Insulin secretagogues: who, what, when, and how?

Full Abstract

Sulfonylurea compounds were the first available oral antidiabetic agents and they remain an important tool in our quest for optimal glycemic control. The more recent introduction of meglitinides offers an approach to short-term insulin release with minimal hypoglycemic risk during fasting periods. Published trials suggest that individuals with a hemoglobin A(1c) above 8.5% are unlikely to reach currently recommended targets (6.5% to 7%) without the use of one of these insulin secretagogues. Starting and probable maximally effective doses for glimepiride are 1 to 2 mg initially and 4 mg thereafter. For glyburide and glipizide, these are 2.5 to 5 mg initially, and 10 mg effective at a maximum. The large majority of the effect can be seen within a week, making them very attractive when rapid lowering of glucose is needed. An understanding of the principles will facilitate more effective use of initial and combination therapy.

Author information

Author/s: Dailey, George (G);

Affiliation: Scripps Clinic, 10666 North Torrey Pines Road, La Jolla, CA 92037, USA. gdailey(-atsign-)scrippsclinic.com

Journal and publication information

Publication Type: Journal Article; Review

Journal: Current diabetes reports (Curr Diab Rep), published in United States. (Language: eng)

Reference: 2005-Oct; vol 5 (issue 5) : pp 329-32

Dates: Created 2005/09/28; Completed 2006/01/26;

PMID: 16188166, status: MEDLINE (last retrieved date: 2/18/2009)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MeSH Headings (categories) shown below.

Administration, Oral
Blood Glucose - metabolism
Diabetes Mellitus, Type 2 - drug therapy
Hemoglobin A, Glycosylated - metabolism
Humans

Note: Bold headings indicate primary MeSH headings or qualifiers.

Associated Chemicals: Blood Glucose (0) ; Hemoglobin A, Glycosylated (0) ; Hypoglycemic Agents (0) ; Sulfonylurea Compounds (0) ; Insulin (11061-68-0) ; glimepiride (93479-97-1)

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