What is Glimepiride?
Glimepiride is an oral antidiabetic medication from the sulfonylurea class of drugs. It is available as a prescription drug; the brand name is Amaryl. Glimepiride is chemically related to glyburide, another sulfonylurea; glimepiride is more potent as a glucose-lowering agent and has a longer duration of action [1, 2].
What does Glimepiride do?
Glimepiride (Amaryl) stimulates insulin secretion from pancreatic beta cells that are still functioning, leading to the release of insulin in proportion to blood glucose levels; the hormone helps to move sugar (or glucose) from the blood into your body’s cells to be utilized as fuel. In people who have type 2 diabetes, the body either doesn’t make enough insulin, or can’t use the insulin it makes, and as a result, blood sugar levels go too high [1, 2].
Glimepiride is a drug used as an adjunct to diet and exercise for non-insulin-dependent diabetes mellitus – an endocrine disorder causing high blood sugar levels. Glimepiride may be used alone or in combination with other drugs like metformin or insulin to treat these elevated blood sugar levels. Low risk with a dose of 1-8 mg/day In the dose range of 1-8 mg/day, glimepiride should be well tolerated with hypoglycaemia being one of the least likely side-effects in the pipeline [1, 3].
Side Effects of Glimepiride
Glimepiride is prescribed for the treatment of type 2 diabetes. Side effects may include low blood sugar, manifested as anxiety, blurred vision, cold sweat, confusion, drowsiness, dizziness, excessive hunger, fast heartbeat, headache, nausea, nervousness, nightmares, profuse perspiration, shakiness, slurred speech, weakness and chills, weight gain [2].
In some cases, glimepiride can cause severe side effects. These include severe low blood sugar, which can lead to mood changes, confusion, sleepiness, blurred vision, headaches, lack of coordination, and even seizures or unconsciousness. Allergic reactions, such as anaphylaxis, angioedema, and Stevens-Johnson syndrome, can also occur [2].
Liver damage is one of the most serious side effects of glimepiride, and symptoms can include jaundice (a yellow discolouration of the skin and whites of the eyes), abdominal pain and tenderness, itchiness, discoloured urine and easy bruising. Severe adverse effects include low blood cell counts, which can lead to infections or prolonged bleeding, and low levels of sodium, which can manifest as nausea, headache, confusion, fatigue, lethargy, restlessness, involuntary muscle movements, seizures and even coma [2].
Effects of Glimepiride on Diet
Glimepiride is a type 2 diabetes drug. Like most medications meant for the disease, glimepiride improves blood sugar control by making the pancreas release extra insulin. However, the effects of glimepiride can extend far beyond blood sugar, strongly influencing patterns of food intake, physical activity, and digestion.
Another diet-impacting effect of glimepiride is body weight. One study determined that type 2 diabetic patients who were treated with glimepiride for 12 months showed lower body weight and body mass index, compared with those who were treated with glibenclamide, a potential antihyperglycemic agent [4].
Glimepiride also modified the levels of some exogenous metabolites. After an injection of this drug, researchers saw profound shifts in metabolites collected in the urine, including those of adenosine 3', 5'-cyclic monophosphate, a metabolite associated with insulin secretion [5].
Moreover, glimepiride enhances GLUT4 protein content in oxidative muscle by 50% and this in turn improves the muscle’s ability to process glucose. This could influence the use of dietary glucose utilisation and insulin sensitivity [6].
Still, while glimepiride can influence these components of diet and metabolic physiology, it is no substitute for a healthy diet. Patients taking glimepiride need to continue following a balanced diet and continue normal exercise regimes to take care of their diabetes.
What foods should be avoided while taking Glimepiride?
When taking Glimepiride, a medication used to treat type 2 diabetes, it's important to be mindful of certain foods and beverages that could interact with the drug.
Firstly, avoid alcohol as this will amplify the effect of the Glimepiride, leading to a risk of low blood sugar, called hypoglycaemia [2].
Secondly, reduce the amount of high-fat and sugary foods (especially refined or processed foods) in your diet. Weight gain can make it harder for people with diabetes to manage their condition (food energy balance) [7].
Third, although not specific to Glimepiride, it is worth mentioning that grapefruit and grapefruit juice react with many medicines, in particular certain drugs used to treat diabetes. Talk over with a specialist whether you’d better not consume grapefruit if you’re taking Glimepiride [7].
Just remember to talk with your healthcare provider about your diet and potential food-drug interactions – they can offer personalised advice based on your unique state of health and medication regimen.