Diabetes is associated with the body’s inability to lower its high blood sugar levels. With Type 2 Diabetes, there are various treatment options that work in different ways to lower the blood sugar level. However, in Type 1 Diabetes, insulin is the only option.
Insulin Secretagogues are medications that stimulate the release of insulin from the pancreas and thereby lower the blood glucose level. Insulin helps glucose in the blood enter the cells in the liver, muscles, and fat. It is released normally by the pancreas in response to a rise in blood glucose levels. Sulfonylureas and Meglitinides classes of oral diabetic medications are insulin secretagogues that act quickly to lower the blood glucose level.
Sulfonylureas
The sulfonylureas class of medications were first discovered by chemist, Marcel Janbon, and his coworkers while studying sulfonamide antibiotics. They observed that the compound, sulfonylurea, induced low blood sugar levels in animals.
Sulfonylureas are further classified into the first-generation and second generation. The first-generation sulfonamides include Chlorpropamide and Tolbutamide. The second-generation sulfonylureas include Glyburide (also known as Glibenclamide), Glipizide, Glimepiride, and Gliclazide.
Meglitinides
The meglitinides class of medications are fast-acting and short duration. They are structurally different from sulfonylureas. Meglitinides are often prescribed with meals to reduce the blood sugar level spike that occurs after meals.
The medications in this class include Repaglinide, Nateglinide, and Mitiglinide.
Adverse effects of insulin secretagogues
Hypoglycemia
Hypoglycemia occurs when the blood glucose level drops below 70 mg/dL. This may be associated with symptoms such as sweating, shakiness, irritability, confusion, racing heartbeat, and a feeling of hunger. These medications stimulate the secretion of insulin regardless of the blood glucose level. Because of this, hypoglycemia can occur and is the major concern associated with sulfonylureas.
Situations in which hypoglycemia is most likely to occur include missing meals, after exercising, taking a high dose of medication, taking longer-acting medications, and alcohol intoxication.
Glipizide, Glimepiride, and Gliclazide are associated with a lower incidence of hypoglycemia, as compared to Glyburide.
Weight gain
Modest weight gain is a common side effect of insulin secretagogues. Weight gain can be prevented or reduced by adopting healthy lifestyle practices
Keep an open mind and discuss with your doctor how the prescribed medications work for you. Understanding the potential side effects and ways to manage and prevent side effects is important when taking any diabetes medications.
