Managing type 2 diabetes mellitus, also referred to as adult onset diabetes, type 2 diabetes, and T2DM, requires a multi-faceted approach. While lifestyle changes like diet and exercise can be effective at helping to slow or even reverse the progression of the disease, doctors may also recommend taking oral medication. In addition to metformin, glyburide is commonly prescribed to help lower blood sugar. 

Glyburide basics

Glyburide belongs to a class of medications known as sulfonylureas.[1],[5] As a whole, sulfonylureas are the oldest class of oral drugs used to manage type 2 diabetes, tracing their history back to the 1950s. 

When people with type 2 diabetes take glyburide, the drug stimulates the beta cells in the pancreas to produce more insulin. With an increase in the amount of natural insulin in the body, glucose can be moved into the cells to be used as energy. In addition, the medication also helps the body to use that insulin more efficiently. These two methods of action both result in ultimately lowering blood glucose levels. 

Glyburide is the generic name for this diabetes prescription medication and it is often sold under the brand name Glynase. 

How is glyburide taken?

Glyburide is an oral tablet that comes in 1.25 mg, 2.5 mg, and 5 mg dosages. The medication is also sold in two formulations — non micronized and micronized (meaning it has smaller particles and is metabolized more quickly).

The prescribing provider determines the appropriate dosing for glyburide, and the dose varies depending on the formula and various patient health factors. 

Nonmicronized glyburide is usually started in the 2.5–5 mg range and is prescribed once daily with a maximum dose of 20mg. Micronized glyburide is also once a day but started at a slightly lower dose of between 1.5–3 mg, with a maximum dose of 12 mg. 

No matter which formulation is prescribed, it’s recommended to take glyburide with breakfast (or the first main meal after waking up in the morning), although doses may be divided and given twice a day. Taking the medication with food can help lessen the odds of either blood sugar becoming too low and causing hypoglycemia, or gastrointestinal side effects such as nausea and diarrhea. 

Glyburide side effects

Like any other medication, there are potential side effects of glyburide. Many of these side effects are most likely to occur when first starting the medication or after a dosage increase. 

The most important side effect for type II diabetes patients to be aware of is the risk for developing either hypo- or hyperglycemia. Before starting on the medication, it is strongly urged that people become familiar with the symptoms of both conditions, if they are not already, so they are able to recognize the signs of an imbalance in blood sugar. 

Other common side effects of glyburide include[3]:

• Nausea (usually without vomiting).

• A feeling of fullness in the upper abdomen and bloating.

• Heartburn.

• Weight gain.

• Rash (an allergic skin reaction).

Less common side effects are also possible, including:

• Dizziness.

• Diarrhea.

• Light-colored stools.

• Dark-colored urine.

• Headache.

• Loss of appetite.

• Right upper quadrant abdominal pain.

• Unusual bruising.

• Sore throat.

• Yellowing of the skin or eyes.

Any unusual or severe side effects should be reported to and evaluated by the prescribing provider as soon as possible, as they may be a sign of an allergic reaction.

Individuals on glyburide should also consult their doctor about the safety of alcohol consumption. While some prescribers may advise that it’s permissible to drink small amounts of alcohol in moderation while taking this medication, there is also a possibility that it may worsen the length and severity of side effects. In rare cases, the combination may cause facial flushing, blurred vision, mental confusion, weakness, sweating, or difficulty breathing.

Interactions between glyburide and other medications

Before prescribing, medical providers will generally review the patient’s current medications, both over-the-counter (including herbal supplements) and prescription, to ensure there will be no significant drug interactions with glyburide. 

The primary potential interaction providers often look for is between glyburide and bosentan, a medication that decreases pulmonary arterial hypertension, but can also decrease the effectiveness of glyburide. 

In addition, glyburide should be used with caution when combined with the following medications (although, in some cases, a medical provider may still recommend glyburide if they believe the benefits of glyburide outweigh the risks of side effects). 

Please note this is not a comprehensive list.

• Aspirin.

• Atenolol.

• Carvedilol.

• Chloroquine.

• Ciprofloxacin.

• Enoxacin.

• Fenugreek.

• Hydroxychloroquine.

• Labetalol.

• Letermovir.

• Levofloxacin.

• Metoprolol.

• Psyllium.

• Propranolol.

• Teriflunomide.

• Warfarin.

Possible contraindications for glyburide use

Certain health conditions and predispositions may affect a patient’s ability to use glyburide safely. Any of the health issues below (as well as a comprehensive medical history) should be discussed with a doctor before using glyburide. 

