Keywords :
Cardiovascular safety; Guidelines; Hypoglycemia; Oral antidiabetic drug; Sulfonylureas; Internal Medicine; Endocrinology, Diabetes and Metabolism; Nutrition and Dietetics; Cardiology and Cardiovascular Medicine
Abstract :
[en] Sulfonylureas (SU) for a long time occupied an essential role in the management of type 2 diabetes (T2D). However, the launch of new oral antidiabetic drugs (OAD), firstly DPP-4 inhibitors (gliptins) and more recently SGLT2 inhibitors (gliflozins), has markedly changed the scene. Indeed, in contrast to SU, these new OAD (of course more expensive) offer the advantage of a very low risk of hypoglycemia and a beneficial impact on bodyweight. Furthermore, gliflozins have proven to exert a cardiovascular and renal protection in patients at high risk. This article is discussing the current place to be reserved to SU in the treatment of T2D, after a short recall about the risk of hypoglycemia and the cardiovascular safety. Contrasted positions still remain in the international literature which translate into different guidelines between countries, especially due to economic constraints. SU keep a place in the management of T2D, yet it becomes more and more limited. For sure, SU should be avoided among elderly frailty people and patients at high risk of hypoglycemia.
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