Sulphonylureas are suitable for the treatment of subjects with non-insulin-dependent diabetes (type II diabetes) when the mere diet is not sufficient. This therapy is indicated in particular for people over 40 years of age as long as the diabetes is no older than 5 years and blood glucose levels are not very high (up to 10 mmol/l in the fasting state). However, in approximately 15% of the patients that have been selected in such a way the sulphonylureas fail in a primary instance. From this perspective there are hardly any differences between the different sulphonylureas. One of the highly efficient drugs of the 'second generation' (glibenclamide or glipizide) should be tested before an insulin treatment is started for type II diabetes.

Due to various causes, secondary failures occur after months or years of sulphonylurea treatment (5-10% per year). About 50% of the treated subjects do not respond to long-term treatment with glibenclamide nor with other sulphonylureas. In such cases a combination with metformin should be tried or as afinal resort an insulin therapy will have to be begun. Glibenclamide has been combined successfully with insulin in several studies.

It has not been demonstrated that sulphonylureas significantly influence the prognosis of diabetes.

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