Glucocrinology of Modern Sulfonylureas: Clinical Evidence and Practice-Based Opinion from an International Expert Group.

Cardiovascular complications Cardiovascular phenotype Extra-pancreatic effects Glimepiride Glucocrinology Modern sulfonylureas Myocardial ischemic preconditioning Type 2 diabetes mellitus

Journal

Diabetes therapy : research, treatment and education of diabetes and related disorders
ISSN: 1869-6953
Titre abrégé: Diabetes Ther
Pays: United States
ID NLM: 101539025

Informations de publication

Date de publication:
Oct 2019
Historique:
received: 23 02 2019
pubmed: 4 7 2019
medline: 4 7 2019
entrez: 4 7 2019
Statut: ppublish

Résumé

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). 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. 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. 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. Sanofi India.

Sections du résumé

AIM OBJECTIVE
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 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 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 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 BACKGROUND
Sanofi India.

Identifiants

pubmed: 31267358
doi: 10.1007/s13300-019-0651-1
pii: 10.1007/s13300-019-0651-1
pmc: PMC6778594
doi:

Types de publication

Journal Article Review

Langues

eng

Pagination

1577-1593

Subventions

Organisme : Sanofi India
ID : 00

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Auteurs

Sanjay Kalra (S)

Department of Endocrinology, Bharti Hospital and BRIDE, Karnal, Haryana, India. brideknl@gmail.com.

A K Das (AK)

Department of Endocrinology and Medicine, Pondicherry Institute of Medical Sciences, Puducherry, India.

M P Baruah (MP)

Department of Endocrinology, Excel Hospital, Guwahati, Assam, India.

A G Unnikrishnan (AG)

Department of Endocrinology and Diabetes, Chellaram Diabetes Institute, Pune, Maharashtra, India.

Arundhati Dasgupta (A)

Department of Endocrinology, Rudraksh Superspecialty Care, Siliguri, India.

Parag Shah (P)

Department of Endocrinology and Diabetes, Gujarat Endocrine Centre, Ahmedabad, India.

Rakesh Sahay (R)

Department of Endocrinology, Osmania Medical College, Hyderabad, India.

Rishi Shukla (R)

Department of Endocrinology, Regency Hospital Ltd., Kanpur, India.

Sambit Das (S)

Department of Endocrinology, Apollo Hospitals, Bhubaneswar, India.

Mangesh Tiwaskar (M)

Department of Diabetology, Shilpa Medical Research Centre, Mumbai, India.

G Vijayakumar (G)

Department of Diabetology, Apollo Hospitals, Chennai, India.

Manoj Chawla (M)

Department of Diabetology, Lina Diabetes Care and Mumbai Diabetes Research Centre, Mumbai, India.

Fatimah Eliana (F)

Department of Internal Medicine, Faculty of Medicine, YARSI University, Jakarta, Indonesia.

Ketut Suastika (K)

Indonesian Association of Endocrinology, Jakarta, Indonesia.

Abbas Orabi (A)

Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt.

Aly Ahmed Abdul Rahim (AAA)

Department of Diabetes and Metabolism, Alexandria University, Alexandria, Egypt.

Andrew Uloko (A)

Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria.

Silver Bahendeka (S)

Department of Internal Medicine, Diabetes and Endocrinology, St. Francis Hospital, Nsambya, Kampala, Uganda.

Abdurezak Ahmed Abdela (AA)

Department of Internal Medicine, Addis Ababa, Ethiopia.

Fariduddin Mohammed (F)

Department of Endocrinology of Bangabandhu Sheikh, Mujib Medical University, Dhaka, Bangladesh.

Faruque Pathan (F)

Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh.

Muhammed Hafizur Rahman (MH)

Department of Endocrinology, Dhaka Medical College and Hospital, Dhaka, Bangladesh.

Faria Afsana (F)

Department of Endocrinology, Bangladesh Institute of Research and Rehabilitation for Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh.

Shajada Selim (S)

Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Muaz Moosa (M)

Department of Internal Medicine, Indira Gandhi Memorial Hospital, Malé, Maldives.

Moosa Murad (M)

Department of Internal Medicine, Indira Gandhi Memorial Hospital, Malé, Maldives.

Pradeep Krishna Shreshtha (PK)

Department of Internal Medicine, Tribhuwan University Teaching Hospital, Kathmandu, Nepal.

Dina Shreshtha (D)

Department of Endocrinologist, Norvic International Hospital, Kathmandu, Nepal.

Mimi Giri (M)

Department of Endocrinology, Nepal Mediciti Hospital, Kathmandu, Nepal.

Wiam Hussain (W)

Department of Endocrinology and Diabetes, Dr Wiam Clinic, Royal Hospital, Awali Hospital, Awali, Bahrain.

Ahmed Al-Ani (A)

Department of Internal Medicine, Hamad Hospital, Doha, Qatar.

Kaushik Ramaiya (K)

Department of Diabetology, Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania.

Surender Singh (S)

Department of Internal Medicine, Aster Al Raffah Hospital, Muscat, Oman.

Syed Abbas Raza (SA)

Department of Endocrinology, Shaukat Khanum Hospital and Research Center, Lahore, Pakistan.

Than Than Aye (TT)

Myanmar Society of Endocrinology and Metabolism, Yangon, Myanmar.

Chaminda Garusinghe (C)

Department of Endocrinology, Colombo South Teaching Hospital, Colombo, Sri Lanka.

Dimuthu Muthukuda (D)

Department of Endocrinology, Sri Jayawardenepura General Hospital, Sri Jayawardenepura Kotte, Sri Lanka.

Muditha Weerakkody (M)

Department of Endocrinology, Teaching Hospital Karapitiya, Galle, Sri Lanka.

Shyaminda Kahandawa (S)

Department of Endocrinology, District General Hospital, Matara, Sri Lanka.

Charlotte Bavuma (C)

Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Rwanda.

Sundeep Ruder (S)

Department of Endocrinology and Metabolism, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa.

Koy Vanny (K)

Department of Diabetes and Endocrinology, Dr Koy Vanny Diabetes and Endocrine Clinic, Phnom Penh, Cambodia.

Manish Khanolkar (M)

Department of Endocrinology and Diabetes, Waikato Hospital, Hamilton, New Zealand.

Leszek Czupryniak (L)

Department of Diabetology and Internal Medicine, Medical University of Warsaw, Warsaw, Poland.

Classifications MeSH