One study concluded that one of the most common diabetes treatments may accelerate the progression of type 2 diabetes, due to insulin-producing cells losing their functional identity.
Scientific warning: Common diabetes medications may worsen the disease with prolonged use.
Sulfonylureas have been used to treat type 2 diabetes since the early 1950s and remain among the most common drugs used to treat this disease.
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Common examples of these medications include glimepiride (Amari), glipizide (Glucotrol), and glyberide (Diabeta, Micronize). However, evidence suggests that their effectiveness may decline with long-term use, and they may produce more side effects than several newer diabetes medications.
A new research paper from the University of Barcelona, the Belvitge Institute for Biomedical Research (IDIBELL), Belvitge University Hospital, and the CIBERDEM Center for Diabetes and Related Metabolic Diseases, published in the journal Diabetes, Obesity and Metabolism, indicates that sulfonylurea drugs may interfere with the normal function of insulin-producing cells.
The study found that these drugs can induce loss of cellular identity in pancreatic beta cells, limiting their ability to release insulin and possibly accelerating the progression of type 2 diabetes.
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Laboratory results showed that cells treated with these drugs gradually lost their primary ability to produce insulin, and the activity of genes responsible for their specialized function decreased, while their death rate increased. Researchers explained this phenomenon by suggesting that the drug causes a "loss of functional identity" in beta cells, transforming them from insulin-producing cells into non-functional cells, even while they are still alive.
This effect is linked to increased internal stress in the endoplasmic reticulum within the cell, the part responsible for producing important proteins such as insulin. With continued use of the drug, this condition worsens, which may explain why these drugs lose their effectiveness over time—a condition medically known as "secondary sulfonylurea failure."
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These findings open a door to promising research. Since the problem lies in "loss of identity" rather than "cell death," the process is theoretically reversible. This points the way to future research aimed at developing therapies that restore cells to their normal functional capacity, which could represent a new approach to addressing the long-term decline in pancreatic function in diabetic patients.The researchers stressed that these results do not mean an immediate cessation of medication, but rather provide a scientific explanation for one of the challenges in treating diabetes, and highlight the importance of regular follow-up and evaluation of the treatment plan with the treating physician, especially with the availability
of newer treatment options.
