Drain P. Antidiabetic sulfonylurea stimulates insulin secretion independently of plasma membrane KATP channels. Am J Physiol Endocrinol Metab 293: E293-E301, 2007. First published April 3, 2007; doi:10.1152/ajpendo.00016.2007.-Understanding mechanisms by which glibenclamide stimulates insulin release is important, particularly given recent promising treatment by glibenclamide of permanent neonatal diabetic subjects. Antidiabetic sulfonylureas are thought to stimulate insulin secretion solely by inhibiting their high-affinity ATP-sensitive potassium (KATP) channel receptors at the plasma membrane of -cells. This normally occurs during glucose stimulation, where ATP inhibition of plasmalemmal KATP channels leads to voltage activation of L-type calcium channels for rapidly switching on and off calcium influx, governing the duration of insulin secretion. However, growing evidence indicates that sulfonylureas, including glibenclamide, have additional KATP channel receptors within -cells at insulin granules. We tested nonpermeabilized -cells in mouse islets for glibenclamide-stimulated insulin secretion mediated by granule-localized KATP channels by using conditions that bypass glibenclamide action on plasmalemmal KATP channels. High-potassium stimulation evoked a sustained rise in -cell calcium level but a transient rise in insulin secretion. With continued high-potassium depolarization, addition of glibenclamide dramatically enhanced insulin secretion without affecting calcium. These findings support the hypothesis that glibenclamide, or an increased ATP/ADP ratio, stimulates insulin secretion in part by binding at granule-localized KATP channels that functionally contribute to sustained second-phase insulin secretion.-cells; glibenclamide; permanent neonatal diabetes; exocytosis; endocytosis; adenosine 5Ј-triphosphate-sensitive potassium channels TO UNDERSTAND THE MECHANISMS underlying insulin secretion by glibenclamide, its functional sites of action in the -cell of the endocrine pancreas must be identified. The plasmalemmal ATP-sensitive potassium (K ATP ) channel site for glibenclamide-stimulated insulin release is well studied (3). In glucose-stimulated insulin secretion (GSIS), the plasmalemmal K ATP channel transduces the signal of elevated glucose metabolism into calcium influx across the plasmalemma. The calcium then completes the final exocytic step by fusing previously primed insulin granules to the plasmalemma, experimentally observed as a transient first-phase insulin release (36).Generally, K ATP channels couple glucose metabolism and membrane electrical signaling (1, 2, 10, 16, 27). K ATP channels are ideal receptors for ligands signaling changes in glucose metabolism, because they are designed as sensors of adenine nucleotide levels. ATP binding to the K ir 6.2 subunit of the K ATP channel inhibits the potassium efflux that otherwise maintains the electrically negative resting state of the cell. ADP binding to the sulfonylurea receptor 1 (SUR1) subunit of the K ATP channel can antagonize the in...