Dangerous Sulfonylurea Side-Effects for Diabetes

SULFONYLUREA DRUG WARNINGS

Jan was almost a hundred pounds overweight. She came into my office because she was getting “tired spells,” headaches and severe fatigue that interfered with her work. Her doctor had put her on diabetes medications. But ever since then she had no energy and was getting these episodes. She was also horrified that she was gaining weight. Jan was worried what might happen to her if she continued taking these medications with such side-effects. She was hoping I could help get her off of them, even though her doctor said she would be on them for life.

After assessing Jan’s laboratory tests and medications, I reassured her that she did not need to take these medications for life. I could help her body and blood sugar return to normal. It turns out that she was given a medication that is commonly used in diabetes called glyburide, a sulfonylurea type medication that is known to cause all of these problems.

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What are Sulfonylureas?

The use of sulfonylurea medications to lower blood sugar began in the 1940s. It was found that sulfur-containing antibiotics would cause an increase in insulin from the pancreas. It wasn’t the sulfur, but the specific chemical antibiotics that blocked a certain calcium channel and caused excess insulin to be excreted in those who had insulin resistance.

The first generation of sulfonylurea drugs began to be marketed to those with high blood sugar in the 1950s. These include:

• Chlorpropamide (Diabinese)
• Tolazamide (Tolinase)
• Tolbutamide (Orinase, Tol-Tab)

In the 1980s, the second-generation agents became available:

• Glipizide (Glucotrol)
• Glyburide (DiaBeta, Glynase, Micronase)

The last class of sulfonylurea drugs came in 1995.

• Glimepiride (Amaryl)

Sulfonylureas lower blood sugar by causing a release of insulin from the pancreas. Thus, they require a working pancreas that can make insulin. Those with type 1 diabetes cannot benefit from this class of drugs.

Sulfonylurea Side-effects

Doctors often consider the desired effects of a medication, but downplay the side-effects. It is important to understand that all drugs are toxins and that they are not natural to the body. There is a desired part of toxicity – lowering blood sugar, for example – but there are other effects of toxicity that are undesirable.

When a sulfonylurea drug is introduced into the body, it targets not only the pancreas, but is distributed throughout every other system. It acts on a certain enzyme that affects how calcium enters the cells. So, wherever these calcium channels exist, the drug will block them, causing a certain effect. For example, nerve cells contain the same calcium channel so the sulfonylurea can damage nerve function.

Genetic differences increase susceptibility to the effects of sulfonylureas. Some people will get very ill. Others may die, while most are only mildly affected.

The “desired” effect of sulfonylureas is to increase insulin. However, there are several undesirable effects:

• Hypoglycemia (low blood sugar)
• Obesity
• Increased hunger, especially craving carbohydrates

The sulfonylureas class of drugs can block the liver from making more glucose (sugar). The result is extremely low blood sugar. The low blood sugar causes people to feel weak, tired, get headaches and feel pain all over. They also start craving sugar, causing them to eat more…and create additional fat.

Weight Gain from Sulfonylurea

One of the worst side-effects of sulfonylureas is obesity. First, sulfonylureas stop fat cells from using fat for energy. Second, because sulfonylureas increase insulin, this fat is deposited into cells. Together, sulfonylureas create more fat cells that aren’t used, which increases obesity.

Higher insulin also causes more insulin resistance, which increases fat, making diabetes worse. As blood sugar gets higher, doctors often increase the dose of the medications. This causes further toxicity to the calcium in the cell, eventually leading to cell death.

There is evidence that these medications also worsen diabetes by killing the very cells that make insulin in the first place.[1] Some with type 2 diabetes progress to type 1 diabetes. When the pancreas no longer produces insulin, the sulfonylurea medications don’t work, and the patient needs insulin injections for life.

Besides causing obesity, higher insulin levels are also associated with worse outcomes. One study that compared the outcomes of several different treatment regimens concluded, “…insulin was associated with higher rates of death, major cardiac and cerebrovascular events, and microvascular disease.”[2] There is a direct association with high insulin to complications such as stroke, heart disease and death.

Other areas that are known to be affected by the toxicity of sulfonylureas include:

• Liver
• Nerves
• Heart

Chlorpropamide (a drug in the sulfonylurea class) seemed to have an effect on the protein production in the liver, but wasn’t found in one study to cause hepatitis, or damage liver cells.[3] Thus, it may not directly cause hepatitis, but indirectly kills liver cells by increasing insulin and causing excessive storage of glycogen and fatty liver disease.

