I. Glipizide XL Medication

Glipizide XL (Glipizide) is an oral blood-glucose-lowering drug of the sulfonylurea class. Glipizide XL is indicated as an adjunct to diet for the control of hyperglycemia and its associated symptomatology in patients with type 2 diabetes formerly known as non-insulin-dependent diabetes mellitus (NIDDM) or maturity-onset diabetes.

Antidiabetics: Information

Diabetes is a progressive disease. This means that as people with diabetes go through life, diabetes will change. So will the ways it needs to be treated. Sometimes diet and exercise are all that is needed to get blood glucose (sugar) levels back to a normal range. But when your blood glucose can't be controlled with diet and exercise alone, your doctor may prescribe medication to help you lower your blood glucose levels. Moving to new types of treatments, such as medication, does not mean failure. It just means that the body can no longer do its job on its own and needs a little help.

Oral medications prescribed for type 2 diabetes help control blood glucose by making more insulin, making insulin work better or by delaying the breakdown of sugars and starches. Some of these pills, either alone or when used with other treatments, may lower blood glucose levels too much. It is important to test blood glucose levels regularly and keep the doctor informed if the levels are consistently low.

Diabetes: Information

Diabetes is a disorder characterized by hyperglycemia or elevated blood glucose (blood sugar). Our bodies function best at a certain level of sugar in the bloodstream. If the amount of sugar in our blood runs too high or too low, then we typically feel bad. Diabetes is the name of the condition where the blood sugar level consistently runs too high. Diabetes is the most common endocrine disorder.

Diabetes is divided into two major subgroups: Type 1 diabetes and Type 2 diabetes. This division is based upon whether the blood sugar problem is caused by insulin deficiency (Type 1) or insulin resistance (Type 2). Insulin deficiency means there is not enough insulin being made by the pancreas due to a malfunction of their insulin producing cells. Insulin resistance occurs when there is plenty of insulin made by the pancreas (it is functioning normally and making plenty of insulin) but the cells of the body are resistant to it's action which results in the blood sugar being too high.

Type 1 Diabetes: Information

Type 1 Diabetes is much less common than Type 2 Diabetes and typically affects younger individuals. Type 1 Diabetes usually begins before age 40 although there are exceptions. In the United States, the peak age at diagnosis is around 14. Type 1 Diabetes is associated with deficiency (or lack) of insulin. It is not known why, but the pancreatic islet cells quit producing insulin in the quantities needed to maintain a normal blood glucose level. Without sufficient insulin, the blood glucose rises to levels, which can cause some of the common symptoms of hyperglycemia. These individuals seek medical help when these symptoms arise, but they often will experience weight loss developing over several days associated with the onset of their diabetes. The onset of these first symptoms may be fairly abrupt or more gradual.

Type 2 diabetes: Information

Type 2 Diabetes is more common than Type 1 Diabetes. Whereas Type 1 Diabetes is characterized by the onset in young persons (average age at diagnosis = 14), Type 2 Diabetes usually develops in middle age or later. This tendency to develop later in life has given rise to the term "adult onset diabetes". The typical Type 2 Diabetes patient is overweight although there are exceptions. In contrast to Type 1 Diabetes, symptoms often have a more gradual onset. Type 2 Diabetes is associated with insulin resistance rather than the lack of insulin like seen in Type 1 Diabetes. This often is obtained as a hereditary tendency from one's parents. Insulin levels in these patients are usually normal or higher than average but the body's cells are rather sluggish to respond to it. This lack of insulin activity results in higher than normal blood glucose levels.

Causes of Diabetes

In type 1 diabetes, the pancreas secretes little or no insulin. Unable to use glucose in the blood, the body tries to produce energy by burning fat and muscle. Type 1 diabetes usually develops before age 20.

Type 2 diabetes usually develops in people over age 40, and more likely in people who are overweight. Although this particular group of patients may have sufficient or even excessive amounts of insulin in their systems, their bodies are unable to use the hormone effectively - called insulin resistance. Excessive food intake boosts blood sugar levels, and the pancreas cannot produce enough insulin to convert the extra sugar into energy. Sometimes a similar form of this disease, called gestational diabetes, occurs as a temporary condition in women who are pregnant.

Risk Factors for Diabetes

Risk factors for type 1 diabetes include:

• Family history of type 1 diabetes
• Being white
• Having islet cell antibodies in the blood

Risk factors for type 2 diabetes include:

• Being overweight
• Family history of diabetes
• Being of Hispanic, African American, Native American, or Asian origin
• Being over 40 years of age
• Impaired glucose tolerance - a pre-diabetes condition in which blood sugar levels are too high after eating
• High blood pressure
• Abnormal blood cholesterol levels
• Heavy alcohol use
• Smoking
• History of gestational diabetes
• Women with polycystic ovary syndrome

The Role of Insulin in Diabetes

Diagram 3: The Role of Insulin: Carbohydrates that we eat make our blood glucose (sugar) rise. To utilize the carbohydrates and lower the blood sugar, insulin opens the doors of the body's cells to glucose circulating in the blood. The glucose enters the cells and is used as the cells' fuel for energy. Insulin binds to a spot on the cell surface called a receptor. Likened to a lock and key, insulin is the key that opens up the lock (receptor) so that glucose can pass through the door into the cell. Using this analogy in type 1 diabetes, the keys have been stolen (no insulin is made by the pancreas). In type 2, the door won't open fully even with the right key (insulin resistance).

Side effects of Antidiabetics

SERIOUS SIDE EFFECTS OF ANTIDIABETICS

Notify your health care provider as soon as possible if any of these symptoms occur:

Body as a whole

• urine - dark colored
• fever
• chills
• sweating
• weakness - unusual
• unsteady walk
• respiratory
• coughing up blood
• shortness of breath
• eyes, ears, nose, and throat
• yellow eyes
• sore throat
• vision problems
• skin
• itching, redness or inflammation
• yellow skin
• cool, pale skin
• gastrointestinal
• stool - light colored
• stomach pain - mild
• hunger - excessive
• nausea or vomiting (continuous)
• heart and blood vessels
• chest pain
• bleeding or bruising (includes internal loss of blood)
• heartbeat, rapid
• nervous system
• fatigue
• difficulty concentrating
• confusion
• drowsiness
• headache (continuous)

MINOR SIDE EFFECTS OF ANTIDIABETICS

These symptoms need no attention unless they become annoying:

Body as a whole

• taste, changes
• skin
• hives
• sensitivity to the sun, increased
• gastrointestinal
• appetite changes (increase or decrease)
• heart and blood vessels
• heartburn
• constipation
• diarrhea
• nervous system
• shortness of breath

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II. Useful links

http://www.cdc.gov/

http://www.fda.gov/

http://www.fda.gov/cder/ogd/

http://www.nih.gov/

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi

http://www.health.gov.on.ca/

National Library of Medicine

World Health Organization

http://www.mayoclinic.com/index.cfm

MedicineNet.com

Drugdigest.org

Healthsquare.com

Pharmacy sites

http://www.endocrineweb.com/diabetes/

http://www.endocrineweb.com/diabetes/2diabetes.html

Sanofi-Aventis

www.amaryl.com

Merck

drugdigest.org/DD/DVH/Uses/0,3915,298%7CAmaryl,00.html

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