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Tolbutamide is a first-generation sulfonylurea oral hypoglycemic agent used primarily in the treatment of type-2 diabetes. It functions by stimulating insulin secretion through binding to the high-affinity subunit SUR1 of the beta-cell ATP-sensitive potassium channel (KATP channel). The gene encoding the SUR1 subunit is located on chromosome 11p15.1 and is part of the ABCC8 gene, which plays a critical role in insulin regulation. Structurally, tolbutamide is characterized by its sulfonylurea moiety, which is essential for its hypoglycemic activity. Recent studies have explored the synthesis of tolbutamide derivatives with NO-donor properties, aiming to enhance its biological profile by linking it with furoxan derivatives or classical nitrooxy functions, potentially offering improved therapeutic benefits.
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