Sulfonylureas in Type 2 Diabetes Treatment
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Questions and Answers

What is the primary mechanism by which sulfonylureas lower blood glucose levels?

  • They promote glucose excretion in the urine.
  • They inhibit gluconeogenesis in the liver.
  • They stimulate insulin secretion from pancreatic β-cells. (correct)
  • They increase insulin sensitivity in peripheral tissues.
  • What is the typical reduction in A1C levels observed in drug-naïve patients taking sulfonylureas?

  • 2.5% to 3%
  • 0.5% to 1%
  • 1.5% to 2% (correct)
  • 3.5% to 4%
  • Which of the following is a significant side effect associated with the use of sulfonylureas?

  • Hypoglycemia (correct)
  • Nausea and vomiting
  • Liver damage
  • Weight loss
  • In which scenario should the use of glyburide be avoided?

    <p>In patients with renal impairment</p> Signup and view all the answers

    What is the usual daily dosage schedule for sulfonylureas?

    <p>1-2 mg once daily in the morning after breakfast</p> Signup and view all the answers

    Study Notes

    Sulfonylureas: Treatment for Type 2 Diabetes

    • Oral medications stimulating insulin secretion in pancreatic beta cells.
    • They bind to sulfonylurea receptors.
    • Used as monotherapy or with other oral/injectable drugs.

    Second-Generation Sulfonylureas

    • Glyburide (Glibenclamide)

    • Glipizide

    • Glimepiride (Amaryl)

    • All equally effective at lowering blood glucose (BG) in equipotent doses

    • Typical A1C reduction: 1.5%–2% (16–22 mmol/mol Hb)

    • Typical fasting plasma glucose (FPG) reduction: 60–70 mg/dL

    • Typically one daily dosage

    • Taken orally with breakfast or first meal

    Usage Considerations and Side Effects

    • Widely used due to effectiveness, oral administration, and affordability.
    • Caution advised by current guidelines due to:
      • Hypoglycemia risk: Most common side effect, especially in patients with:
        • Irregular meal schedules
        • Intensive exercise routines
        • Significant weight loss
        • Requires conservative dose initiation/titration
      • Weight gain: Typically 1–2 kg
      • Tachyphylaxis: Reduced effectiveness over time.
      • Long-acting sulfonylureas: High hypoglycemia risk in older patients and those with kidney/liver problems. Avoid or use with extreme caution.
      • Renal impairment: Glyburide use is not recommended, while glipizide/glimepiride use should be cautious.
      • Cardiovascular risk: Increased risk of death in patients with coronary artery disease.

    Cross-reactivity and Allergies

    • Patients with sulfa allergies rarely experience cross-reactivity with sulfonylureas.

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    Description

    Explore the role of sulfonylureas in managing Type 2 diabetes. This quiz covers second-generation medications, their effectiveness in lowering blood glucose, and considerations regarding their usage and potential side effects. Test your knowledge on this important class of oral diabetes medications.

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