What are sulfonylurea drugs?

Donna Hill Howes, RN
Family Practitioner

Sulfonylureas lower blood glucose by stimulating beta cells in the pancreas to release insulin. Sulfonylureas are taken by mouth. They may be prescribed alone or in combination with other diabetes drugs.

Several sulfonylureas are available in the US. These include glimepiride (Amaryl), glipizide (Glucotrol), glyburide (Diabeta, Glynase), acetohexamide, chlorpropamide (Diabinese), tolazamide, and tolbutamide. Some other products combine a sulfonylurea with another diabetes drug such as metformin in a single pill. 

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The first oral medications for people with type 2 diabetes, sulfonylureas stimulate the pancreas to produce more insulin, increasing the amount in the bloodstream and lowering blood glucose.

These medications are effective when combined with diet and exercise, but can also reduce blood sugar to dangerously low levels. In addition, for the drugs to work, patients have to produce at least some insulin on their own.

Sulfonylureas are medications used to treat type 2 diabetes. They’re taken by mouth (orally) as a pill. Sulfonylureas work best when you’re following the rest of your diabetes treatment plan. This means checking your blood glucose regularly, following your meal plan and exercising every day. It may also include taking other diabetes medications.

Some examples of sulfonylurea medication are glipizide XL (Glucotrol XL) and glimepiride (Amaryl).

Sulfonylureas help to lower the amount of glucose in your bloodstream (your blood glucose). They do this by increasing the amount of insulin released by your pancreas. With more insulin to “unlock” your body’s cells, more glucose can move into them. As a result, your blood glucose goes down.

Sulfonylureas can’t cure your diabetes. But by helping control your blood glucose, they lower the chance that your diabetes will cause serious problems. As you know, when you have diabetes, you tend to have high blood glucose. Over time, this can damage your blood vessels and nerves, leading to heart attack or stroke, kidney and eye disease, and problems with your teeth, feet and skin. If you have high blood pressure or high cholesterol -- like many people with diabetes -- you have an even greater risk for these problems. (This is why you should always take your blood pressure or cholesterol medications as well as your diabetes medications.)

One class of diabetes oral medications are sulfonylurea drugs. The effects of sulfonylurea drugs on blood glucose levels were discovered by accident in the 1940s (they were used as antibacterial drugs during World War II). Sulfonylureas lower blood glucose levels by encouraging the pancreas to produce and release more insulin. Scientists have many leads on how these drugs accomplish this. Seven different sulfonylureas are prescribed in this country: glyburide (Glynase PresTab, or Micronase), glipizide (Glucotrol or Glucotrol XL), glimepiride (Amaryl), chlorpropamide (Diabinese). Until 1994, sulfonylureas were the only oral medication for type 2 diabetes available to Americans.

William Lee Dubois

Sulfonylurea is a class of oral diabetes medications for type-2 diabetics that stimulate the pancreas to produce more insulin.

Once widely used, they are now falling out of favor due to the fact that they cause premature pancreatic burnout, leading to total insulin dependence, and because they can cause dangerously low blood sugars if patients are more active than usual or miss meals.

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