1. Glucocrinology of Modern Sulfonylureas: Clinical Evidence and Practice-Based Opinion from an International Expert Group
- Author
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Sanjay Kalra, Dina Shreshtha, Mimi Giri, Silver Bahendeka, Shyaminda Kahandawa, M. P. Baruah, Surender Singh, Ketut Suastika, Moosa Murad, Sambit Das, Faria Afsana, Shajada Selim, Arundhati Dasgupta, Aly Ahmed Abdul Rahim, Kaushik Ramaiya, Fariduddin Mohammed, Ahmed Al-Ani, Fatimah Eliana, Syed Abbas Raza, Abdurezak Ahmed Abdela, Manoj Chawla, Charlotte Bavuma, Mangesh Tiwaskar, Sundeep Ruder, Muaz Moosa, Chaminda Garusinghe, AG Unnikrishnan, Pradeep Krishna Shreshtha, Dimuthu Muthukuda, Parag Shah, Muhammed Hafizur Rahman, Than Than Aye, Manish Khanolkar, Abbas Orabi, Muditha Weerakkody, Koy Vanny, Rishi Shukla, Leszek Czupryniak, Andrew Uloko, Faruque Pathan, Rakesh Sahay, Wiam Hussain, A K Das, and G. Vijayakumar
- Subjects
medicine.medical_specialty ,Patient Empowerment ,Endocrinology, Diabetes and Metabolism ,030209 endocrinology & metabolism ,Review ,030204 cardiovascular system & hematology ,Panacea (medicine) ,03 medical and health sciences ,0302 clinical medicine ,Type 2 diabetes mellitus ,Internal Medicine ,medicine ,Cardiovascular complications ,Glucocrinology ,Medical prescription ,Intensive care medicine ,Myocardial ischemic preconditioning ,Glycemic ,business.industry ,Clinical judgement ,Glimepiride ,Type 2 Diabetes Mellitus ,Modern sulfonylureas ,Cardiovascular phenotype ,Expert group ,Clinical evidence ,Extra-pancreatic effects ,business - Abstract
Aim 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 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 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 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 Sanofi India. Electronic Supplementary Material The online version of this article (10.1007/s13300-019-0651-1) contains supplementary material, which is available to authorized users.
- Published
- 2019