A new study from Taiwan suggests that long-term use of sulfonylurea type 2 diabetes drugs can lead to an impaired awareness of hypoglycemic episodes. After 5 years of use, there is a higher risk of desensitization to the symptoms of hypoglycemia with sulfonylureas as compared to insulin. While both medications are associated with an increased chance of hypoglycemia in the short term, sulfonylurea users are three times more likely to have impaired awareness after 5 or more years.
Sulfonylureas are among the oldest type 2 diabetes medications available and work by stimulating beta cells in the pancreas to produce insulin. Drugs such as Glipizide, Glimepiride, and Glyburide are commonly prescribed in the United States for their effectiveness and affordability. A recent study conducted in Taiwan involved 898 individuals with type 2 diabetes, comparing sulfonylurea and insulin users’ experiences of impaired hypoglycemia awareness using standardized questionnaires.
While both groups initially experienced impaired awareness of hypoglycemic episodes, over time, insulin users saw a decrease while sulfonylurea users experienced an increase in impaired awareness. This highlights the long-term risks associated with sulfonylurea medications in terms of hypoglycemia sensitivity. Dr. Jason Ng, an endocrinology and metabolism expert, explained the differences between sulfonylureas and insulin in managing blood sugar levels and why a physician may choose one over the other based on the patient’s needs.
Recognizing the symptoms of hypoglycemia is crucial for individuals taking diabetes medications to ensure timely intervention. Symptoms such as tremors, dizziness, hunger, confusion, and changes in mental status can indicate dangerously low blood sugar levels. Regular blood glucose monitoring, retinal scans, and frequent check-ins with healthcare providers are recommended to prevent adverse outcomes related to hypoglycemia. The study also suggests that newer blood sugar control medications may offer alternative mechanisms that reduce the risk of hypoglycemia associated with sulfonylureas.
Despite the important findings of the study, there are limitations to consider, such as the homogeneity of the participant population in one city and the reliance on self-reported medical care. Establishing a causal link between sulfonylurea use and impaired hypoglycemia awareness was not within the scope of the study, as it was observational in nature. However, the study underscores the importance of monitoring hypoglycemia risk in individuals taking sulfonylurea medications over the long term and the need for regular healthcare provider consultations to mitigate potential complications.
