Sulfonylureas and Meglitinides
| Who? |
| Sulfonylureas and meglitinides are recommended for persons with type 2 diabetes who have poorly controlled blood glucose levels. On average, most patients find that their Hb A1c levels drop by up to 1.5% on these medications. |
| What? |
| Oral tablets – sulfonylureas stimulate the pancreas to release insulin over a period of several hours. Common brands include:
Meglitinides stimulate a shorter term burst of insulin to cover mealtimes. Common brands include:
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| Where? |
| Sulfonylureas and meglitinides work by stimulating the pancreas to release insulin. |
| When? |
Sulfonylureas are usually taken once or twice a day, in the morning and/or evening, depending on the brand:
- Chlorpropramide is taken once a day (typical daily dose: 100 mg to 500 mg)
- Glipizide is taken once or twice a day (typical daily dose: 5 mg to 40 mg)
- Glyburide is taken once or twice a day (typical daily dose: 1.25 mg to 20 mg)
- Glimepiride is taken once a day (typical dose: 1 mg to 4 mg; maximum 8 mg daily)
Meglitinides are usually taken 15-30 minutes before each meal:
- Repaglinide is taken at doses ranging usally from 0.5 mg to 4 mg with each meal
- Nateglinide is taken at doses ranging usually from 60 mg to 120 mg
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| Why? |
- Sulfonylureas are very effective at controlling blood glucose and can lower A1C levels.
- Sulfonylureas can cause low blood glucose, or hypoglycemia, if the patient skips a meal. This tends to occur in patients who are older or have kidney disease.
- Patients with worsening kidney function may need to reduce their dose or stop these medications to avoid hypoglycemia
- Patients tend to gain a few pounds of weight on these medications
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