Glyburide
- Class: Sulfonylurea
- Used for: type 2 diabetes
- Say it: GLYE-byoo-ride
- Forms: tablet
They close the beta cell's potassium channel directly, so insulin is released whatever the glucose is doing. That is why they cause hypoglycaemia and metformin does not.
These close the beta cell's potassium channel directly, releasing insulin whatever the blood sugar is doing. Glucose-independent is the phrase to hold on to: it is exactly why this class causes hypoglycaemia and weight gain, and why metformin does not. All drug suffixes ›
Side effects
Common: hypoglycemia, weight gain, nausea
Serious: prolonged severe hypoglycemia
Typical dose
2.5–10 mg daily
Avoid in the elderly and in renal impairment — it accumulates and causes prolonged hypoglycaemia.
Check yourself
Why does glyburide cause hypoglycaemia when metformin does not?
- It releases insulin regardless of the blood glucose level
- It blocks glucose absorption from the gut
- It makes tissues far more sensitive to insulin
- It stops the liver storing glycogen
Show answer
A. It releases insulin regardless of the blood glucose level
Metformin reduces hepatic glucose output and improves sensitivity, which cannot push glucose below normal on its own. A sulfonylurea forces insulin release whether or not it is needed — glucose-independent, and therefore capable of causing hypoglycaemia.
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