Depending on the sulphonylurea, once-daily administration, about half an hour before breakfast, is initially feasible. With the exception of gliclazide and acetohexamide, sulphony-lureas are available generically at low cost. Sulphonylureas are unique among the oral agents in producing weight gain. This can be disconcerting to the already obese individual, and increased weight may heighten the risk of cardiovascular morbidity and increase the degree of insulin resistance present in NIDDM patients. Sulphonylureas exert no direct effects on cholesterol or triglyceride levels, although a modest improvement may be observed, secondary to improvement in glycemic control. Shop online to always get Buy Cheap Claritin enjoying safe and quick shopping.
Biguanides have been in clinical use for as long as the sulphonylureas. Cheap Metformin is considered to be as effective as a sulphonylurea for initial monotherapy. Reductions in FPG and HbA1c are, on average, 20% to 30% of baseline values (eg, 2.2 to 4.4 mmol/L and 1.5% to 2.0%, respectively). One exception to this rule may be nonobese patients presenting with more severe fasting hyperglycemia, which may be indicative of a more severe deficiency in insulin secretory capacity. In its clinical practice guidelines, the Canadian Diabetes Association indicated that a sulphonylurea may produce greater improvement than metformin in patients with FPG greater than 13 mmol/L.