Sulfo nylureas

The answer is b. (Hardman, p 1507. Katzung, pp 723-724J Three proposed mechanisms for sulfonylurea action are (1) the release of insulin from pancreatic cells, (2) reduction of serum glucagon levels, and (.3) increased binding of insulin to tissue receptors. On binding to a specific receptor that is associated with a K channel in cell membranes, sulfo-nylureas inhibit K efflux, which causes influx of Ca followed by release of preformed insulin. 

In 33 patients with type 2 diabetes treated with sulfo-nylureas and insulin who took miglitol 50 mg bd for 1 week and then over the next month increased the dose to 50 mg tds, 15% developed adverse effects (6% diarrhea, 6% abdominal distension), which disappeared within 3 weeks of continuing therapy (42). 

S. Tsuchiya, S. Tamiko and S. Sekiguchi, Nonenzymatic glucosylation of human serum albumin and its influence on binding capacity of sulfo-nylureas, Biochem. Pharmacol, 1984, 33, 2967-2971. 

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