Both glyburide and glipizide provide safe and effective treatment for patients with non-insulin-dependent diabetes mellitus, but more patients will benefit from once-daily therapy with glyburide .
Appropriate studies performed to date have not demonstrated geriatric -specific problems that would limit the usefulness of glipizide in the elderly . However, elderly patients are more likely to have age-related heart, liver, or kidney problems which may require caution in patients receiving glipizide .
Earlier this year, The American Geriatrics Society updated the Beers Criteria for potentially inappropriate medication use in older adults. Glyburide was added to this list due to prolonged hypoglycemic side effects more commonly seen in older patients.
“In these patients, we now know that glimepiride appears to be safer than the other commonly prescribed sulfonylureas, glipizide and glyburide, available in the United States.”
According to a double-blind, clinical trial, metformin showed a greater cardioprotective effect than glipizide after a period of five years. Another comparative trial found that metformin provided better blood sugar control than glipizide .
COMMON side effects Constipation . Diarrhea . Dizziness . Drowsiness . Gas. Headache . Muscle Tremors. Nausea .
For those with a contraindication or intolerance to metformin, a short-acting sulfonylurea like glipizide is recommended as initial therapy. Long-acting sulfonylureas like chlorpropamide , glyburide , and glimepiride aren’t recommended for older patients due to increased risk for hypoglycemia.
Glyburide use should be avoided in patients with severe kidney impairment as defined by a GFR of less than 60 mL/min (CKD stage 3 and below). Because 50 percent of the glyburide is excreted by the kidneys , the drug can build up in people with CKD, causing low blood sugar levels.
Glyburide may build up in your body, which can cause lower blood sugar levels. For people with liver disease : Your doctor may lower your dosage of glyburide if you have liver damage or liver disease .
Metformin is still the safest and most effective type 2 diabetes medication, said Bolen. She is an assistant professor of medicine at Case Western Reserve University’s Center for Health Care Research and Policy, in Cleveland.
Glipizide can cause low blood sugar (hypoglycemia). If you don’t treat low blood sugar, you can have a seizure, pass out, and possibly develop brain damage. Low blood sugar can even be fatal.
Advertisement. Glyburide causes your pancreas to release more insulin into the bloodstream. Metformin reduces the absorption of sugar from the stomach, reduces the release of stored sugar from the liver, and helps your body use sugar better .
Previous research indicates that the diabetes drugs sitagliptin and glipizide may not cause considerable kidney damage. New clinical trial results presented during the American Society of Nephrology’s Annual Kidney Week compared the two drugs.
Glipizide begins working in approximately 30 minutes to an hour. Since this drug increases insulin secretion, it is recommended that you take it before meals to reduce the risk of hypoglycemic episodes. If you take it only once a day, it’s best to do so prior to the largest meal of the day, or with breakfast.
Some medicines that control your blood sugar, like glipizide ( Glucotrol ) and glyburide (DiaBeta), can make you gain weight . A better option may be a drug like metformin (Glucophage) or sitagliptin (Januvia), which will help you manage diabetes and lose a few pounds.