Diabetes type 2 sulfonylureas

Type 2 diabetes with sulfonylurea, metformin, or insulin to improve glycemic control Type 2 diabetes in combination with metformin to improve glycemic control... 

In patients with Type II diabetes the sulfonylureas can provide good control of blood glucose, but it remains controversial to what extend they are of benefit for the long-term prognosis and if they protect against tissue damage, e.g. microvasculopathy. Sometimes the combination of a sulfonylureas with a biguanide is indicated for adequate control. 

Burge MR, Zeise TM, Sobhy TA, Rassam AG, Schade DS. Low-dose ethanol predisposes elderly fasted patients with type 2 diabetes to sulfonylurea-induced low blood glucose. Diabetes Care 1999 22(12) 2037-43. 

There is no indication for combining insulin with insulin secretagogues (sulfonylureas, meglitinides, or D-phenylalanine derivatives) in individuals with type 1 diabetes. Type 1 diabetics with diets very high in starch may benefit from the addition of tt-glucosidase inhibitors, but this is not typically practiced in the USA. 

In a multicenter, double-blind, randomized, parallel-group, placebo-controlled trial in 22 European centers for specialist diabetes care over 6 months, sibutramine, in conjunction with moderate caloric restriction, enabled obese patients with type 2 diabetes taking sulfonylureas to achieve clinically significant weight loss (7). This was... 

Trade names Dimelin Dimelor Dymelor (Barr) Indications Non-insulin dependent diabetes type II Category Sulfonylurea Half-life 1-6 hours... 

A randomized placebo-controlled clinical study of powdered C. cassia bark in type 2 diabetics taking sulfonylurea drugs and maintaining their usual diets found that daily supplementation with the bark immediately after each of three daily meals produced significant decreases in triglyceride, LDL, and total serum cholesterol levels and serum glucose levels." ... 

Meglitinide contains a benzamide group. Meglitinide-related compounds such as nateglinide are non-sulfonylurea oral hypoglycemic drugs used in the treatment of type 2 (non-insulin dependent) diabetes mellitus. 

Type 2 diabetes combination therapy with a sulfonylurea to enhance glycemic control... 

Sulfonylurea receptor 1 (SUR1) Sulfonylurea (tolbutamide) Decreased tolbutamide-stimulated insulin secretion in healthy subjects with sequence variants in the high-affinity sulfonylurea receptor gene (94) Susceptibility to type II diabetes (95)... 

Cvetkovic RS, Plosker GL. (2007) Exenatide A review of its use in patients with type 2 diabetes mellitus (as an adjunct to metformin and/or a sulfonylurea). Drugs 67 935-954. 

Type 2 diabetes mellitus For type 2 diabetes, as an adjunct treatment in patients who use mealtime insulin therapy and who have failed to achieve desired glucose control despite optimal insulin therapy, with or without a concurrent sulfonylurea agent and/or metformin. 

Type 2 diabetes mellitus Adjunctive therapy to improve glycemic control in patients with type 2 diabetes mellitus who are taking metformin, a sulfonylurea, or a combination of metformin and a sulfonylurea. 

Hypersensitivity to sulfonylureas diabetes complicated by ketoacidosis, with or without coma sole therapy of type 1 (insulin-dependent) diabetes mellitus diabetes when complicated by pregnancy. 

Loss of blood glucose control When a patient stabilized on any diabetic regimen is exposed to stress such as fever, trauma, infection, or surgery, a loss of control may occur. At such times, it may be necessary to discontinue the drug and give insulin. Disulfiram-like syncframe. A sulfonylurea-induced facial flushing or breathlessness reaction may occur when some sulfonylureas are administered with alcohol. Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) Water retention and dilutional hyponatremia have occurred after administration of sulfonylureas to type 2 diabetes patients, especially those with CHF or hepatic cirrhosis. 

Nephropathy in type 2 diabetes-The usual starting dose is 50 mg once daily. Increase the dose to 100 mg once daily based on blood pressure response. Losartan may be administered with insulin and other commonly used hypoglycemic agents (eg, sulfonylureas, glitazones, glucosidase inhibitors). 

Sulfonylureas are the most widely prescribed drugs in the treatment of type 11 diabetes mellitus. The initial sulfonylureas were introduced nearly 50 years ago and... 

The sulfonylureas are ineffective for the management of type I and severe type II diabetes mellitus, since the number of viable -cells in these forms of diabetes is small. Severely obese diabetics often respond poorly to the sulfonylureas, possibly because of the insulin resistance that often accompanies obesity. 

The patient who would benefit the most from a thi-azolidinedione is a type 11 diabetic with a substantial amount of insulin resistance (e.g., one who does not respond to other oral therapies or who requires excessive amounts of insulin [>100 units/day]). Improvements in diabetic control are variable, ranging from a 1% reduction in hemoglobin Ale when used as monotherapy to greater reductions (>2% reduction in hemoglobin Ale) when used in combinations with other agents, such as sulfonylureas or metformin. 

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