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This review addresses the question of the cardiovascular (CV) safety of sulfonylureas (SUs) in patients with type 2 diabetes mellitus (T2DM) when directly tested against comparator agents in CV outcome trials. Presented at a recent symposium entitled "SUs in the treatment of T2DM: a fresh look and new insights" held on Wednesday September 18, 2019 during the 55th Annual Meeting of the European Association for the Study of Diabetes (EASD) in Barcelona Spain, this review discusses the initial evidence that sparked concerns over the CV safety of SUs as well as more recent findings from large studies of SUs (i.e. ADVANCE, TOSCA.IT and CAROLINA trials), highlighting the differences in CV and hypoglycaemia risks among the various SUs. Finally, the impact of glycaemic control on CV outcomes is also discussed, where the data suggest that the recent positive CV outcomes with some antihyperglycaemic agents may have been driven in part by improved glycaemic control. [ABSTRACT FROM AUTHOR]