Laurentiu M Pop1, Ildiko Lingvay2,3. 1. Department of Internal Medicine, Division of Endocrinology, UT Southwestern Medical Center, Dallas, TX, USA. 2. Department of Internal Medicine, Division of Endocrinology, UT Southwestern Medical Center, Dallas, TX, USA. ildiko.lingvay@utsouthwestern.edu. 3. Department of Clinical Science, UT Southwestern Medical Center, 5323 Harry Hines Blvd, U9.134C, Dallas, TX, 75390-9302, USA. ildiko.lingvay@utsouthwestern.edu.
Abstract
PURPOSE OF REVIEW: Sulfonylureas (SUs) are one of the most commonly used glucose-lowering agents worldwide. While their efficacy is undisputed, their cardiovascular safety has been debated since the 1970's. RECENT FINDINGS: With no dedicated cardiovascular studies to definitively answer this question, observational studies and meta-analyses abound and have reported divergent results, fueling the controversy. Studies that compared SUs to metformin or newer agents, like GLP-1 agonists and SGLT2 inhibitors, suggest a difference in cardiovascular events, yet this is likely the result of beneficial effects of the latter. Studies comparing SUs to other agents have been reassuring. SUs remain a common choice of treatment for patients with type 2 diabetes due to their exceptional value. They are effective at lowering glucose and thus contributing to the prevention of microvascular complications. Weight gain and hypoglycemia are their main side effects, although less severe when compared to insulin treatment. Their cardiovascular safety will remain a controversial topic due to lack of conclusive data, but there is no definitive evidence of harm with the second-generation agents.
PURPOSE OF REVIEW: Sulfonylureas (SUs) are one of the most commonly used glucose-lowering agents worldwide. While their efficacy is undisputed, their cardiovascular safety has been debated since the 1970's. RECENT FINDINGS: With no dedicated cardiovascular studies to definitively answer this question, observational studies and meta-analyses abound and have reported divergent results, fueling the controversy. Studies that compared SUs to metformin or newer agents, like GLP-1 agonists and SGLT2 inhibitors, suggest a difference in cardiovascular events, yet this is likely the result of beneficial effects of the latter. Studies comparing SUs to other agents have been reassuring. SUs remain a common choice of treatment for patients with type 2 diabetes due to their exceptional value. They are effective at lowering glucose and thus contributing to the prevention of microvascular complications. Weight gain and hypoglycemia are their main side effects, although less severe when compared to insulin treatment. Their cardiovascular safety will remain a controversial topic due to lack of conclusive data, but there is no definitive evidence of harm with the second-generation agents.
Authors: Azim S Gangji; Tali Cukierman; Hertzel C Gerstein; Charles H Goldsmith; Catherine M Clase Journal: Diabetes Care Date: 2007-02 Impact factor: 19.112
Authors: Erland Erdmann; John A Dormandy; Bernard Charbonnel; Massimo Massi-Benedetti; Ian K Moules; Allan M Skene Journal: J Am Coll Cardiol Date: 2007-04-16 Impact factor: 24.094
Authors: Christianne L Roumie; Adriana M Hung; Robert A Greevy; Carlos G Grijalva; Xulei Liu; Harvey J Murff; Tom A Elasy; Marie R Griffin Journal: Ann Intern Med Date: 2012-11-06 Impact factor: 25.391
Authors: Walter N Kernan; Catherine M Viscoli; Karen L Furie; Lawrence H Young; Silvio E Inzucchi; Mark Gorman; Peter D Guarino; Anne M Lovejoy; Peter N Peduzzi; Robin Conwit; Lawrence M Brass; Gregory G Schwartz; Harold P Adams; Leo Berger; Antonio Carolei; Wayne Clark; Bruce Coull; Gary A Ford; Dawn Kleindorfer; John R O'Leary; Mark W Parsons; Peter Ringleb; Souvik Sen; J David Spence; David Tanne; David Wang; Toni R Winder Journal: N Engl J Med Date: 2016-02-17 Impact factor: 91.245
Authors: Olga Vaccaro; Maria Masulli; Enzo Bonora; Stefano Del Prato; Antonio Nicolucci; Angela A Rivellese; Gabriele Riccardi Journal: Diabetes Care Date: 2012-12 Impact factor: 19.112
Authors: Steven P Marso; Gilbert H Daniels; Kirstine Brown-Frandsen; Peter Kristensen; Johannes F E Mann; Michael A Nauck; Steven E Nissen; Stuart Pocock; Neil R Poulter; Lasse S Ravn; William M Steinberg; Mette Stockner; Bernard Zinman; Richard M Bergenstal; John B Buse Journal: N Engl J Med Date: 2016-06-13 Impact factor: 176.079
Authors: Amelia D Dahlén; Giovanna Dashi; Ivan Maslov; Misty M Attwood; Jörgen Jonsson; Vladimir Trukhan; Helgi B Schiöth Journal: Front Pharmacol Date: 2022-01-19 Impact factor: 5.810