Synonyms
Drugs Diabetes mellitus, diabetes drugs, glibenclamide (e.g. Euglucon ®N), glimepiride (e.g. Amaryl®), gliquidone (e.g. Glurenorm®)
How do sulfonylureas work?
Sulfonylureas stimulate the pancreas to release more insulin. The prerequisite for this, however, is that the beta cells of the pancreas are still capable of producing insulin themselves. When the pancreas is no longer able to produce insulin, sulfonylureas are no longer effective.
Insulin therapy must be started now at the latest. Glibenclamide (Euglucon ®N) is the most effective of all sulfonylureas and has been studied most thoroughly. It acts very quickly and is able to reduce the blood sugar level below the fasting standard values of 80 to 110 mg/dl.
Uncontrolled intake can therefore provoke hypoglycaemia. At the start of therapy with glibenclamide, the dose should be taken in order to prevent hypoglycaemia. Practically this means that you start with half a tablet per day (3.5 mg) with a morning dose before breakfast and slowly increase the dose at weekly intervals.
The maximum dose of glibenclamide is 3 times 3.5 mg (3 whole tablets) per day. Morning administration or tablet division in the scheme 2-1-0 (morning – noon – evening) is most sensible at the beginning because the pancreas is stimulated longer after ingestion beyond the day. If you always take the other tablets with your main meals, do not vary the dose yourself and do not follow a diet, there is generally no risk of hypoglycaemia.
No effect despite maximum dose
If the maximum dose of 3 times 3.5 mg per day has been reached and still no desirable blood glucose control is achieved, insulin therapy must be considered. According to various studies it can already be predicted today that after a glibenclamide therapy of about 6 years the insulin reserves of the pancreas are exhausted and insulin therapy becomes necessary. Do not delay this time unnecessarily in order to avoid consequential damage caused by elevated blood sugar levels at all costs. Regular blood glucose monitoring by your general practitioner is therefore particularly advisable when treating with glibenclamide.
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