5 mg plus a sulfonylurea
was significantly more effective than a sulfonylurea
alone in lowering hemoglobin A1c (A1C) from baseline after 24 weeks of treatment.
In the RCTs, the hazard ratios comparing sulfonylureas
to all treatments combined were 1.
is indicated in combination with metformin or metformin plus a sulfonylurea
for the treatment of adults with type 2 diabetes mellitus if metformin alone or in combination with a sulfonylurea
or basal insulin does not provide adequate glycaemic control.
Writing in the journal Diabetes, Obesity and Metabolism, Craig Currie and colleagues report that treatment with metformin improved survival in diabetics in comparison with those treated with sulfonylurea
drugs, as well as in comparison with untreated nondiabetics.
therapy was started by 3,570 patients (23 percent), 948 patients (6.
Similarly, in a model with sulfonylureas
as the referent, metformin was significantly better, with adjusted HRs of 0.
Recently, however, research has shown some sulfonylureas
may be safer than others.
The second-generation sulfonylureas
glimepiride (Amaryl), glipizide (Glucotrol), and glyburide (DiaBeta, Glynase, and Micronase) are prescribed much more frequently in pregnancy than the first-generation agents because they do not cause animal developmental toxicity, and can be considered low risk.
Side effects include weight gain and hypoglycemia, although to a much lower extent than the sulfonylureas
The study, a randomized, double-blind, placebo-controlled trial conducted by researchers at Pennington Biomedical Research Center (Baton Rouge, LA), concludes that the addition of chromium to a regimen consisting of a sulfonylurea
drug in subjects with type 2 diabetes significantly improves insulin sensitivity, improves glucose control, and attenuates body weight gain.
For inclusion, patients had to be treated with maximally effective doses of sulfonylureas
for the 3 weeks prior to screening.
Several analytical methods for the screening and measurement of Sulfonylureas
in biological fluids have been described.
Key Words: acarbose, meglitinides, metformin, oral treatment, sulfonylureas
, thiazolidinediones, type 2 diabetes mellitus
Find Your Diabetes Medicines(*) Sulfonylureas
Amaryl DiaBeta Diabinese Dymelor Glucotrol Glucotrol XL Glynase PresTab Micronase Orinase Tolinase Biguanides Glucophage Alpha-glucosidase Inhibitors Glyset Precose Thiazolidinediones Rezulin Meglitinides: Prandin Insulins Lispro (Humalog) Regular Premixed Ultralente NPH or Lente
Tell your health care provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, herbal supplements, and other medicines to treat diabetes, including insulin or sulfonylureas