Thulé Peter M, Umpierrez Guillermo
Section Endocrinology and Metabolism, Atlanta VA Medical Center, Atlanta, GA, USA.
Curr Diab Rep. 2014 Apr;14(4):473. doi: 10.1007/s11892-014-0473-5.
Sulfonylurea compounds were the first available oral antidiabetic agents and they remain an important tool in our quest for optimal glucose control. The sulfonylureas stimulate the release of insulin from pancreatic β-cells and have a number of extrapancreatic effects, including decreasing hepatic insulin clearance and reducing glucagon secretion in patients with type 2 diabetes. Although these agents have been the mainstay of pharmacotherapy for patients with type 2 diabetes mellitus (T2DM), their safety and clinical utility has been a matter of active debate in recent years, as their use is associated with risks of hypoglycemia and weight gain. We review the discovery and mechanisms of action of sulfonylureas, and the results of clinical trials to provide practical information on the pros and cons of their use in clinical practice. This review addresses advances in our understanding of mechanisms of action of sulfonylurea agents, their efficacy in T2DM, side effects, and impact on cardiovascular disease outcomes.
磺脲类化合物是最早可用的口服抗糖尿病药物，并且在我们追求最佳血糖控制的过程中，它们仍然是一项重要手段。磺脲类药物可刺激胰腺β细胞释放胰岛素，并具有多种胰腺外效应，包括降低2型糖尿病患者肝脏对胰岛素的清除率以及减少胰高血糖素分泌。尽管这些药物一直是2型糖尿病（T2DM）患者药物治疗的主要支柱，但近年来它们的安全性和临床实用性一直是激烈争论的话题，因为使用它们会带来低血糖和体重增加的风险。我们回顾了磺脲类药物的发现、作用机制以及临床试验结果，以提供有关其在临床实践中使用利弊的实用信息。本综述阐述了我们对磺脲类药物作用机制、其在T2DM中的疗效、副作用以及对心血管疾病结局影响的认识进展。
