As soon as cause of diabetes was discovered and insulin was developed the attempt to find oral drug which would replace Insulin was investigated. So, Sulfonylureas (SU) were developed, a new compound which could be taken orally. Now there is the question, would SU effective to replace Insulin? Anti diabetes medicine is long running medicine. So far no one medicine which cure diabetes was discovered yet. Insulin is not cure for diabetes but treatment, effective, long running, but still it is not cure for diabetes ether type of it.
History of Sulonylureas development.
First generation of SU, tolbutamide, was statretd to be used in Germany in 1950s.
Second generation of this medicine was glipizide and glyburide enter to the market in 1985.
Third generation is glimepirid, was released in 1995.
Personally I took glipizade from 2002, time I was diagnosed with diabetes type 2, till 2011, time when I stopped to take any oral agents to control blood sugar and started to use insulin as treatment for type 2 diabetes.
My doctor at that time when I asked what this medicine for , usually answered, it makes me stronger. Needless to say, it does not mean anything but clear massage, no questions, just do what I said to do. It is also the point that no one doctor ever will say what this medicine for and why diabetic must take it. At that time I took metformin, and I was sure it is metformin the medicine I have to take to reduce high glucose in my blood. I did not run any log book at that time, and I had no one idea what is diabetes type 2 I was diagnosed with. So, I simple followed doctor's order, as we all do.
Now I read many comments what diabetic feel and how they react on medicine their doctors Rx for them. The same as I did many years ago. I did know nothing about condition such as low blood sugar, and when I try to ask doctor that my sugar run under 40 mg/dl, he answered: "It is important! We do care for low blood sugar even more then for high blood sugar. Get dress and follow me." End the conversation. He still work in the same office. I hate that man. I just hate him. What type of human he is? Bloody money do not smell. How many of us paid by our lives for his new office, and all riches he does have? No one count.
I survived this office, this treatment. I collected many extra pounds, but I still able to go to Lincoln Center and listen to the music. I go camping every Summer season. I like boating. I wish I can paddle on kayak but I cannot put my big body inside of small compartment.
There are many waters run into Atlantic ocean. I am not the same as I was back in 2002. I do know very well, what is low blood sugar, and how SU work in my body, what this medicine is doing for my health and well being.
Clinical and Experimental.
volume V, Number 6.
November 1956.
published by Grune & Stratton.
So, what are SU good for? What they are not so good for?
Let us start from the beginning. SU not good for every type of diabetes. Insulin is only medicine which is effective to address to all diabetes types and stages. So, if one have to make the choice, then what I would be? So simple. Put the shoe diabetic type 2 in, and try it to yourself. Is not that shoe to tight?
Diabetics very often suggested to make the choice, and what they do know about subjects they chose from? Tha's right. One medicine I have to take in injections. Another type of medicine can be taken orally. All another differences diabetics need time to discover.
In case of trauma, severe infection, or severe diabetes when there are only limited amount of Beta Cells left, SU will not work. What SU suppose to stimulate if there is no insulin secretion available?
ON many other instances the secretion of insulin still possible, and SU can temporary work.
SU reduce blood sugar level.
It is wrong. SU does not reduce blood sugar level. Sound confusing and not exeptable. But it is fact. SU stimulate insulin secreting beta cells. So, the level of insulin rise in the blood. The rise of insulin level decrease blood sugar. At first look it seems to be the same. But remember, in all diabetes treatment education there are first line treatment diet. When nutrition decreased there is no need in elevated level of insulin, so blood sugar getting down. Temporary. It still not controlled diabetes because of regardless how severe malnutrition is, the diabetes will be developed as a result of malnutrition. This type of diabetes long ago known as Tropical Diabetes.
With SU insulin secretion does not go in the natural way. Insulin secretion continues till medicine still in blood, regardless of the level of sugar in blood or the demand in insulin. So, part of energy which released with SU in use, go into hit, severe sweating. Diabetic cannot fall asleep because of activity of SU in body system, and raised insulin demand active state of body. Still with every use of SU there are opposite effect. Less and less Beta Cells remained. To control aggressively raised blood sugar diabetic increase dose of SU. Then more SU taken then less Beta Cells remained.
With depletion of Beta Cells the diminish of the insulin content follow. As it was told before SU does not effect children. Kids have low insulin content, less then 10 % compare with adults who has above 30% on insulin content. This is why SU is not effective on kids.
History of Sulonylureas development.
First generation of SU, tolbutamide, was statretd to be used in Germany in 1950s.
