Hypoglycemics: Insulin secretagogues

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Hypoglycemics: Insulin secretagogues

Medicine and surgery

Allergy and immunology

Antihistamines for allergies

Glucocorticoids

Cardiology, cardiac surgery and vascular surgery

Coronary artery disease: Clinical (To be retired)

Heart failure: Clinical (To be retired)

Syncope: Clinical (To be retired)

Hypertension: Clinical (To be retired)

Hypercholesterolemia: Clinical (To be retired)

Peripheral vascular disease: Clinical (To be retired)

Leg ulcers: Clinical (To be retired)

Adrenergic antagonists: Alpha blockers

Adrenergic antagonists: Beta blockers

ACE inhibitors, ARBs and direct renin inhibitors

Thiazide and thiazide-like diuretics

Calcium channel blockers

Lipid-lowering medications: Statins

Lipid-lowering medications: Fibrates

Miscellaneous lipid-lowering medications

Antiplatelet medications

Dermatology and plastic surgery

Hypersensitivity skin reactions: Clinical (To be retired)

Eczematous rashes: Clinical (To be retired)

Papulosquamous skin disorders: Clinical (To be retired)

Alopecia: Clinical (To be retired)

Hypopigmentation skin disorders: Clinical (To be retired)

Benign hyperpigmented skin lesions: Clinical (To be retired)

Skin cancer: Clinical (To be retired)

Endocrinology and ENT (Otolaryngology)

Diabetes mellitus: Clinical (To be retired)

Hyperthyroidism: Clinical (To be retired)

Hypothyroidism and thyroiditis: Clinical (To be retired)

Dizziness and vertigo: Clinical (To be retired)

Hyperthyroidism medications

Hypothyroidism medications

Insulins

Hypoglycemics: Insulin secretagogues

Miscellaneous hypoglycemics

Gastroenterology and general surgery

Gastroesophageal reflux disease (GERD): Clinical (To be retired)

Peptic ulcers and stomach cancer: Clinical (To be retired)

Diarrhea: Clinical (To be retired)

Malabsorption: Clinical (To be retired)

Colorectal cancer: Clinical (To be retired)

Diverticular disease: Clinical (To be retired)

Anal conditions: Clinical (To be retired)

Cirrhosis: Clinical (To be retired)

Breast cancer: Clinical (To be retired)

Laxatives and cathartics

Antidiarrheals

Acid reducing medications

Hematology and oncology

Anemia: Clinical (To be retired)

Anticoagulants: Warfarin

Anticoagulants: Direct factor inhibitors

Antiplatelet medications

Infectious diseases

Pneumonia: Clinical (To be retired)

Urinary tract infections: Clinical (To be retired)

Skin and soft tissue infections: Clinical (To be retired)

Protein synthesis inhibitors: Aminoglycosides

Antimetabolites: Sulfonamides and trimethoprim

Miscellaneous cell wall synthesis inhibitors

Protein synthesis inhibitors: Tetracyclines

Cell wall synthesis inhibitors: Penicillins

Miscellaneous protein synthesis inhibitors

Cell wall synthesis inhibitors: Cephalosporins

DNA synthesis inhibitors: Metronidazole

DNA synthesis inhibitors: Fluoroquinolones

Herpesvirus medications

Azoles

Echinocandins

Miscellaneous antifungal medications

Anti-mite and louse medications

Nephrology and urology

Chronic kidney disease: Clinical (To be retired)

Kidney stones: Clinical (To be retired)

Urinary incontinence: Pathology review

ACE inhibitors, ARBs and direct renin inhibitors

PDE5 inhibitors

Adrenergic antagonists: Alpha blockers

Neurology and neurosurgery

Stroke: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Headaches: Clinical (To be retired)

Migraine medications

Pulmonology and thoracic surgery

Asthma: Clinical (To be retired)

Chronic obstructive pulmonary disease (COPD): Clinical (To be retired)

Lung cancer: Clinical (To be retired)

Antihistamines for allergies

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Bronchodilators: Leukotriene antagonists and methylxanthines

Pulmonary corticosteroids and mast cell inhibitors

Rheumatology and orthopedic surgery

Joint pain: Clinical (To be retired)

Rheumatoid arthritis: Clinical (To be retired)

Lower back pain: Clinical (To be retired)

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Wrist and hand

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Foot

Acetaminophen (Paracetamol)

Non-steroidal anti-inflammatory drugs

Glucocorticoids

Opioid agonists, mixed agonist-antagonists and partial agonists

Antigout medications

Osteoporosis medications

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Hypoglycemics: Insulin secretagogues

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Transcript

Content Reviewers

Yifan Xiao, MD

Contributors

Alaina Mueller

Ursula Florjanczyk, MScBMC

Robyn Hughes, MScBMC

Evan Debevec-McKenney

Jake Ryan

Hypoglycemics are used to treat high blood sugar, a condition commonly known as diabetes mellitus.

As a quick review, Type 1 diabetes mellitus, which most commonly affects children and adolescents, arises when certain cells of the pancreas known as beta cells are unable to produce enough insulin to maintain normal blood glucose levels.

This is in contrast to Type 2 diabetes mellitus where the body is able to produce insulin, but the tissues don’t respond as well to it, or in other words, these individuals are insulin resistant.

In this video, we’ll be focusing specifically on the use of insulin secretagogues like sulfonylurea for the treatment of Type 2 diabetes.

In general, diabetes mellitus occurs when your body has trouble moving glucose from your blood into your cells.

This leads to high levels of glucose in your blood and not enough in your cells, and remember that your cells need glucose as a source of energy.

So not letting glucose enter, means that the cells starve for energy despite having glucose right on their doorstep.

Insulin reduces the amount of glucose in the blood by binding to insulin receptors embedded in the cell membrane of various insulin-responsive tissues like muscle cells and adipose tissue.

When activated, the insulin receptors cause vesicles containing glucose transporter that are inside the cell to fuse with the cell membrane, allowing glucose to be transported into the cell.

Now in Type 2 diabetes, the body usually makes insulin, but the tissues don’t respond as well to it.

The exact reason why cells don’t “respond” isn’t fully understood, but the cells don’t move their glucose transporters to their membrane in response, which if you remember, is needed for glucose to get into the cell, these cells are therefore insulin resistant.

Sources

  1. "Katzung & Trevor's Pharmacology Examination and Board Review,12th Edition" McGraw-Hill Education / Medical (2018)
  2. "Rang and Dale's Pharmacology" Elsevier (2019)
  3. "Goodman and Gilman's The Pharmacological Basis of Therapeutics, 13th Edition" McGraw-Hill Education / Medical (2017)
  4. "Sulfonylurea versus metformin monotherapy in patients with type 2 diabetes: a Cochrane systematic review and meta-analysis of randomized clinical trials and trial sequential analysis" CMAJ Open (2014)
  5. "Ion Transporters, Channelopathies, and Glucose Disorders" International Journal of Molecular Sciences (2019)
  6. "Meglitinide analogues: a review of clinical data focused on recent trials" Diabetes & Metabolism (2006)
  7. "CONSENSUS STATEMENT BY THE AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS AND AMERICAN COLLEGE OF ENDOCRINOLOGY ON THE COMPREHENSIVE TYPE 2 DIABETES MANAGEMENT ALGORITHM – 2019 EXECUTIVE SUMMARY" Endocrine Practice (2019)
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