Mitch was previously diagnosed with T2DM. He admits that he often does not take his medications. What types of medications are metformin and glyburide? Describe their mechanisms as well as their potential side effects/drug-nutrient interactions

Question

What will be an ideal response?

Answer 1

Metformin is a biguanide and is also referred to as Glucophage. It decreases hepatic glucose production or gluconeogenesis and improves insulin resistance by increasing insulin uptake in the muscles. There are very few side effects with metformin, which is why it is commonly used as the initial drug of choice for type 2 diabetes. Hypoglycemia is not a side effect with metformin like it is with the other glucose-lowering medications.
Potential side effects:
• Diarrhea
• Nausea
• Bloating
• Anorexia
• Flatulence
• Lactic acidosis (although this is very rare)
Drug-nutrient interactions:
• Decreases folate and vitamin B12 absorption (may need supplementation of these vitamins)
• Avoid alcohol
• Needs to be taken with meals to help avoid GI distress or symptoms of nausea, diarrhea, flatulence, etc.
Glyburide is a second-generation sulfonylurea agent. Sulfonylurea drugs work by stimulating insulin secretion from the beta cells of the pancreas. It can only be used in individuals with type 2 diabetes because insulin production is necessary in order for the mechanism of this drug to be effective. Hypoglycemia can be a potential side effect when using sulfonylurea drugs, especially glyburide. Hypoglycemia is the main side effect associated with this medication (weight gain and contraindicated with renal insufficient patients, too). Since glyburide increases insulin secretion, more than enough insulin may be released into the blood, which can lead to hypoglycemia.
Drug-nutrient interactions: Avoid alcohol; take once before breakfast (30-60 min. prior)