ATP-sensitive K ϩ (K ATP ) channels are composed of pore-forming subunits (Kir6.x) and of regulatory subunits, the sulfonylurea receptors (SURx). Subtypes of K ATP channels are expressed in different organs. The sulfonylureas and glinides (insulinotropes) close the K ATP channel in pancreatic -cells and stimulate insulin secretion. The insulinotrope binding site of the pancreatic channel (Kir6.2/SUR1) consists of two overlapping (sub)-sites, site A, located on SUR1 and containing Ser1237 (which in SUR2 is replaced by Tyr1206), and site B, formed by SUR1 and Kir6.2. Insulinotropes bind to the A-, B-, or A ϩ B-site(s) and are grouped accordingly. A-ligands are highly selective in closing the pancreatic channel, whereas B-ligands are nonselective and insensitive to the mutation S1237Y. We have examined the binding of insulinotropes representative of the three groups in [ 3 H]glibenclamide competition experiments to determine the contribution of Kir6.x to binding affinity, the effect of the mutation Y1206S in site A of SUR2, and the subtype selectivity of the compounds. The results show that the bipartite nature of the SUR1 binding site applies also to SUR2. Kir6.2 as part of the B-site may interact directly or allosterically with structural elements common to all insulinotropes, i.e., the negative charge and/or the adjacent phenyl ring. The B-site confers a moderate subtype selectivity on B-ligands. The affinity of B-ligands is altered by the mutation SUR2(Y1206S), suggesting that the mutation affects the binding chamber of SUR2 as a whole or subsite A, including the region where the subsites overlap.Sulfonylureas and glinides (termed here insulinotropes) are used in the therapy of type 2 diabetes. They act by closing the ATP-sensitive K ϩ (K ATP ) channel in pancreatic -cells, thereby inducing depolarization, Ca 2ϩ entry, and insulin secretion (Sturgess et al., 1985; for review, see Proks et al., 2002). K ATP channels are closed by intracellular ATP and opened by MgADP. They are composed of two types of subunits, inwardly rectifying K ϩ channels (Kir6.x), which form the pore of the channel, and sulfonylurea receptors (SURx), which serve as regulatory subunits (Fig. 1). SURs are members of the ATP-binding cassette protein superfamily and carry binding sites for nucleotides, sulfonylureas, and the K ATP channel openers. Both Kir6.x and SURx are encoded by two genes, giving rise to two subtypes each; in addition, alternative splicing of SUR2 results in two major isoforms, SUR2A and SUR2B, which differ in the last 42 amino acids. The K ATP channels in pancreatic -cells have the composition Kir6.2/SUR1, in cardiomyocytes Kir6.2/SUR2A, and in vascular myocytes Kir6.1/SUR2B (Aguilar-Bryan and Bryan, 1999;Gribble and Reimann, 2003;Seino and Miki, 2003). K ATP channels subserve important functions not only in the pancreatic -cells (in which they link the secretion of insulin to the plasma glucose level) but also in other tissues (Seino and Miki, 2003). Hence, the selectivity of the insulinotropes for the panc...