Authors: AK Singh1, Binayak Sinha2, AG Unnikrishnan3, Sasikumar V4, Vageesh Ayyar5, R Srinivasan6, Sharvil Gadve7, AP Selvam8, Gaurav Beswal9, Abhiudayay Verma10,Bhavesh Kotak11, Deepak Bachani11, Simran Chhatwal11 Affiliations: 1GD Hospital & Diabetes Institute, Kolkata, West Bengal, India;2Fortis Hospital, Anandpur, Kolkata, West Bengal, India;3Chellaram Diabetes Institute, Pune, Maharashtra, India;4NIMS Medicity, Thiruvananthapuram, Kerala, India ;5St. John’s Medical College & Hospital, Bangaluru, Karnataka, India;6Surya Clinic and Research Centre, Coimbatore, Tamil Nadu, India;7Excel Endocrine Centre, Kolhapur, Maharashtra, India;8Aruna Diabetes Centre, Chennai, Tamil Nadu, India;9Good Hope Diabetes Thyroid Clinic, Mumbai, Maharashtra, India;10Superspeciality Endocrinology and Women’s Care Center, Indore, Madhya Pradesh, India;11Department of Medical Affairs, Dr. Reddy’s Laboratories Ltd., Hyderabad, Telangana, India Corresponding author: Dr. Simran Chhatwal, Department of Medical Affairs, Dr. Reddy’s Laboratories Ltd., Hyderabad, Telangana, India; Email: [email protected] Diabetes Mellitus, a prevalent metabolic disorder, poses a significant global health challenge. Type 2 Diabetes Mellitus (T2DM), the most common form, arises from pancreatic beta-cell dysfunction and insulin resistance. Effective management of T2DM is critical to prevent complications such as cardiovascular disease, nephropathy, neuropathy, and retinopathy. Sulfonylureas, as insulin secretagogues, play a vital role in the management of T2DM. Despite the emergence of newer antidiabetic agents, sulfonylureas remain widely used due to their efficacy, cost-effectiveness, and extensive clinical experience. This article explores the positioning of sulfonylureas in the management of T2DM, drawing on insights from recent expert discussions and advisory board meetings. The discussions underscored the benefits of intensive glycemic control, particularly in reducing microvascular complications, with sulfonylureas playing a significant role. Newer-generation sulfonylureas, such as gliclazide and glimepiride, offer improved safety profiles and reduced risk of hypoglycemia. Gliclazide, with its antioxidant properties and cardiovascular benefits, is preferred in patients with renal impairment or high hypoglycemia risk. Real-world practice indicates a preference for sustained-release formulations due to better patient adherence and more consistent blood glucose control. The article also highlights the need for personalized treatment approaches that consider patient-specific factors such as age, comorbidities, and lifestyle. Sulfonylureas, particularly gliclazide and glimepiride, remain integral to the management of T2DM. Their role is reinforced by their efficacy, affordability, and potential benefits beyond glycemic control. Ongoing research and real-world evidence continue to shape their optimal use, emphasizing individualized treatment strategies to achieve the best clinical outcomes.
