and 24 hours after administration to determine concentrations of insulin, glucose, and glipizide. RESULTS Glipizide was detected in all treated cats. Mean +/- SD transdermal absorption was 20 +/- 14% of oral absorption. Mean maximum glipizide concentration was reached 5.0 +/- 3.5 hours after oral and 16.0 +/- 4.5 hours after transdermal administration. Elimination half-life was variable (16.8 +/- 12 hours orally and 15.5 +/- 15.3 hours transdermally). Plasma glucose concentrations decreased in all treated cats, compared with concentrations in control cats. Plasma glucose concentrations were significantly lower 2 to 6 hours after oral administration, compared with after transdermal application; concentrations were similar between treatment groups and significantly lower than for control cats 10 to 24 hours after treatment. CONCLUSIONS AND CLINICAL RELEVANCE Transdermal absorption of glipizide was low and inconsistent, but analysis of our results indicated that it did affect plasma glucose concentrations. Transdermal administration of glipizide is not equivalent to oral administration. Formulation, absorption, and stability studies are required before clinical analysis can be performed. Transdermal administration of glipizide cannot be recommended for clinical use at this time.
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Affiliation(s)
- Nicole Bennett
- D Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University Fort Collins, CO 80523, USA
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