Requirement of High Dosage of Insulin in Previous Users of Glibenclamide with Uncontrolled Diabetes

     Patients who were using glibenclamide(glyburide), a commonly used sulphonyl urea (Daonil,Glucored forte etc), required more insulin later to control diabetes. Studies suggest that forcing β cells to secrete insulin when it is struggling to cope with demands accelerates its demise.

     In a Swedish study newly diagnosed T2DM were given insulin or glibenclamide. A1c improved identically during 1st year but thereafter deteriorated in glibenclamide group.

     Early initiation of insulin therapy in T2DM and avoidance of 1st generation SU like glibenclamide will help prevent rapid deterioration in β cells and also reduce dosages of insulin in future. This observation has a major impact on economics of diabetes when more and more T2DM subjects live longer and eventually all of them requiring escalating dosages of insulin to sustain life.