| Amaryl (generic name: Glimepiride) works in a different way that in time may result in less elevation of insulin levels. It appears to increase insulin sensitivity and increases glucose uptake by muscles.
It is the only medicine of its type that can be used with insulin, and can reduce the requirement for insulin by up to 50% in some patients. Manufacturer - Hoechst Marion Roussel |
| Glucophage (generic name: Metformin) has been associated with severe cases of lactic acidosis although the incidence of this is significantly lower than similar medicines in the past. Metformin reduces
glucose production by the liver and may improve the insulin sensitivity of tissues elsewhere in the body. Metformin does not cause weight gain; indeed, it may cause weight loss, perhaps because it does not
stimulate insulin secretion, or perhaps because the drug causes anorexia (heartburn, diarrhea, and anorexia occur in 20% to 30% of patients). Metformin has been shown to work effectively with glyburide when neither alone is effective.
It is rapidly absorbed and cleared through the kidneys. Guar, a naturally occuring substance used as a thickener and as an agent in diet foods, inhibits absorption of the Metformin into the body.Manufacturers - Lipha
Pharmaceuticals; Bristol-Myers Squibb |
| Glucotrol (generic name: glipizide) is part of the sulfonylurea class that includes tolbutamide (brand name: Orinase, manufactured by Upjohn), chlorpropamide (brand name: Diabinese, manufactured by Pfizer),
and second-generation glipizide (brand name: Glucotrol, manufactured by Pratt) and glyburide (brand names: Micronase, Glynase, manufactured by Upjohn). The sulfonylureas can cause weight gain and does cause
hypoglycemia that can be prolonged and is often misdiagnosed. Manufacturer - Pratt |
| Glynase (generic name: glyburide) one of the sulfonylureas. For more information about this class, see Glucotrol (above). Manufacturer - Upjohn |
| Prandin (generic name: repaglinide) is the first of a new meglitinide class of drugs approved by the FDA. It can be taken immediately before meals since it has a quick onset and short duration of action.
If a meal is skipped, the patient should also skip the repaglinide dose. Repaglinide stimulates insulin secretion by binding to sites on the beta cells of the pancreas. It is
minimally excreted by the kidneys. When the drug was considered by an FDA advisory panel, experts seemed to doubt that most patients would want to take the three-times-daily regimen over available once-daily
therapies. The primary advantage seemed to be in patients who skip meals or do not eat regularly. Concern was also expressed about the possibility of cardiovascular side effects with the drug, since five patients
on repaglinide experienced myocardial infarctions during clinical trials of the drug in 2,200 patients, compared with only one patient taking other treatments. Manufacturer - Novo Nordisk |
| Rezulin (generic name: troglitazone) is one of a new class of compounds known collectively as the thiazolidinediones. These compounds appear to lower blood glucose
primarily by enhancing the activity of insulin already present rather than by stimulating insulin secretion. Troglitazone acts at insulin's two major target organ sites, the liver
and skeletal muscle. The drug improves glucose utilization by stimulating the uptake of glucose by muscle tissue. In the liver, troglitazone decreases glucose production and also
decreases circulating insulin levels. No serious side effects, such as lactic acidosis, have been reported in clinical studies. No significant weight gain was reported, and
gastrointestinal complaints were the most common adverse effects. In women, improvement in insulin levels that occurred during troglitazone therapy also resulted in improvement in selected
hormone levels. Not only did this confirm the effect of troglitazone on insulin sensitivity, but this may represent a new approach to treating women with polycystic ovary syndrome. Manufacturer - Warner-Lambert (Parke-Davis) |
| Glossary |
|---|
Beta Cells A type of cell in the pancreas in areas called the islets of Langerhans. Beta cells make and release insulin, a hormone that controls the level of glucose (sugar) in the blood.
Hypoglycemia Too low a level of glucose (sugar) in the blood. This occurs when a person with diabetes has injected too much insulin, eaten too little food, or has exercised without extra food. A person with hypoglycemia may
feel nervous, shaky, weak, or sweaty, and have a headache, blurred vision, and hunger. Taking small amounts of sugar, sweet juice, or food with sugar will usually help the person feel better within 10-15 minutes.
Insulin Sensitivity is the healthy interaction of insulin helping the body use ingested sugars.
Lactic Acidosis Too much acid in the body, related to poor functioning of the liver.
Myocardial Infarction is the formation of dead tissue caused by obstruction of circulation to a region of the heart; also called a heart attack.
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