Sulfonylurea
Sulfonylureas are a class of oral medications primarily used to manage type 2 diabetes by stimulating the pancreas to release more insulin. These drugs are not effective for type 1 diabetes, where the pancreas produces little to no insulin. Developed in the late 1940s, sulfonylureas are categorized into two generations: first-generation and second-generation, with the latter having longer durations of action and typically requiring lower doses. By decreasing potassium levels in pancreatic beta cells, sulfonylureas create a calcium influx that prompts increased insulin production, which helps reduce blood glucose levels. While effective for many individuals with type 2 diabetes, they may not be suitable for those who are overweight due to the need for regular eating, which can lead to weight gain. Additionally, sulfonylureas carry risks of hypoglycemia (low blood sugar) and potential allergic reactions. Overall, they play a significant role in diabetes management but must be used with consideration of individual health factors.
On this Page
Subject Terms
Sulfonylurea
A sulfonylurea is a class of oral drugs used to treat type 2 diabetes. Sulfonylureas work by increasing the amount of insulin the pancreas releases. Although sulfonylureas are among the most commonly used drugs to treat type 2 diabetes, they are not used to treat type 1 diabetes and may not be the best choice for people who are overweight. For many other type 2 diabetics, sulfonylureas are a good choice for reducing the amount of glucose in the blood.
Overview
Diabetes is a condition that develops when the body has too much glucose, a form of sugar, in the bloodstream. Insulin is a hormone that helps convert blood sugar into fuel that can be used by cells. When the pancreas is unable to produce enough insulin or when the body has trouble using the insulin it does produce, diabetes results. Diabetes can be a contributing factor to heart disease, kidney disease, blindness, and a number of nerve problems. Estimates indicate that nearly 10 percent of the American population has diabetes.
Three types of diabetes exist: type 1, type 2, and gestational. Type 1 diabetes occurs when the body does not produce any insulin. This type usually develops in children or younger adults, and the patient needs to take insulin injections every day to survive. Type 2 diabetes can develop at any time but usually occurs in people who are middle-aged or older. The body of a type 2 diabetic produces insulin but either does not produce enough or does not use it well. Gestational diabetes develops only during pregnancy.
Sulfonylureas were developed in the late 1940s and were the first drugs developed to treat diabetes. They are in a class of drugs known as oral hypoglycemic agents, which means they are drugs taken by mouth that lower the amount of glucose in the blood. The two types of sulfonylureas are first-generation and second-generation. The main difference is that second-generation sulfonylureas have longer half-lives, which means they last longer in the body. For this reason, they often require lower doses or are taken less frequently than first-generation sulfonylureas.
Sulfonylureas work by stimulating beta cells in the pancreas to release insulin. These cells are not usually present in type 1 diabetics, so sulfonylureas do not work to treat that form of the condition. These drugs work by decreasing the amount of potassium in the beta cells. This forces an imbalance in the cell that allows more calcium in, which stimulates the cells to produce more insulin.
The presence of more insulin helps the body use blood glucose more effectively and reduces the chance that it will cause damage that leads to other health problems. However, those who are overweight are not good candidates for sulfonylureas because people who take them must eat at regular intervals, even if they are not hungry. This can lead to added weight gain and more potential health problems. Sulfonylureas also can cause hypoglycemia, or low blood sugar, in some people and allergic reactions.
Bibliography
Higgins, Thomas. "Oral Hypoglycemic Drugs." Boulder Medical Center,www.bouldermedicalcenter.com/oral-hypoglycemic-drugs/. Accessed 17 Jan. 2018.
Leontis, Lisa M. "Sulfonylureas for Type 2 Diabetes." Endocrine Web, 14 June 2010, www.endocrineweb.com/conditions/type-2-diabetes/sulfonylureas-type-2-diabetes. Accessed 17 Jan. 2018.
"Medical Definition of Sulfonylurea." MedicineNet, www.medicinenet.com/script/main/art.asp?articlekey=18045. Accessed 17 Jan. 2018.
Sola, Daniele, et al. "Sulfonylureas and Their Use in Clinical Practice." Archives of Medical Science, vol. 11, no. 4, 12 Aug. 2015, pp. 840–848, www.ncbi.nlm.nih.gov/pmc/articles/PMC4548036/. Accessed 17 Jan. 2018.
"Sulfonylureas." Diabetes UK, www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/treating-your-diabetes/tablets-and-medication/sulphonylureas. Accessed 17 Jan. 2018.
"Sulfonylureas for Type 2 Diabetes." WebMD, www.webmd.com/diabetes/sulfonylureas-for-type-2-diabetes. Accessed 17 Jan. 2018.
"What Are My Options?" American Diabetes Association,6 June 2013, www.diabetes.org/living-with-diabetes/treatment-and-care/medication/oral-medications/what-are-my-options.html. Accessed 17 Jan. 2018.
"What Is Diabetes?" National Institute of Diabetes and Digestive and Kidney Diseases, Nov. 2016, www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes. Accessed 17 Jan. 2018.