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Sulphonylurea monotherapy for patients with type 2 diabetes mellitus


Hemmingsen, B., et al

Subject Keywords: To assess the effects of sulphonylurea monotherapy versus placebo, no intervention or other antidiabetic interventions for patients with T2DM
Set: Chronic Conditions
Type: Article
Region: International (other)

Sulphonylureas are widely used for patients with type 2 diabetes mellitus. Sulphonylureas lower blood glucose by stimulating insulin secretion from the pancreas thereby increasing the insulin levels in the blood. Seventy-two trials were included in the systematic review assessing the effects of sulphonylurea as sole therapy versus other comparators in patients with type 2 diabetes mellitus. A total of 22,589 participants were included. The number of participants randomised to a sulphonylurea was 9707 and the number of participants randomised to a comparator was 12,805. The duration of the interventions varied from 24 weeks to 10.7 years. All trials had deficiencies (risk of bias) and for the individual comparisons the number of participants were small, resulting in a high risk of random errors (play of chance). Data on mortality and diabetic complications were sparse and inconclusive. Stopping taking the antidiabetic drug due to adverse events were more common with alpha-glucosidase inhibitors (for example acarbose) compared with second-generation sulphonylureas (for example glibenclamide, glipizide, glibornuride and gliclazide), but the data were sparse. Severe hypoglycaemia was more common with second-generation sulphonylureas compared with metformin and thiazolidinediones (for example pioglitazone), but again the data were sparse. Due to lack of data we could not adequately evaluate health-related quality of life and costs.

There is insufficient evidence regarding patient-important outcomes from high-quality randomised controlled trials (RCTs) to support the decision as to whether to initiate sulphonylurea as sole therapy. Large-scale and long-lasting randomised clinical trials with low risk of bias, which focus on mortality, diabetic complications, adverse events and health-related quality of life, are needed.



Rights: © The Cochrane Collaboration
Suggested citation:

Hemmingsen, B., et al. (2013) Sulphonylurea monotherapy for patients with type 2 diabetes mellitus [Online]. Available from: [Accessed: 21st May 2018].


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