Glyburide in non-insulin-dependent diabetes: an update

Recent data suggest that non-insulin-dependent diabetes mellitus (NIDDM) may evolve in genetically predisposed individuals beginning with impaired peripheral glucose metabolism followed by insulin deficiency. Glyburide is an effective, long-acting, second-generation oral sulfonylurea introduced in the United States in 1984. In comparison with the first-generation sulfonylureas, glyburide is at least as effective, has a lower incidence of side effects, and may enhance postreceptor insulin activity to a greater degree. Glyburide can improve glycemic control, as evidenced by reduced fasting blood glucose concentrations and glycohemoglobin levels, without the inconvenience of insulin injections, the higher plasma insulin concentrations, and the additional training required to administer insulin. Because of its ability to enhance target tissue insulin action, glyburide also improves glycemic control in many NIDDM patients who have previously failed therapy with other sulfonylurea agents. Gluburide, as adjunctive therapy, may reduce the daily dosage needed by those who require insulin. Favorable pharmacokinetics and high inherent potency of glyburide often allow effective therapy when the drug is administered once a day.