Nikhil Prasad Fact checked by:Thailand Medical News Team Jan 05, 2026 1 month, 2 weeks, 1 day, 4 hours, 42 minutes ago
Medical News: One of the world’s most widely prescribed diabetes medications may be quietly accelerating the very disease it is meant to control, according to a major new scientific study.
A Long-Trusted Diabetes Treatment Under Scrutiny
For more than seven decades, a group of medications known as sulphonylureas has been used to treat people living with type 2 diabetes. These drugs, which include well-known names such as glimepiride, glipizide, and glyburide (also known as glibenclamide), are still prescribed to millions worldwide because they are claimed to be effective and fast-acting.
A widely prescribed diabetes drug may quietly damage insulin-producing cells, potentially accelerating type 2 diabetes progression.
However, new research from scientists in Spain suggests that these medications may come with a hidden long-term cost. According to the findings, sulphonylureas may gradually damage the insulin-producing cells in the pancreas, potentially speeding up the progression of type 2 diabetes rather than slowing it.
This
Medical News report highlights findings that could change how doctors and patients view one of the most common diabetes treatments.
Who Conducted the Research?
The study was led by Professor Eduard Montanya and carried out by researchers from several leading medical institutions in Spain. These include the University of Barcelona (Faculty of Medicine and Health Sciences), the Bellvitge Biomedical Research Institute (IDIBELL), Bellvitge University Hospital, and the CIBER Area for Diabetes and Associated Metabolic Diseases (CIBERDEM).
Professor Montanya is both a senior academic and a practicing physician, giving the research strong scientific and clinical grounding.
Understanding Diabetes in Simple Terms
Type 2 diabetes is a chronic condition where blood sugar levels become too high. This happens mainly because the body either does not respond properly to insulin or does not make enough of it.
Insulin is a hormone produced by special cells in the pancreas called beta cells. These cells act like tiny factories, releasing insulin to keep blood sugar under control. Over time, in people with type 2 diabetes, these beta cells begin to fail.
Until now, most attention has focused on beta cells dying. This study shows that something else is happening too.
What the Study Discovered About Beta Cells
The researchers found that sulphonylureas do not just overwork beta cells. Instead, prolonged exposure causes these cells to lose their identity. In simple terms, the cells stop behaving like proper insulin-producing cells even though they are still alive.
When beta cells lose their identity:
-They produce less insulin
-They respond poorly to rising blood sugar
-They become more likely to die over time
This loss of identity makes
diabetes harder to control and may explain why sulphonylurea drugs often stop working after several years, a problem known as “secondary drug failure.”
The Double-Edged Nature of Sulphonylureas
Sulphonylureas work by forcing beta cells to release insulin, regardless of blood sugar levels. In the early stages of treatment, this helps lower glucose quickly. But the study shows that constant stimulation may exhaust and damage the cells.
In laboratory experiments using human pancreatic cells, the researchers exposed healthy beta cells to glibenclamide under normal sugar conditions. Over just a few days, the cells showed alarming changes:
-Reduced insulin gene activity
-Increased cell death
-Poor insulin release when glucose levels rose
-Signs of internal stress within the cells
The longer the cells were exposed to the drug, the worse the damage became.
Stress Inside the Cell: The Hidden Trigger
A key finding of the study involves something called endoplasmic reticulum stress. The endoplasmic reticulum is part of the cell that helps fold and process proteins, including insulin.
Sulphonylureas caused this system to become overwhelmed. When stress levels stayed high for too long, the beta cells began shutting down important insulin-related functions. The researchers confirmed this by using a chemical that reduced stress inside the cells, which partially protected them from damage.
This shows that internal cell stress plays a major role in how these drugs harm beta cells over time.
Why This Matters for Millions of Patients
Sulphonylureas are still widely prescribed around the world, especially in low- and middle-income countries. While they remain effective in the short term, this study suggests they may silently worsen the disease in the long run.
Importantly, the research does not suggest patients should stop taking their medication suddenly. Instead, it highlights the need for doctors to carefully consider long-term treatment strategies and possibly prioritize newer diabetes drugs that protect beta cells.
A Ray of Hope: Damage May Be Reversible
One encouraging discovery is that beta cell identity loss may not be permanent. Unlike dead cells, living cells that have lost function could potentially recover if the right treatments are developed.
This opens the door to future therapies aimed at restoring beta cell identity rather than replacing them. Scientists believe that understanding how identity loss happens is the first step toward reversing it.
Conclusions
This landmark study provides strong evidence that long-term use of sulphonylurea drugs may accelerate the decline of insulin-producing cells in people with type 2 diabetes. By triggering internal cell stress, these medications appear to reduce insulin production, weaken glucose response, and increase cell death. While effective in the short term, their prolonged use may worsen disease progression. These findings highlight the urgent need for personalized treatment choices, closer monitoring, and further research into therapies that preserve or restore beta cell function for long-term diabetes management.
The study findings were published in the peer reviewed journal: Diabetes, Obesity and Metabolism – A Journal of Pharmacology and Therapeutics.
https://dom-pubs.pericles-prod.literatumonline.com/doi/10.1111/dom.16632
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https://www.thailandmedical.news/articles/diabetes
https://www.thailandmedical.news/articles/med-news
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