Nutrition Assessment


Box 2.15 (cont.) Glucose-Lowering Medications for Type 2 Diabetes4,14


• Advantages: Extensive experience; no hypoglycemia; decrease in cardiovascular disease (CVD) events; low cost


• Disadvantages: gastrointestinal (GI) side effects (diarrhea, abdominal cramping); lactic acidosis (rare); vitamin B-12 deficiency


• Usual dosage information:


○ Glucophage: 500 mg/d twice daily with meals, increase by 500 mg every 1–3 wk, 2 or 3 times daily; usually most effective at 2,000 mg/d; maximum 2,550 mg/d


○ Glucophage XR: 500 mg once daily; maximum 2,000 mg once daily


Sulfonylureas (second generation)


• Examples: ○ Glipizide (Glucotrol and Glucotrol XL) ○ Glyburide (Glynase PresTab) ○ Glimepiride (Amaryl) • Expected decrease


decrease): 1%–2%


• Principal action: Stimulate insulin action from pancreatic beta cells


• Advantages: Extensive experience; decrease in microvascu- lar risk; low cost


• Disadvantages: Hypoglycemia; weight gain; loss of response with time


• Usual dosage information:


○ Glucotrol: 2.5–20 mg once or twice daily; maximum 40 mg/d


○ Glucotrol XL: 2.5–10 mg once or twice daily; maximum 20 mg/d


○ Glynase: 1.5–3 to 12 mg/d; maximum 12 mg/d ○ Amaryl: 1–8 mg/d; maximum 8 mg/d


Meglitinides (glinides)


• Examples: ○ Repaglinide (Prandin)


Continued on next page.


41


in HbA1c with monotherapy


(unit


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