Position of Sulfonylureas in the Current ERA: Review of National and International Guidelines.

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM Clinical Medicine Insights-Endocrinology and Diabetes Pub Date : 2022-02-14 eCollection Date: 2022-01-01 DOI:10.1177/11795514221074663
Viswanathan Mohan, Banshi Saboo, Jabbar Khader, Kirtikumar D Modi, Sushil Jindal, Subhash Kumar Wangnoo, Sugumaran Amarnath
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Abstract

Sulfonylureas (SUs) are one of the commonly prescribed oral anti-hyperglycemic agents (AHA) in low- and middle-income countries (LMICs), either in combination with metformin therapy or alone. However, concern about cardiovascular safety has limited the use of SUs in the management of type 2 diabetes mellitus (T2DM). Additionally, lack of uniformity in the national and international guidelines regarding the positioning of SUs in the management of diabetes has also been reported. The objective of this review was to assess the various national and international guidelines on diabetes management and understand the recommendations specific to SUs in various scenarios. A total of 33 national and international guidelines on the management of T2DM published in English were evaluated. These guidelines have considered the latest evidence and suggest the use of certain second-generation SUs as second-line therapy or in combination with other AHAs in select population and specific scenarios. Identification of the appropriate population, classification based on underlying risk, thorough assessment of the comorbid conditions, and a step-wise approach for the selection of appropriate SUs is essential for the effective management of T2DM. Additionally, cost-to-benefit ratio should be considered, particularly in LMICs, and SUs could continue to play an important role in such settings.

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磺脲类药物在当前 ERA 中的地位:国家和国际指南回顾。
磺脲类药物(SUs)是中低收入国家(LMICs)常用的口服降糖药物(AHA)之一,既可与二甲双胍联合使用,也可单独使用。然而,对心血管安全性的担忧限制了 SUs 在 2 型糖尿病(T2DM)治疗中的使用。此外,关于 SUs 在糖尿病治疗中的定位,国内和国际指南也缺乏统一性。本综述旨在评估有关糖尿病管理的各种国家和国际指南,并了解在各种情况下针对 SU 的具体建议。本研究共评估了 33 份以英语出版的有关 T2DM 管理的国家和国际指南。这些指南考虑了最新证据,建议在特定人群和特定情况下将某些第二代 SUs 作为二线疗法或与其他 AHAs 联合使用。确定合适的人群、根据潜在风险进行分类、对合并症进行全面评估以及采用循序渐进的方法选择合适的 SUs 对于有效治疗 T2DM 至关重要。此外,还应考虑成本效益比,特别是在低收入国家, SUs 可继续在这些国家发挥重要作用。
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来源期刊
CiteScore
4.30
自引率
0.00%
发文量
15
审稿时长
8 weeks
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