A recent Taiwanese study found a link between the use of sulfonylurea type 2 diabetes medications and a higher long-term risk of impaired awareness of hypoglycemic episodes. The study indicates that sulfonylurea users become less sensitive to the occurrence of hypoglycemic symptoms after five years of use due to recurrent hypoglycemic episodes. The reduced awareness of hypoglycemia caused by sulfonylureas was contrasted with the gradual decrease in insulin use.

A recent study found that long-term use of sulfonylureas, a class of type 2 diabetes medications, is linked to a higher risk of impaired awareness of hypoglycemia.
The study discovered that although both were associated with short-term elevated risk of hypoglycemia (a dangerously low blood sugar level), individuals taking sulfonylureas after five or more years had a roughly three-fold increased risk of hypoglycemia awareness impairment. The term impaired hypoglycemia awareness, or IHA, describes a diminished ability to recognize when blood sugar levels are too low, or even dangerously low. Years of recurrent hypoglycemic episodes can cause psychological desensitization to the condition’s symptoms and an awareness of when it is happening, which can lead to IHA.

Sulfonylureas: Some of the oldest diabetes drugs in use
Among the most established diabetes treatments, sulfonylureas were first identified in 1946 and made available for clinical use in 1956. They function by activating the pancreatic beta cells, which increase the production of insulin. Drugs like Glipizide, Glipizide ER, Glimepiride, and Glyburide are examples of sulfonylureas and are available in the US. These are some of the most affordable drugs for diabetes. There were 898 type 2 diabetics in the new study, which was carried out in Tainan City, Taiwan. Of them, 41.0 percent were on insulin and 65.1% were taking sulfonylureas.

The Gold and Clarke questionnaires, two commonly used measures, were used by the researchers to evaluate IHA. Their results were about the same in both measures. Age, sex, education, marital status, place of residence, employment, and living arrangement were among the sociodemographic factors taken into consideration. Other factors included self-reported diabetes-related medical care, anti-hyperglycemic agent use, disease and treatment histories, and living arrangements. IHA was a common side effect of both insulin and sulfonylurea users in the early years of treatment. Regarding the former, sulfonylurea patients with IHA had a presence rate of 65.3% on the Gold questionnaire and 51.3% on the Clarke questionnaire. The incidence among insulin users was 28.2 percent (Clarke) and 41.0% (Gold).

Why prescribe sulfonylureas over other diabetes drugs?
When patients don’t produce enough endogenous insulin to help control their blood sugar, insulin acts by substituting it. Insulin is recommended to help patients with higher blood sugar levels significantly and fairly quickly lower their blood sugar levels.
But he added that if the patient has slightly elevated blood sugar, sulfonylureas may be more effective, and they might not want to take insulin injections every day.

“Sulfonylureas primarily stimulate the pancreas to produce insulin and improve the function of endogenous insulin,” Ng continued. However, according to Ng, people with type 2 diabetes now have access to more medications than just insulin and sulfonylureas. He stated, “Newer blood sugar control medications operate through different mechanisms than sulfonylureas.”. The more recent drugs do not cause the pancreas to produce more insulin, so there is less chance of insulin overstimulation and hypoglycemia as there was in the past. “

How to prevent low blood sugar
The best way to prevent the negative effects of diabetes medication is to visit your doctor regularly. First, Ng advised people to check their blood sugar levels “every three months if possible to ensure that the levels are coming down effectively based on the prescribed medication, and then every six to twelve months once the levels are stable and at goal.”. The study’s authors discovered that reduced rates of IHA in their subjects were linked to routine blood glucose checks and retinal scans. A retinal scan enables a physician to check the retina’s small blood vessels for damage caused by abnormally high blood sugar, a condition known as diabetic retinopathy.

REFERENCES:
https://www.aol.com/common-diabetes-drug-may-desensitize-161500417.html
https://www.nih.gov/news-events/news-releases/two-popular-diabetes-drugs-outperformed-others-large-clinical-trial
https://www.healthline.com/health/diabetes/medications-list
https://www.drugs.com/condition/diabetes-mellitus-type-ii.html

Medications that have been suggested by doctors worldwide are available here
https://mygenericpharmacy.com/category/disease/diabetes