Interactions With Nondiabetes Drugs

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The subject is ill-documented, but whenever a diabetic under treatment takes other drugs it is prudent to be on the watch for disturbance of control.

fi-adrenoceptor blocking drugs impair the sympathetic mediated (p2-receptor) release of glucose from the liver in response to hypoglycaemia and also reduce the adrenergic-mediated symptoms of hypoglycaemia (except sweating). Insulin hypoglycaemia is thus both more prolonged and less noticeable. A diabetic needing P-adrenoceptor blocker should be given a Pj-selective member, e.g. bisoprolol.

Thiazide diuretics at a higher dose than generally now used in hypertension can precipitate diabetes, and it is wise to use low doses especially in established diabetes.

Hepatic enzyme inducers may enhance the metabolism of sulphonylureas that are metabolised in the liver (tolbutamide). Cimetidine, an inhibitor of drug metabolising enzymes, increases metformin plasma concentration and effect.

Monoamine oxidase inhibitors potentiate oral agents and perhaps also insulin. They can also reduce appetite and so upset control.

Interaction may occur with alcohol (hypoglycaemia with any antidiabetes drug).

Salicylates and fibrates can increase insulin sensitivity.

The action of sulphonylureas is intensified by heavy sulphonamide dosage and some sulphonamides increase free tolbutamide concentrations, probably by competing for plasma protein binding sites. These examples suffice to show that the possibility of interactions of practical clinical importance is a real one.

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Diabetes 2

Diabetes 2

Diabetes is a disease that affects the way your body uses food. Normally, your body converts sugars, starches and other foods into a form of sugar called glucose. Your body uses glucose for fuel. The cells receive the glucose through the bloodstream. They then use insulin a hormone made by the pancreas to absorb the glucose, convert it into energy, and either use it or store it for later use. Learn more...

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