Apart from their action on the pancreas are there extrapancreatic actions of sulfonylureas

Sulfonylureas directly or indirectly influence other metabolic indices as well. For example, glibenclamide was shown to improve post-prandial hypertriglyceridaemia, by decreasing chylomicron concentrations. It also restricts the post-prandial activation of coagulation, by decreasing fibrinogen, the thrombin-antithrombin complexes and the D-dimers. For gliclazide, a favourable action on the retina of diabetic patients has been reported.

Very interesting experimental data have also been reported with regard to the action of sulfonylureas on the heart. Glibenclamide for example does not allow, under experimental conditions, the so-called 'ischaemic preconditioning', a situation that protects, in varied degrees, against myocardial necrosis in the event of an infarction. More specifically, in myocardial ischaemia, when glibenclamide is administered the opening of the Katp channels does not take place, so that the necessary depolarization and opening up of the calcium channels, which protects the myocardial cell, does not happen. This phenomenon does not happen when glimepiride or gliclazide is administered. In this regard, these sulfonylureas are considered by many authors to be more advantageous compared to the other sulfonylureas. It should be noted, however, that in the UKPDS study, in which glibenclamide was compared with chlorpropamide and insulin, no differences were found with regard to the clinical importance of their use concerning the risk for cardiovascular events.

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