March 24, 2023

Suphonylureas are a class of medications used mostly in type 2 diabetes. Here we discuss how they work, the benefits and the contraindications.

Hi everybody welcome back to another video if you don’t know me i’m mark a diabetes specialist dietitian and author of today we’re continuing with our medication series and today we are looking at sulfonylureas like all the videos in our medication series this is not advice about whether or not you should be taking these medications it’s purely

To show you how they work so you have a better understanding about how these are helping treat your diabetes what are sulfanillars let’s start with what sulfonylureas are so there are medication class used in type 2 diabetes primarily although you might see them used elsewhere for example with steroid induced diabetes they’re one of the older medication classes

Actually and they’ve been around a long time so we have a lot of experience in using them particularly in type 2 diabetes the way they work is by stimulating the pancreas to produce more insulin so in practice we say that they give the pancreas a little kick and it splurts out a bit more insulin to help cover food and episodes of hypoglycemia it’s for this reason

That they’re generally taken with food usually breakfast and your evening meal to help prevent the glucose rise caused by carbohydrates in your diet if you took these without eating then the risk is that you may have a low blood glucose level there are lots of different types and brands but the most common are known as gilbenclamide glimepiride glipizide some

Examples of these medications like talbutamide are first-generation sulfamel ureas so if you’re still taking these medications they’re not widely used anymore and therefore it might be worth checking in with your medical team to see if they can update you to a second generation option the dose will depend on the type of medication that you’re taking so there can

Be a wide range between how many tablets you may take with each meal benefits of self-familiar ears one of the key benefits to taking sulfur new ureas is that they’re quite effective at lowering blood glucose levels we could expect a drop in your hba1c which is your month average of your glucose control by anywhere between one and two percent in old money which

Equates to 11 to 22 millimoles per mole in the new readings so they can actually be quite effective compared to other type 2 diabetes medications negatives are self-familiar ears as sulfonylureas make your pancreas release more insulin low blood glucose levels are a risk therefore you’ll need to test your glucose levels anywhere between one to two times per day

Which for some people can be a big deal as it involves a finger prick test the other downside is that insulin is an anabolic hormone it means it builds you up and if you’re producing more of it it can lead to weight gain so we can expect an average weight gain around two kilograms in patients taking sulfanil urease but some people will be less some people will be

Much more obviously this is a problem in type 2 diabetes where the vast majority of patients have the condition or at least one of the major contributing reasons to having the condition is that they’re carrying too much fat mass in the first place therefore if we give them medications that encourage more weight gain it just really exacerbates the problem longer

Term when not to use self familiar ears one of the key contraindications with sulfamil ureas is for people that have variable appetites this is because they make you produce more insulin and therefore if you don’t eat when taking them you’re producing more insulin without extra carbohydrate or glucose entering your system which can leave you susceptible to low

Glucose levels this is a particular problem in vulnerable populations such as the elderly who might have a hyperglycemic episode and perhaps have a fall or something worse which can cause damage chronic kidney disease may also be a contraindication to taking self-familiar ears insulin is cleared by the kidneys so when we have kidney damage the excess insulin

That’s produced from the pancreas might hang around for longer which can again leave you susceptible to low glucose levels sulfonylureas are also contraindicated in type 1 diabetes and type 3 diabetes where insulin production might be hindered this is because these patients produce little or no insulin of their own so essentially asking the pancreas to produce

More insulin when it has no insulin producing capabilities isn’t going to work finally some diabetes teams may recommend stopping your sulfamil urea if you commence insulin therapy the reason for this is quite simple if you start insulin therapy it shows us that your body is struggling either to produce enough insulin or the insulin that you’re producing isn’t

Working very well so we’re having to supplement that with a subcutaneous injection so by continuing sulfur in the urease alongside the additional insulin that’s being injected then essentially we’re asking the pancreas to produce even more insulin even though it’s not working very well and we’re adding in extra insulin anyway so what we can start to do is tire

Out the pancreas and overwork it over time this can start to further wear out the pancreas and over time it can actually lead to progression of your type 2 diabetes therefore the thinking is that by stopping the self in the urea alongside insulin therapy we’re actually preserving some of the pancreatic function and that’s it guys for self familiar ribs i hope

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Your diabetes we also offer courses that is one step down from our one-to-one personalised service but it shows you everything you need to know about your condition at the time of filming we have our type 2 diabetes recovery plan but we’re also producing a type 1 diabetes plan and a winning weight loss solutions plan so keep an eye out for those they are coming

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Transcribed from video
Sulphonylureas – Gliclazide, Glipizide, Glimepiride, Glibenclamide By Diabetes Diet Guy