Khaberni - A recent scientific study conducted by the University of Barcelona and Bellvitge Institute for Biomedical Research has found that one of the oldest and most common treatments for type 2 diabetes—sulfonylurea drugs—may indirectly contribute to the disease's exacerbation over the long term.
These drugs, such as glyburide, glipizide, and amaryl, have been used since the 1950s to stimulate the pancreas to produce more insulin. Initially effective at reducing blood sugar levels, their effectiveness often diminishes over time, a phenomenon medically known as "secondary failure".
Researchers discovered in experiments on human Islets of Langerhans—the insulin-producing tissue in the pancreas—that chronic exposure to these drugs, especially glyburide, leads to a severe phenomenon: loss of functional identity of beta cells.
Danger threatening the pancreatic cells
The study pointed out that instead of these cells dying, they remain alive but gradually lose their essential properties; the genes responsible for insulin production decline, their ability to respond to sugar decreases, and their death rates increase in later stages.
The study attributed this effect to severe stress that affects the endoplasmic reticulum within the cell—the factory that produces insulin protein—leading to a "confusion" in the cell's identity and transforming it into an ineffective state.
Professor Eduard Montanya, the study leader, said, "Not only do beta cells die, but they also lose their functional identity and become incapable of effectively producing and secreting insulin, and it appears that sulfonylurea contributes to accelerating this loss."
The reason behind the decline in drug efficacy over time
The findings of the study published in the journal "Diabetes, Obesity and Metabolism" provide a possible scientific explanation for why the effectiveness of these drugs diminishes with long-term use, and perhaps accelerates the deterioration of pancreatic function in patients with type 2 diabetes.
Despite the seriousness of the findings, the researchers emphasized that this does not mean patients should abruptly stop taking the medication. Instead, it is crucial to consult a doctor to evaluate the treatment plan, especially with the availability of newer, safer, and more sustainable alternatives like SGLT2 inhibitors or GLP-1 agonists.
The study also noted that since the loss of identity is theoretically reversible and not a final death of the cells, this discovery could open the door to future research aimed at developing treatments that restore cells' functional identity, potentially changing long-term diabetes treatment strategies.
