Question
Sulfonylureas in type II diabetes mellitus.
Q33 marksShort Notes
Answer
Sulfonylureas are insulin secretagogues used in type 2 diabetes mellitus.
Examples
- Glibenclamide, Glimepiride, Glipizide
Mechanism of action
- Bind to the SUR1 (sulfonylurea receptor) subunit of ATP-sensitive K⁺ channels on pancreatic β-cells
- Cause channel closure → membrane depolarization → opening of voltage-gated calcium channels → calcium influx → increased insulin secretion
- Require functioning β-cells to be effective (ineffective in type 1 DM)
Uses
- Type 2 diabetes mellitus, particularly in non-obese patients with residual β-cell function
Adverse effects
- Hypoglycaemia (most important)
- Weight gain
- GI upset
- Hypersensitivity reactions
- (Glibenclamide has a higher hypoglycaemia risk than newer agents like glimepiride)
- 1Diabetes Mellitus and Oral Hypoglycaemic Drugs
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