Resumen

The evidence regarding sulfonylureas glucose-lowering efficacy is robust; furthermore, they are convenient and their out-ofpocket cost is in the range of many other diabetes medications. Sulfonylureas can cause weight gain, and particularly if used inappropriately, hypoglycemia. Furthermore, some studies have related their use to adverse cardiovascular outcomes, including mortality. In addition, sulfonylurea-associated induced beta-cell dysfunction has been proposed as one of the most important disadvantages related to their use. On the other hand, hypoglycemia is related to death, cardiovascular events, myocardial infarction, stroke, cognitive impairment, dementia, impaired autonomic function, fall-related fractures, poor quality of life, and increased health-care costs. These adverse outcomes seem to be related more to episode(s) of hypoglycemia per se rather than to the use of sulfonylureas or a particular anti-hyperglycemic drug class. In addition, across studies, data associating sulfonylureas with adverse cardiovascular events, including death, remains imprecise, and inconsistent. Likewise, the pancreatic beta-cell function is modified by many factors, and its relation with sulfonylureas remains open to debate. Hence, when choosing a diabetes drug, patients and clinicians should discuss differences between glucose-lowering medications in terms of benefits, harms, cost, and convenience. In this patient-centered discussion, sulfonyl ureas should be included as one of the evidence-based available options.

Palabras clave: Diabetes sulfonylurea hypoglycemia betacell dysfunction.

2018-01-02   |   200 visitas   |   Evalua este artículo 0 valoraciones

Vol. 4 Núm.3. Julio-Septiembre 2017 Pags. 130-136 Rev Mex Endocrinol Metabol Nut 2017; 4(3)