Glyburide (Diabeta, Micronase, Glynase)

Most commonly used secretagogue associated with increased incidence of hypoglycemia.

Increased frequency of hypoglycemia seen with this drug may be related to suppressed release of glucagon and growth hormone, which help avoid and correct low blood sugar levels.

Associated with suppression of glucagon and growth hormone which may be due to the closure of the K+ ATPase channels in the hypothalamus, resulting in a lack of recognition and release of these cont2242egulatory hormones needed to correct the hypoglycemia.

Has a short half-life and is administered twice daily.

Undergoes hepatic metabolism and has active metabolites which are weakly active, and this weak level of activity and does not contribute substantially to lowering of the hemoglobin A-1 C in most patients.

In patients with renal insufficiency thrse metabolites are poorly cleared and patients will experience accumulation which can lead to increased therapeutic effects and risk of hypoglycemia.

Relative lack of advantages of glyburode compared with other agents, combined with increased risk of adverse effects, creates a risk to benefit ratio does not favor its use.

Risks are increased in patients with reduced kidney function.

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