,Increased risk for cerebral ischemic stroke in diabetes:genetically polymorphic CYP mediated produc

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Dear Editor,Szeto et al.thoroughly reviewed the role of ATP sensitive potassium (KATP) channels in cerebral ischemic stroke and diabetes in a recent article [1].KATP channels are expressed in many organs,such as brain,heart,and pancreas.Recent studies demonstrated the protective role of these channels in cardiac pathologies and ischemia of brain [1].Diabetic patients are often prescribed with sulfonylurea oral antidiabetics,for which the mechanism of action is inhibition of KATP channels and thereby,increased excretion of insulin by pancreatic islet cells.Tolbutamide,glyburide,glibenclamide,glipizide,gliclazide,and glimepiride are among sulfonylureas that are mainly metabolized by cytochrome P450 (CYP) 2C9 [2,3].Meglitinides are another group of frequently used oral antidiabetics.Nateglinide and repaglinide are members of this newer group.They stimulate insulin release by partly acting on KATP channels and this group of drugs are also partly metabolized by CYP2C9 and 2C8 [3].
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