Diabetes mellitus is a disorder of metabolism, the processes through which the body uses food that has been broken down by digestion. Most food is broken down into glucose, which the body can use for energy and growth. Glucose travels through the bloodstream to cells throughout the body. But glucose cannot enter the cells without the help of a hormone called insulin. Insulin is produced by the pancreas, a large gland beneath the stomach. In people with diabetes mellitus, the body does not have enough insulin to move the glucose into the cells. This may be because the pancreas does not produce enough insulin or because the cells do not respond to the insulin, even though plenty is produced. Either way, glucose builds up in the blood and passes out of the body in urine without ever having been used as fuel.
There are two types of insulin called Insulin-dependent diabetes mellitus and Non-Insulin-dependent diabetes mellitus. In Type 1 diabetes, the pancreas produces little or no insulin. People with this type of diabetes must take injections of insulin every day to stay alive. Type 2 diabetes is a condition where enough insulin is produced, but the bodies are unable to use it.
Consult your physician periodically while taking antidiabetic drugs. The physician will check to make sure the medicine is working as it should and will watch for unwanted side effects.
For this medicine to be effective, doses must be carefully balanced with meals and daily activity. Following all guidelines for diet, exercise, regular blood sugar testing, use of alcohol and tobacco, sick days, and preparation for emergencies is extremely important.
Older people may be especially sensitive to the effects of sulfonylureas, especially when they are taking more than one type of antidiabetic medicine. In addition, the early signs of low or high blood sugar may not be as noticeable in older people.
Children who have not reached puberty may be particularly sensitive to the effects of insulin and are more likely to have their blood sugar levels drop too low.
If seizures (convulsions), fainting, or unconsciousness occur during treatment with sulfonylureas or insulin, get medical help immediately.
Too much insulin or sulfonylurea may cause weight gain or low blood sugar. Check with a physician as soon as possible if weight gain or any of these signs of low blood sugar occur:
- Drowsiness (more than mild)
- Nightmares or fitful sleep
- Blurred vision
- Slurred speech
Other common side effects include dizziness, mild drowsiness, heartburn, changes in taste, changes in appetite, mild nausea, vomiting, stomach pain, fullness or discomfort in the stomach, constipation, frequent urination or increased urine output, usually go away as the body adjusts to the drug and do not require medical treatment unless they continue.
Diabetes drugs may interact with a number of other medicines. When this happens, the effects of one or both of the drugs may change or the risk of side effects may be greater. For example:
- Alcohol may cause low blood sugar problems to last longer than they normally would. Also, people who drink alcohol while taking antidiabetic drugs may have uncomfortable flushing of the face, arms, and neck.
- Many types of medicine may increase the chance of low blood sugar when taken with antidiabetic drugs. Examples are aspirin and other salicylates; medicines such as cimetidine (Tagamet) and ranitidine (Zantac), used to treat ulcers and heartburn; antifungal drugs such as fluconazole (Diflucan), ketoconazole (Nizoral), and miconazole (Monistat i.v.); medicine for infections, such as chloramphenicol (Chloromycetin) and ciprofloxacin (Cipro); and quinine, used to treat malaria.
- Other types of drugs may increase the chance of high blood sugar when taken with antidiabetic drugs. Some drugs that may have this effect are: corticosteroids; lithium, used to treat bipolar disorder (manic-depressive illness); and thiazide diuretics (a type of water pill).
The list above does not include all the drugs that may interact with antidiabetic drugs. Be sure to check with a physician or pharmacist before combining anti-diabetic drugs with any other medicine.