Should sulfonylureas be retired ?
My answer is a strong YES .
The short answer is that we have better safer medications that actually preserve Beta cell function. The sulfonylureas are just as effective at lowering abnormal glucose levels but at the cost of increased risk of hypoglycemia , they seem to burn out any remaining Beta cells , cause weight gain and are suspect for increase risk of cardiovascular disease .
These medicines served us very well and helped a lot of people when the only choices of medications for type 2 diabetes was animal based insulins and sulfonylureas . Technology and better understanding of type 2 diabetes has made dramatic improvements in diabetes care and these drugs should join urine glucose test and move into the history of diabetes care.
Names on my list for receiving a gold watch and a slap on the back for a job well done during their day
chlopromamide ( Diabinase )
tolazamide ( Tolinase)
Tolbutamide
Glipazide (Glucatrol )
gliclazide (Damicron )
Glyburide ( Diabetea, Glynase )
Glimapiride ( Amaryl ) Amaryl could remain on the on call list for the occasional
patient who could benefit .
Will they be retired is probable no ?
These meds will not go away because they are inexpensive and they are effective for lowering
glucose levels.
Have Fun , Be Smart and Defeat Diabetes
David Calder,MD
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