Sulphonylureas are an accepted and widely used treatment for hyperglycaemia in type 2 diabetes. The UK Prospective Diabetes Study (UKPDS) demonstrated that, like other oral agents used in clinical practice, there are early good results which fail over time. Conclusions drawn show that it is in fact a result of progressive loss of beta-cell function. Results from the UKPDS and several other studies reinforce the need for ongoing and tailored treatment to maintain glycaemic control and slow symptom progression. So sulphonylureas improve beta-cell function in those with type 2 diabetes over many years, but their effects are lessened by progressive beta-cell failure. In the enthusiasm for new therapies they should not be neglected as a mainstay of oral treatment early in the course of type 2 diabetes.
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