Diabetes Treatment Review

Hypoglycemia risk with oral antidiabetic drugs

Martin Gilmour of the Diabetic Hypoglycemia Editorial Team

Diabetic Hypoglycemia January 2009, Volume 1, Issue 3: page 17-18

Abstract

In many patients with type 2 diabetes, oral antidiabetic drug therapy with metformin alone does not result in adequate glycemic control, and a second oral antidiabetic agent (usually a sulphonylurea) may be included in the therapy regimen. The addition of a sulphonylurea improves glycemic control, but may also increase the risk of hypoglycemia.

This issue’s treatment review focuses on four publications on the incidence and effects of hypoglycemia in patients receiving oral antidiabetic drugs. The first paper assesses the incidence of hypoglycemia in patients receiving metformin or sulphonylureas, while two further articles evaluate patients receiving combination therapy, and the fourth investigates the prevalence of hypoglycemia in patients receiving metformin and a sulphonylurea in combination, evaluating effects on quality of life.

The review concludes that these studies provide strong evidence that treatment with sulphonylureas increases the risk of hypoglycemia in patients with type 2 diabetes. Adding sulphonylureas to metformin may achieve modest improvements in glycemic control, but substantially increases the risk of hypoglycemic episodes, which may promote high levels of worry and quality of life impairment among affected patients.

Keywords: hypoglycemia, oral antidiabetic drugs, glycemic control