Diabetes Medications – The Sulfonylurea group

Okay, I have already started out this week’s column with a strange word. I promise that is the most painful part of our talk this week (smile). We will continue on with our brief discussions about common diabetes medications, but I do need to remind you that these little blurbs of information are not to replace a good long talk with your doctor, nurse or pharmacist.{{more}} When in doubt, ASK-they are here to help.

The Sulfonylurea group of medications was the first category of medications taken by mouth for treatment of diabetes, and in truth were the only ones on the market for quite some time. It is a fairly big group and includes Glipizide (Glucotrol), Glyburide (Diabeta, Glynase, Micronase), Glimiperide (Amaryl), Glucotrol XL, Chlorpropamide (Diabenase) and other less-often prescribed ones like Dymelor and Orinase. These medications are often in the first line of offense regarding diabetes and are recommended to be used alone or with other diabetes medications.

Now this group is quite different from Metformin, which we discussed last week. The sulfonylureas generally work by making your pancreas produce more insulin. They have other effects that all together help bring blood sugars down, but this increase in insulin production is thought to be their greatest effect. Even though they are in the same family, just like you and your sister, the drugs are similar but not identical. For instance, Glipizide lasts longer than Glyburide, but is not quite as strong in bringing blood sugar down quickly. So even though they are all in the same several family of medications, those little differences are some factors your doctor needs to take into account when deciding which may be best for you.

Knowing that these medications stimulate insulin production, it should be no surprise to you when I tell you their most common side effect: low blood sugars. And yes, that is what we WANT them to do, but you need to keep an eye on your sugars to ensure they do not go too low. This is especially true in the elderly, in folks who do not have regular eating habits, and in those with not-so-normal kidneys. In fact, many of these medications should not be used if your kidney function is particularly poor, as well as if you have liver issues. There are other possible side effects besides the low blood sugar: the usual ones including upset stomach and rash are the most common. The ones to be especially cautious with are possible liver problems, but these are very uncommon.

This group of medications has been around for a LONG time, they are well studied and most doctors are very comfortable prescribing them. They can be used in all sorts of combinations: with each other, with other types of diabetes pills and even with insulin. So do not be surprised if your doctor has suggested a combination regimen that includes different types of medications.

I admit, descriptions of your medications are not the sexiest thing to read over the weekend when you settle down with your newspaper. But it is important to know, so hang in there with me!

Anita Ramsetty,
MD endodocs@endocrinehelp.com
Medical Director Endocrine Care Group
www.endocrinehelp.com
Tel: 843-798-4227