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The minimal stimulating effect of glimepiride on insulin secretion provides a lower risk of hypoglycemia. Like traditional sulfonylurea derivatives, but to a much greater extent, glimepiride has pronounced extrapancreatic effects decrease in insulin resistance, anti-atherogenic, antiplatelet and antioxidant effects. Utilization of glucose by peripheral tissues muscle and fat occurs with the help of special transport proteins GLUT1 and GLUT4 located in cell membranes. The transport of glucose to these tissues in type 2 diabetes mellitus is a speed-limited step of glucose utilization. Glimepiride very quickly increases the amount and activity of glucose transporting molecules GLUT1 and GLUT4, contributing to an increase in glucose uptake by peripheral tissues. Glimepiride has a weaker inhibitory effect on the ATP-dependent potassium channels of cardiomyocytes.

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