Glyburide is a drug that is used to treat Type II diabetes. It is in the sulfonylurea class of anti-diabetic medications. There are some problems with this compound in that it can cause the levels of blood sugar to become dangerously low, a condition known as hypoglycemia. Also known as glibenclamide, this drug is frequently prescribed with the biguanide type of anti-diabetic drug metformin in a combination commonly known as Glucovance®.
The sulfonylureas evolved from sulfa antibiotics. They all have a similar mode of action. These compounds act on the pancreas to increase the amount of insulin released. Glyburide is a second generation type of sulfonylurea and has fewer side effects than earlier drugs in this class.
One side effect that is still a problem is a tendency to cause blood sugar levels to be too low, known as hypoglycemia. Generally, one thinks of diabetes as being a problem of blood sugar levels that are too high, known as hyperglycemia. Hypoglycemia can also be life threatening, causing coma and death. Studies have suggested an increased risk of mortality due to the possibility of hypoglycemia from the use of this drug.
An advantage of the biguanide class of anti-diabetic drugs, such as the widely used metformin, is that they do not have a tendency to cause hypoglycemia. Metformin is frequently combined with glyburide in one pill, which results in more effective treatment of Type II diabetes. The two drugs have different modes of action and work well in combination. There is some concern that this mixture may have dangerous side effects.
Glyburide is only effective in treating Type II diabetes. Most people with this type of disease can still produce insulin. Patients with Type I diabetes are incapable of producing insulin. Since the mode of action of this drug is to cause an increase in insulin, it will not help people who do not produce any at all.
There has been great concern about whether sulfonylurea drugs are safe to use during pregnancy to treat gestational diabetes. The fear was that they could cause birth defects in the fetus. More recent research with glyburide has indicated that it is safe to use during pregnancy. In addition, gestational diabetes generally does not occur until at least the second trimester. The drug would not be required during the first trimester, which is when most of the effects of drugs that cause mutation manifest their effects.