• Underactive adrenal or pituitary glands.

• Malnourishment.

• Physical weakness.

• Other conditions (in addition to T2D) that may cause imbalances in blood sugar.

• Diabetic ketoacidosis (DKA).

• Glucose-6-phosphate dehydrogenase (G6PD) deficiency.

• Heart disease.

• Liver or kidney disease.

In addition, active fever, infection, trauma, or recent surgery may influence a patient’s blood sugar control. In these situations, glyburide alone may not be enough to manage the effects of diabetes. Other medications, including insulin injections, may be ordered by a diabetes specialist doctor to help temporarily control blood sugar.  

Combine glyburide with lifestyle changes for full effectiveness

Oral diabetes prescriptions like glyburide should generally be combined with lifestyle changes to help manage blood sugar levels and reduce the chances of type 2 diabetes complications. 

Specifically, this means eating a more diabetes-friendly diet and getting in the recommended amount of exercise.[4]

Diabetes diets are designed to help keep blood sugar in the normal range and prevent blood sugar spikes as much as possible. The main way they do this is by reducing the number of simple carbohydrates in the diet, which are often the cause of uncontrolled spikes in blood sugar. 

Examples of simple carbs include anything with high fructose corn syrup, like soda and fruit juice, as well as anything made with white flour, such as white bread and tortillas. However, some carbs are still needed to provide the body with the energy it requires to function.

Those carbohydrates are better obtained from a second category of carbs known as complex carbs. Complex carbs take longer to break down into sugar, which means they don’t typically cause the same spike that simple carbs tend to. Whole grains, fresh vegetables, steel-cut oats, and beans are all healthy examples of complex carbs. 

For people newly diagnosed with type 2 diabetes and type 1 diabetes alike, a consultation with a medical provider or dietician can help clarify the best diet plan for their specific needs. 

Exercise is also a vital part of combating the potential side effects of diabetes. When people with type 2 diabetes mellitus are physically active, it can help increase insulin sensitivity in the body, making insulin more efficient at using glucose, reducing chances of hyperglycemia.

For all adults, a minimum of 150 minutes a week (30 minutes a day, five days a week) of moderate-intensity activity (swimming, walking briskly, bicycling) is recommended. Not only does exercise help with the management of blood glucose, but it can also help keep obesity at bay, which is one of several preventable type 2 diabetes risk factors. 

Can glyburide be used for type 1 diabetes mellitus?

Type 2 diabetes mellitus is a condition that, at its core, is the body’s inability to properly use or produce enough insulin to safely manage blood sugar levels. With this form of diabetes, the beta cells in the pancreas can still typically produce some insulin — the problem usually stems from the insulin not being able to properly do its job to move glucose out of the blood, whether due to insulin sensitivity issues or there simply not being enough insulin present. 

Type 1 diabetes mellitus (previously known as insulin-dependent diabetes mellitus) works differently. This type of diabetes is an autoimmune condition that often starts in childhood, though it can be diagnosed in adults as well. Instead of producing at least some insulin, type 1 diabetics do not produce any because the body destroys its own pancreatic cells, preventing the pancreas from producing insulin. That is why it was previously referred to as insulin-dependent diabetes, as individuals with this condition need injectable insulin to keep their blood sugar in check.

Unfortunately, that means that type 1 diabetics cannot use glyburide, as the drug depends on the body’s production of at least a small amount of insulin to be effective. 

Consult about glyburide online

Not everyone has access to medical care when they need it. Luckily, now more than ever,  affordable online doctor help is available. After a thorough medical evaluation via video consultation, online physicians may be able to prescribe medication for diabetes, high blood pressure, thyroid insufficiency, and birth control for people who qualify. 

The patient must schedule an online doctor appointment to meet with their potential prescriber to review their medical history and review their diabetes. Once the medication has been discussed and approved, the appropriate prescription is usually sent to a local pharmacy of the patient’s choosing. Most prescriptions are filled within just a few hours, making it a quick, affordable, and efficient way for people to obtain prescription medications without having to wait for an in-person appointment with their family doctor or specialist. 

Summary

Type 2 diabetes mellitus is a life-changing condition, but with the right combination of medications and healthy lifestyle choices, it can be safely and effectively managed. 

For people with adult onset diabetes interested in discussing whether or not glyburide is appropriate for them, or people needing a refill on their current medications, HealthTap offers affordable virtual visits with a trained medical provider. This helps put online doctor help within everyone’s reach, no matter where they live, 24 hours, 7 days a week. 

Get started with HealthTap here — your personal doctor, one tap away.