Diabetes Mellitus:  Lipids

 

Introduction

Sulfonylureas have been used since the 1950's for the treatment of diabetes.  They were derived from sulfonic acid and urea.   They are frequently classified as either 1st generation or 2nd generation agents. First generation sulfonylureas (acetohexomide, chlorpropamide, tolazamide, and tolbutamide) possess a lower binding affinity for the ATP-sensitive potassium channel, their molecular target , and thus require higher doses to achieve efficacy, increasing the potential for adverse events. In addition, the plasma half-life of 1st generation sulfonylureas is extended (e.g. 5-36 h) compared to the 2nd generation agents.

Mechanism of Action

Sulfonylureas are insulin secretogogues, since they control blood glucose levels by directly stimulating first-phase insulin secretion in the pancreatic b cells. Through the concerted efforts of GLUT2 (the high Km glucose transporter), glucokinase (the glucose sensor) and glucose metabolism, these cells are responsible for sensing and secreting the appropriate amount of insulin in response to a glucose stimulus.

Section  Details:

Introduction

Mechanism of Action

Efficacy

Side Effects

Dosing

 

Required Screens:  3
Optional Screens:   5