The nerves are also affected indirectly by decreasing the energy available to them. Nerves are very sensitive to energy production, and when there is not enough energy, the nerve cells die, causing neuropathy, or numbness and tingling in the hands and feet, as well as Alzheimer’s disease.[4]

Sulfonylureas affect the energy production of the heart because of their effect on the chloride channels, creating fatal arrhythmias and death. Because of the risk of cardiovascular death, the FDA requires a warning label such as this on sulfonylurea medications:

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SULFONYLUREAS WARNINGS

SPECIAL WARNING ON INCREASED RISK OF CARDIOVASCULAR MORTALITY The administration of oral hypoglycemic drugs has been reported to be associated with increased cardiovascular mortality as compared to treatment with diet alone or diet plus insulin. [5]

Even when blood sugar improves, these medications have not been shown to improve or prevent the complications of blood vessel disease.

Avoid Drugs to Reverse Diabetes

The best way to treat diabetes and avoid the complications of drugs is with a lifestyle program. Even doctors who want to help you with non-drug therapies will just exchange some vitamin or supplement pills for the drugs. This is called “Green Medicine,” but most often it still doesn’t get to the root of the problem. The supplements can be helpful, but only a full program designed to reverse the problem will do so. When the process that caused diabetes in the first place is reversed, then you will have no complications of diabetes, nor will you have to worry about the side-effects from any of the medication (because you won’t need it).

Complete diabetes reversal programs must include:

• Exercise
• Proper diet
• Supplements
• Stress-reduction
• Ongoing management

Medications only address the symptoms, never the cause. Supplements might have some effect on the cause of diabetes, if it is caused by a chromium deficiency, for example. However, to be successful, the program must address each of the issues that relate to diabetes in order to be able to reverse it.

Barton Publishing has a step-by-step program designed to reverse the cause of diabetes, and prevent the complications that can come with it. The simple instructions allow anyone to follow the program. Each potential cause of diabetes is addressed so you can reverse the root cause. I have been using this program in my office for over ten years with excellent results, allowing many to lose weight, get off of medications, and reverse their diabetes.

After completing this program, Jan lost almost 100 pounds. She was able to completely come off all of her diabetes medications and maintain normal blood sugar. She stopped getting hypoglycemia and had much more energy. Her endocrinologist was actually excited for her! She was worried about Jan getting worse, requiring more medications…and eventually insulin.

While sulfonylureas may lower blood sugar for a brief time, they do not address the problems of diabetes. Sulfonylureas actually make diabetes worse. I do not recommend the use of these medications in any form of diabetes. They don’t help type 1 diabetes because there is no insulin made in the pancreas, and they cause weight gain and increase insulin resistance for type 2 diabetes. If you are already on a sulfonylurea, it’s best to use a program like Barton Publishing’s Diabetes Solution Kit to reduce insulin resistance until you no longer need these medications. Plan with you doctor to do the tests needed to determine when it is best to come off of them.

If you liked this article, then you’ll love these:

• Metformin and Diabetes: Trouble in Paradise
• Leave it to Beaver to Reverse Your Type 2 Diabetes!
• Why Diabetes is Becoming Epidemic

 

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Dr. Scott D. Saunders, M.D. is a practicing physician, specializing in preventative health care, who utilizes eclectic health care for the whole family, including conventional, orthomolecular and natural medicine. He is also the medical director of The Integrative Medical Center of Santa Barbara in Lompoc, CA. He went to UCLA medical school and is board certified in family medicine. View natural remedies with Dr. Saunders at: http://drsaundersmd.com

 

 

 

Sources:
[1] (Maedler K, Carr RD, Bosco D, Zuellig RA, Berney T, Donath MY (2005). Sulfonylurea induced beta-cell apoptosis in cultured human islets” J Clin Endocrinol Metab 90:501–506).
[2] http://cardiab.biomedcentral.com/articles/10.1186/s12933-015-0172-9
[3] http://www.ncbi.nlm.nih.gov/pubmed/14113990
[4] http://www.lifeextension.com/magazine/2006/12/report_alzheimer/page-01
[5] http://www.accessdata.fda.gov/drugsatfda_docs/label/2009/017532s030lbl.pdf