Sulfonylureas and cardiovascular complications of type 2 diabetes mellitus

This article addresses possible mechanisms for development of cardiovascular events (CVE) in type 2 diabetes mellitus (T2DM) patients treated with sulfonylurea derivatives (SU). Several problems are highlighted in this review, including molecular aspects of pancreatic and extrapancreatic action of these drugs, their comparative potential to induce hypoglycemic events (as predictors of acute CVE) and impairment of ischemic preconditioning, as well as antiarrhythmic activity of certain SU agents. Finally, efficacy and cardiovascular safety of glimepiride in T2DM patients is substantiated based on a survey of current literature.