04 September 2025
Despite the distinct advantages of new antidiabetic agents, gliclazide retains specific roles in contemporary type 2 diabetes management when prescribed judiciously. This article looks at a narrative review of current evidence examining gliclazide’s pharmacology, efficacy, safety profile, and targeted clinical applications. The main findings were that gliclazide demonstrates robust glucose-lowering efficacy (haemoglobin A1C (HbA1c) reduction 11–16mmol/mol) in patients with residual beta-cell function (Simpson et al, 2013). Hypoglycaemia risk remains significant. Contemporary evidence also suggests that gliclazide does not accelerate beta-cell exhaustion (Khunti et al, 2013; Kalra et al, 2018). Specific scenarios where gliclazide is useful include short-term rescue therapy for steroid-induced hyperglycaemia, rapid glycaemic control when front-loading is appropriate, and when contraindications preclude sodium-glucose cotransporter-2 (SGLT2) inhibitors or glucagon-like peptide-1 (GLP-1) receptor agonists. Renal function monitoring is essential due to prolonged action in impairment (National Institute for Health and Care Excellence [NICE], 2022; British National Formulary [BNF], 2024). The author concludes that gliclazide maintains validity in targeted scenarios when prescribed with individualised assessment. General practice nurses (GPNs) should ensure comprehensive hypoglycaemia education and regular patient monitoring.
