Role of Gliclazide in safely navigating type 2 diabetes mellitus patients towards euglycemia: Expert opinion from India

Navigating safely towards euglycemia in type 2 diabetes mellitus (T2DM) is a real challenge in the current clinical practice despite availability of a number of glucose-lowering drugs; major barriers are hypoglycemia and weight gain. Sulfonylureas (SUs) have been recommended as one of the most common choice of add-on therapy to metformin (used as first line therapy). They are used extensively in Southeast Asia due to their high efficacy and low cost. However, there have been concerns regarding hypoglycemia, weight gain and cardiovascular safety with SUs. There is a need for an oral molecule that does not cause weight gain, has low risk of causing hypoglycemia, which can be used to navigate safely towards euglycemia with minimal constraints. Literature has shown that gliclazide provides consistent glycemic control with fewer hypoglycemic episodes and has long-term micro- and macrovascular benefits. This expert opinion was developed to highlight the role of SUs, and gliclazide in particular, in navigating effectively and safely towards the desired glycemic control in T2DM.