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Aetiology/Harm
Cohort study
High-dose sulphonylurea treatment in patients with renal impairment should be considered with caution
  1. Gyuri Kim,
  2. Eun Seok Kang
  1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
  1. Correspondence to: Dr Eun Seok Kang, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea; edgo{at}yuhs.ac

http://dx.doi.org/10.1136/ebmed-2016-110569

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Commentary on: van Dalem J, Brouwers MC, Stehouwer CD, et al. Risk of hypoglycaemia in users of sulphonylureas compared with metformin in relation to renal function and sulphonylurea metabolite group: population based cohort study. BMJ 2016;354:i3625.

Context

Type 2 diabetes mellitus (T2DM) is one of the most serious health problems worldwide.1 Strict glycaemic control has been emphasised, and the number of patients with the risk of hypoglycaemia has increased.2 Hypoglycaemia is a serious side effect of treatment with sulphonylureas, which stimulate insulin secretion regardless of blood glucose level. It is more common in patients using long-acting sulphonylureas with renally excreted active metabolites.3 Therefore, an increasing number of patients with renal impairment may currently live with the risk of hypoglycaemia. …

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