Side Effects and Cautions
Sulfonylureas, as opposed to metformin, the thiazolidinediones, exenatide, symlin and other newer treatment agents may induce hypoglycemia as a result of excesses in insulin production and release. This typically occurs if the dose is too high, and the patient is fasting. Some people attempt to change eating habits to prevent this, however it can be counter productive.
Like insulin, sulfonylureas can induce weight gain, mainly as a result their effect to increase insulin levels and thus utilization of glucose and other metabolic fuels. Other side-effects are: abdominal upset, headache and hypersensitivity reactions.
Sulfonylureas are potentially teratogenic and cannot be used in pregnancy or in patients who may become pregnant. Impairment of liver or kidney function increase the risk of hypoglycemia, and are contraindications. As other anti-diabetic drugs cannot be used either under these circumstances, insulin therapy is typically recommended during pregnancy and in hepatic and renal failure, although some of the newer agents offer potentially better options.
Second-generation sulfonylureas have increased potency by weight, compared to first-generation sulfonylureas. All sulfonylureas carry an FDA-required warning about increased risk of cardiovascular death. The ADVANCE trial (Action in Diabetes and Vascular Disease), a randomized trial sponsored by the vendor of gliclazide, found no benefit from tight control with gliclazide for the outcomes of heart attack (myocardial infarction), cardiovascular death, or all-cause death. Similarly, ACCORD (Action to Control Cardiovascular Risk in Diabetes) and the VADT (Veterans Affairs Diabetes Trial) studies showed no reduction in heart attack or death in patients assigned to tight glucose control with various drugs.
Read more about this topic: Sulfonylureas
Famous quotes containing the words side and/or effects:
“As I went forth early on a still and frosty morning, the trees looked like airy creatures of darkness caught napping; on this side huddled together, with their gray hairs streaming, in a secluded valley which the sun had not penetrated; on that, hurrying off in Indian file along some watercourse, while the shrubs and grasses, like elves and fairies of the night, sought to hide their diminished heads in the snow.”
—Henry David Thoreau (1817–1862)
“Society’s double behavioral standard for women and for men is, in fact, a more effective deterrent than economic discrimination because it is more insidious, less tangible. Economic disadvantages involve ascertainable amounts, but the very nature of societal value judgments makes them harder to define, their effects harder to relate.”
—Anne Tucker (b. 1945)