Eva Babjaková, Martin Javorský, Lucia Klimčáková, Mária Fabianová, Pavol Pobeha, Ivan Tkáč
Sulphonylurea (SU) derivatives and glinines (meglitinides) we rate among oral insulin secretagogues, because they stimulate insulin secretion from pancreatic β-cells. The condition for their effect is preserved residual secretion of pancreatic β-cells. They have been already used in the treatment of diabetes mellitus 2 type (DM2) for more than over 50 years. Despite their overall effectiveness there were observed substantial interindividual differences in the treatment response, disposition of the drug in the organism and also in the frequency of adverse effects. Besides phenotypical differences which cause the stated variability, also different genetic background of patients contribute to it. The knowledge of pharmacogenetics is used in investigation of this variability component. Pharmacogenetics deals with the study of dependency between the treatment response of the patient to the administered drug and his genetic information. The association of genetic polymorphines of enzymes metobolising the derivatives of sulphonylurea (cytochrome-P450 isoenzyme 2C9 coded by the gene CYP2C9). Recently the research was oriented to variants of genes coding target molecules for particular secretagogues as well as candidate genes DM2. Until now the associations of therapeutic effect of insulin secretagogues with polymorphisms of the gene coding transcription factor 7 similar to the factor 2 (TCF7L2), as well as genes coding proteins creating ATP-dependent kalium channel Kir6.2 - (gene KCNJ11) and sulphonylurea receptor 1 (SUR1 - gene ABCC8) were found from these genes.