Sulfonylureas

Type 2 diabetes is a chronic disease and is due to the body being what is termed "insulin resistant". Insulin is a hormone that allows sugars in the blood stream to enter the body's cells to provide the energy we need to function. When insulin is not produced in sufficient quantities, sugars build up in the blood to dangerous levels and we feel tired and lethargic. Left untreated, diabetes also has severe health implications for later life in the form of possible blindness, renal failure and amputations.

When someone is first diagnosed with type 2 diabetes, the first thing your doctor will assess is whether or not your disease can be controlled by diet and exercise alone. The fact is most type 2 diabetics are overweight, so a combination of diet and exercise to lose weight is important.

However, this is often insufficient to control blood sugar levels and oral medications have to be introduced. The diabetic may be given a range of tablets for various aspects of their disease and one of the types in the first line of attack are called the sulfonylureas.

Sulfonylureas include glimepiride, glibenclamide and gliclazide to name three. The job of this type of drug is to stimulate the pancreas to make more insulin. Their effectiveness will depend on the individual and to the ability of their pancreas to make more of this hormone. Obviously, they are not used to treat type 1 diabetes, as in type 1 diabetics the pancreas is simply not capable of producing any insulin at all.
Sulfonylureas can be taken along with most other diabetic drugs, including metformin, acarbose, the glitazones and meglitinides. They should not be taken by pregnant or nursing mothers, or anyone suffering from ketoacidosis.

Sulfonylureas are the most commonly prescribed drug in the UK, but no drug should be taken without continued attention to diet and exercise, firstly because it's almost impossible to control your diabetes without taking these measures, and secondly because sulfonylureas tend to cause weight gain.

Sulfonylureas can cause hypoglycaemia, especially when first taken. It is therefore important that you monitor your blood sugars regularly through the day, before each meal is a good idea. Should you have a hypoglycaemic reaction, contact your doctor who will either change the dosage, or change the type of drug.

Because of the hypoglycaemic possibility, long lasting sulfonylureas, glibanclamide for example, are less suitable for elderly patients, and for those who do not eat at regular times. In these cases a shorter acting type, gliclazide for example, may be more suitable