Sulfonylureas 

Sulfonylureas are a group of medicines used in the management of Type 2 diabetes. Sulfonylureas lower blood glucose levels by stimulating insulin release from the Beta cells of the pancreas. Their action is dependent upon the presence of functioning Beta cells, therefore, sulfonylureas do not work in people with type 1 diabetes.

Sulfonylureas stimulate insulin release by blocking ATP sensitive potassium channels in the Beta cells, reducing potassium permeability. This causes depolarization of the cell and increases calcium entry, increasing insulin secretion.

Sulfonylureas are hypoglycemic agents commonly used in the treatment of diabetes mellitus. ^2,4,29. Agents in this class include such drugs as acetohexamide, chlorpropamide, glimepiride, glipizide, glyburide, tolazamide, and tolbutamide.

These drugs exert their hypoglycaemic effects by stimulating insulin secretion from the pancreatic beta-cell. Their primary mechanism of action is to close ATP-sensitive K-channels in the beta-cell plasma membrane, and so initiate a chain of events which results in insulin release.

Sulfonylurea monotherapy is associated with higher risk for all-cause mortality, major hypoglycemic episodes, and cardiovascular events compared with metformin. Although the presence of CKD attenuated the mortality benefit, metformin may be a safer alternative to sulfonylureas in patients with CKD.