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Sulfonylurea/Biguanide Combination
Recently, a new medication came to the market that combines two medications--metformin and glyburide. Metformin is classified as a biguanide and glyburide is classified as a sulfonylurea. Many times, these two drugs are given together in the treatment of diabetes. Combining them into one tablet may help with patient compliance, but it also may make dosing adjustments more tricky.
Sulfonylureas lower
levels of glucose in the blood by stimulating the production of insulin. The
first sulfonylureas were introduced in the 1950's. Newer "second
generation" sulfonylureas have fewer of the side effects associated with
the first generation products.
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Sulfonyureas stimulate cells in the
pancreas to release more insulin.
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The exact mechanism of the biguanides is not known, but the effects are well documented. Biguanides reduce insulin resistance in muscle cells and decrease the release of glucose from the liver. They also reduce the absorption of glucose in the small intestine, and may enhance insulin sensitivity inside the cell, as well as stimulate the disposal of glucose.
Because biguanides do not stimulate insulin secretion, they do not cause as much hypoglycemia (low blood sugar) compared to other diabetes medications. Biguanides may cause weight loss, which can be beneficial in obese patients. Drugs in the class
Glyburide and Metformin (Glucovance)
Glipizide and Metformin (Metaglip) | 
