The Hidden Dangers of Sulfonylureas in Diabetes Management

Sulfonylureas are a group of oral medications prescribed for managing blood sugar levels in individuals with type 2 diabetes. These drugs enhance insulin secretion irrespective of the current glucose levels, which can sometimes result in hypoglycemia due to excessively low blood sugar (1^✔ ✔Trusted Source
Long-Term Sulfonylurea Use and Impaired Awareness of Hypoglycemia Among Patients With Type 2 Diabetes in Taiwan

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Understanding Sulfonylureas: Managing Blood Sugar in Type 2 Diabetes

This study aimed to investigate the prevalence of impaired hypoglycemia awareness among type 2 diabetes patients treated with either insulin or sulfonylureas over both short and long-term durations. The research involved data collection from 898 type 2 diabetes patients recruited from pharmacies, clinics, and health bureaus in Tainan City, Taiwan. Between August and November 2022, participants received treatment with either insulin or sulfonylureas. The researchers evaluated the participants’ impaired awareness of hypoglycemia using the Chinese versions of the Clarke and Gold questionnaires.

Up to 94.3% of participants, half male and half female and mostly aged 40-69, visited a clinician as an outpatient every 2-3 months for diabetes care. For participants who used the medication for less than a year, the prevalence of impaired awareness of hypoglycemia in sulfonylurea users was 47.8% (Gold) and 30.4% (Clarke). The prevalence increased to 70.7% (Gold) and 56.9% (Clarke) for users treated with sulfonylurea for more than five years.

For insulin user participants who used the medication for less than a year, the prevalence of impaired hypoglycemia awareness was 57.3% (Gold) and 30.1% (Clarke). This decreased to 41% (Gold) and 28.2% (Clarke) for participants who used the medication for more than five years. Regular ambulatory care with tests, including blood glucose and retina exams, was associated with lower odds of impaired awareness of hypoglycemia in both sulfonylurea and insulin users.

Comparing Hypoglycemia Awareness in Insulin vs. Sulfonylurea Users

Using sulfonylureas long-term is associated with impaired awareness of low blood sugar in patients with type 2 diabetes. The longer the patient uses this medication, the higher the risk of hypoglycemia unawareness. Current guidelines recommend using newer classes of medications that offer a reduced risk of hypoglycemia to treat type 2 diabetes over sulfonylureas, which are commonly used due to their affordability.

Reference:

1. Long-Term Sulfonylurea Use and Impaired Awareness of Hypoglycemia Among Patients With Type 2 Diabetes in Taiwan - (https://www.annfammed.org/content/22/4/309)

Source-Eurekalert