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Journal of Diabetology | Volume 3
May 16-17, 2019 | Prague, Czech Republic
Diabetes and Endocrinology
27
th
International Conference on
J Diabetol, Volume 3
Sulphonylureas – Do they still have a place in the management of type 2 diabetes?
Debashis Das
USV Private Limited, India
F
or years, Sulphonylureas (SUs) have been the imperative
drugs for the management of type 2 diabetes mellitus
(T2DM),bothasmonotherapyandcombinationtherapy.SUs is
very efficacious class of drugs with concerns of hypoglycaemia
and weight gain. Also, the concept of β-cell preservation did
not go well with this class of drugs. With these limitations
the search went on to find the newer group of drugs such as
sodium-glucose cotransporter 2 (SGLT-2) and Glucagon-like
peptide 1 (GLP-1) receptor agonists. In 2008, Food & Drug
Administration (FDA) issued guidance on the evaluation of
cardiovascular risk in new anti-diabetic therapies leading to
cardiovascular outcomes trial (CVOT) which changed the way
the anti-diabetic drugs were evaluated and preferred. GLP-1
analogues such as Liraglutide & Semaglutide, SGLT-2 inhibitors
like Empagliflozin & Canagliflozin have shown to be not only
CV safe and but CV protective in these trials. More than 80%of
the people globally with T2DMbelong to developing countries
where access&affordability are amajor challenge, using these
newer agents may not be practically feasible. Now the debate
is whether SUs should be used as the second line agent in the
management of T2DM after metformin with lack of evidence
of CV safety, risk of hypoglycaemia and weight gain. There
might not be a straight answer to this now, but SUs would
continue to be an important drug in the treatment of T2DM
with the exponential rise in health care costs worldwide.
e
:
drdebashisdas@gmail.com