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Amaryl the Latest Generation of Sulfonylureas Against Type 2 Diabetes

The core of diabetes problem is the complete or partial crash of hormone insulin production in the human body. Unlike type 1 diabetes, when there is no insulin produced in the human body, in type 2 diabetes some amount of this hormone is still produced. However, one of the key problems in type 2 diabetes is that the amount of produced insulin is insufficient for maintaining all the sugar a human received from food. This results in the elevated levels of blood sugar or glucose, which is removed from the organism with urine instead of being used as the energy for supplying body cells. 

Since insulin is produced by beta cells of the pancreas, scientists have always searched for the ways to fix this problem and stimulate pancreas to produce more insulin. One of the methods to achieve the goal emerged at the times of World War 2. At that time French pharmacologist Marcel Janbon was experimenting with the drug called sulfonylurea, trying to find the remedy against typhoid. By pure accident the scientists noted that this drug caused a drastic drop of the blood sugar in animals. That discovery made the beginning of the new way of type 2 diabetes treatment with the help of oral medications, called sulfonylurea drugs.

Since that time, several generations of sulfonylureas were developed, and Amaryl or glimepiride by generic name represents the latest (third) generation of this class of anti-diabetes medications. Glimepiride was approved by the U.S. Food and Drug Administration in 1995. Since then the medication is marketed by Sanofi Aventis under the brand name Amaryl.  

In treating diabetes, Amaryl helps to lower blood glucose level. Clinical studies showed that this goal is achieved due to the ability of Amaryl to stimulate beta cells in pancreas to produce more insulin. The latter turns glucose into energy, and thus the level of blood sugar is kept under control.

The medication is considered to be effective as initial drug therapy. Usually, the medication is prescribed to the patients, who cannot achieve blood sugar control with the help of special diet and exercising only. However, it should be noted that Amaryl should not be treated as a substitute of non-medical options to treat diabetes. Only the combination of healthy diet, exercising and Amaryl can provide a therapeutic effect.

Amaryl is available in three dosages: 1mg, 2 mg and 4 mg. The initial dose is 1 mg daily, which may be increased up to 2 mg or 4 mg based on the particular case of diabetes. The pill should be taken with breakfast or the first main meal. Sometimes the treatment plan may include the combination of Amaryl and metformin in order to increase the effectiveness of the therapy. Amaryl can also be prescribed in addition to insulin injections, but in that case doctors and patients should be very careful to avoid hypoglycemia (when the levels of blood sugar are extremely low).

Speaking about adverse reactions of Amaryl, it should be noted that the decrease of blood sugar below normal level (hypoglycemia) may happen, and this is, perhaps, the most serious, but, happily, rare side effect. According to the data received from clinical studies about 0.7-1.7% of patients treated with Amaryl may be exposed to this condition. Other side effects include dizziness (1.7%), asthenia or physical weakness (1.6%), headache (1.5%) and nausea (1.1%). The occurrence of some gastrointestinal adverse reactions (abdominal pain, vomiting, diarrhea), as well as allergic skin reactions, hematologic and metabolic reactions have also been reported; however, the rate of those reactions are below 1%, so they are not statistically meaningful.

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Finally, it is important to add that Amaryl should not be taken by people allergic to glimepiride and those, who are in the state of diabetic ketoacidosis. Besides, some medications may also influence the effectiveness of Amaryl. These include non-steroidal anti-inflammatory drugs (common pain killers), MAO antidepressants, salicylates, sulfonamides, chloramphenicol, coumarins, probenecid, and beta adrenergic blocking agents.


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