Extrapancreatic effects

However additional peculiarities are found in some preparations. Glimepiride results in lower insulin and C-peptide levels with similar glucose control, probably due its greater extrapancreatic effect on insulin target tissues. Gliclazide has a lower secondary failure rate than glyburide or glipizide. 

The extrapancreatic effect, in the case of resistance to insulin due to a reduced sensitivity of the peripheral tissue to insulin, there is intensification of the insulin effect as a result of ... 

Sulphonylureas have been used for the treatment of Type-II diabetes for more than 30 years. Two actions are thought to be responsible for their ability to lower glucose concentration in blood (1) their action on B-cells which causes insulin secretion (2) the so-called extrapancreatic effects which have been mainly demonstrated in in vitro experiments. 

From a theoretical point of view there are three possible reasons for the extrapancreatic effects of sulphonylureas that lead to a lowering of blood glucose (1) they increase insulin action (2) they have insulin-like effects (3) they have indirect effects. 

Since most of these extrapancreatic effects of sulphonylureas are coupled to the presence of insulin, it would be attractive to conclude that sulphonylureas possess an extrapancreatic action in Type-II diabetes where insulin secretion is still possible. 

In 1985 Joost pointed out that the extrapancreatic effects of sulphonylureas can be observed with tolbutamide at concentrations of 0.5-5 mM and with... 

All sulfonylureas exhibit both insulin-secreting and extrapancreatic activities. Glimepiride relies on extrapancreatic effects for a greater proportion of its ... 

Yamada Y, Miyawaki K, Tsnkiyama K, Harada N, Yamada C, Seine Y. Pancreatic and extrapancreatic effects of gastric inhibitory polypeptide. Diabetes 2006 55(Suppl. 2) S86-91. 

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