Second generation of this medicine was glipizide and glyburide enter to the market in 1985.
Third generation is glimepirid, was released in 1995.
Personally I took glipizade from 2002, time I was diagnosed with diabetes type 2, till 2011, time when I stopped to take any oral agents to control blood sugar and started to use insulin as treatment for type 2 diabetes.
My doctor at that time when I asked what this medicine for , usually answered, it makes me stronger. Needless to say, it does not mean anything but clear massage, no questions, just do what I said to do. It is also the point that no one doctor ever will say what this medicine for and why diabetic must take it. At that time I took metformin, and I was sure it is metformin the medicine I have to take to reduce high glucose in my blood. I did not run any log book at that time, and I had no one idea what is diabetes type 2 I was diagnosed with. So, I simple followed doctor's order, as we all do.
Now I read many comments what diabetic feel and how they react on medicine their doctors Rx for them. The same as I did many years ago. I did know nothing about condition such as low blood sugar, and when I try to ask doctor that my sugar run under 40 mg/dl, he answered: "It is important! We do care for low blood sugar even more then for high blood sugar. Get dress and follow me." End the conversation. He still work in the same office. I hate that man. I just hate him. What type of human he is? Bloody money do not smell. How many of us paid by our lives for his new office, and all riches he does have? No one count.
I survived this office, this treatment. I collected many extra pounds, but I still able to go to Lincoln Center and listen to the music. I go camping every Summer season. I like boating. I wish I can paddle on kayak but I cannot put my big body inside of small compartment.
There are many waters run into Atlantic ocean. I am not the same as I was back in 2002. I do know very well, what is low blood sugar, and how SU work in my body, what this medicine is doing for my health and well being.
The intensity and the scope of the research, experimental and clinical, into the possible practical application of the suffonylureas in the treatment of diabetes are indicated by the papers comprising this symposium and by the other studies referred to. this intense interest was aroused by the possibility that these compounds might, when administered orally, replace insulin therapy and its attending inconvenience. That they are effective in controlling the glucosuria and hyperglycemia in many diabetics when given orally is the only apparent advantage they do have over insulin. They have disadvantage of being ineffective during acute complications such as severe infections or trauma. They exert no benefit juvenile diabetes, except in rare instances, and they are without effect in the relatively small segment of the older age group in which ketonuria promptly occur following the withdrawal of insulin therapy. (page 725)Metabolism.
Clinical and Experimental.
volume V, Number 6.
November 1956.
published by Grune & Stratton.
So, what are SU good for? What they are not so good for?
Let us start from the beginning. SU not good for every type of diabetes. Insulin is only medicine which is effective to address to all diabetes types and stages. So, if one have to make the choice, then what I would be? So simple. Put the shoe diabetic type 2 in, and try it to yourself. Is not that shoe to tight?
Diabetics very often suggested to make the choice, and what they do know about subjects they chose from? Tha's right. One medicine I have to take in injections. Another type of medicine can be taken orally. All another differences diabetics need time to discover.
In case of trauma, severe infection, or severe diabetes when there are only limited amount of Beta Cells left, SU will not work. What SU suppose to stimulate if there is no insulin secretion available?
ON many other instances the secretion of insulin still possible, and SU can temporary work.
SU reduce blood sugar level.
It is wrong. SU does not reduce blood sugar level. Sound confusing and not exeptable. But it is fact. SU stimulate insulin secreting beta cells. So, the level of insulin rise in the blood. The rise of insulin level decrease blood sugar. At first look it seems to be the same. But remember, in all diabetes treatment education there are first line treatment diet. When nutrition decreased there is no need in elevated level of insulin, so blood sugar getting down. Temporary. It still not controlled diabetes because of regardless how severe malnutrition is, the diabetes will be developed as a result of malnutrition. This type of diabetes long ago known as Tropical Diabetes.
With SU insulin secretion does not go in the natural way. Insulin secretion continues till medicine still in blood, regardless of the level of sugar in blood or the demand in insulin. So, part of energy which released with SU in use, go into hit, severe sweating. Diabetic cannot fall asleep because of activity of SU in body system, and raised insulin demand active state of body. Still with every use of SU there are opposite effect. Less and less Beta Cells remained. To control aggressively raised blood sugar diabetic increase dose of SU. Then more SU taken then less Beta Cells remained.
With depletion of Beta Cells the diminish of the insulin content follow. As it was told before SU does not effect children. Kids have low insulin content, less then 10 % compare with adults who has above 30% on insulin content. This is why SU is not effective on kids.
via Ravenvoron
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