25.10 : 経口血糖降下剤：スルホニル尿素

Sulfonylureas are a class of insulin secretagogues. They are used as oral hypoglycemic agents for managing Type 2 diabetes.

Structurally, these drugs possess a sulfonylurea moiety — a sulfonamide group coupled with urea.

They are categorized into two generations, with the first including tolbutamide and chlorpropamide. The second generation encompasses glyburide, glipizide, and glimepiride.

Their mechanism of action involves binding to the SUR of the K_ATP on the pancreatic β cell.

This blocks the channel, causing cell membrane depolarization and triggers a cellular cascade, causing insulin secretion and release.

Additionally, these drugs enhance insulin sensitivity in peripheral tissues and curtail hepatic glucose production, reducing blood glucose levels.

Common adverse effects associated with sulfonylureas include hypoglycemia, weight gain, and hyperinsulinemia.

Despite these side effects, second-generation drugs remain integral in diabetes management due to their efficacy.