{"id":217,"date":"2023-08-23T15:02:05","date_gmt":"2023-08-23T19:02:05","guid":{"rendered":"https:\/\/ca.beyondtype2.org\/fr\/?p=217"},"modified":"2023-09-02T18:24:44","modified_gmt":"2023-09-02T22:24:44","slug":"tout-sur-les-sulfonylurees","status":"publish","type":"post","link":"https:\/\/ca.beyondtype2.org\/fr\/tout-sur-les-sulfonylurees\/","title":{"rendered":"Tout sur les sulfonylur\u00e9es"},"content":{"rendered":"<p><span style=\"font-weight: 400\">Tous les types de diab\u00e8te n\u00e9cessitent un traitement personnalis\u00e9. Cela signifie qu\u2019il faut suivre un plan et un traitement pr\u00e9cis qui r\u00e9pondent aux exigences et aux besoins du patient. Il existe divers m\u00e9dicaments, appel\u00e9s <\/span><a href=\"https:\/\/beyondtype2.org\/the-type-2-guide-to-oral-medications\/\"><span style=\"font-weight: 400\">m\u00e9dicaments oraux<\/span><\/a><span style=\"font-weight: 400\">, qui ont diff\u00e9rentes fonctions.<\/span><\/p>\n<p><span style=\"font-weight: 400\">L\u2019article d\u2019aujourd\u2019hui porte sur les sulfonylur\u00e9es, les premiers m\u00e9dicaments oraux qui, outre la <\/span><a href=\"https:\/\/beyondtype2.org\/all-about-meformin\/\"><span style=\"font-weight: 400\">metformine<\/span><\/a><span style=\"font-weight: 400\">, ont \u00e9t\u00e9 utilis\u00e9s \u00e0 grande \u00e9chelle pour la prise en charge du diab\u00e8te. Voici quelques-unes des sulfonylur\u00e9es couramment utilis\u00e9es\u00a0:<\/span><\/p>\n<p><b>Noms de marque<\/b><span style=\"font-weight: 400\"> (d\u00e9nomination commune)<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><b>Amaryl<\/b><span style=\"font-weight: 400\"> (glim\u00e9piride)<\/span><\/li>\n<li style=\"font-weight: 400\"><b>DiaBeta<\/b><span style=\"font-weight: 400\">\u00a0(glyburide)<\/span><\/li>\n<li style=\"font-weight: 400\"><b>Diamicron<\/b><span style=\"font-weight: 400\"> (glycazide)<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400\">Pendant de nombreuses ann\u00e9es, les sulfonylur\u00e9es ont \u00e9t\u00e9 consid\u00e9r\u00e9es comme des m\u00e9dicaments de premi\u00e8re intention pour le traitement du diab\u00e8te de type\u00a02. \u00c0 l\u2019heure actuelle, dans certains pays, l\u2019utilisation de la <\/span><a href=\"https:\/\/beyondtype2.org\/all-about-meformin\/\"><span style=\"font-weight: 400\">metformine<\/span><\/a><span style=\"font-weight: 400\"> est privil\u00e9gi\u00e9e aux premiers stades du traitement, et les sulfonylur\u00e9es sont utilis\u00e9es chez les personnes qui ne tol\u00e8rent pas la metformine (qui pr\u00e9sentent de graves effets secondaires) ou \u00e0 des doses plus faibles en association avec la metformine.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Dans la mise \u00e0 jour de 2018 et le consensus de l\u2019<\/span><a href=\"https:\/\/care.diabetesjournals.org\/content\/41\/12\/2669?ijkey=c42ec7e11b5790d331055af5d95177d70b3af36f&amp;keytype2=tf_ipsecsha\"><span style=\"font-weight: 400\">ADA\/EASD<\/span><\/a><span style=\"font-weight: 400\">, la recommandation sur le choix d\u2019une sulfonylur\u00e9e indique d\u2019opter pour la derni\u00e8re g\u00e9n\u00e9ration de m\u00e9dicament en raison du risque r\u00e9duit d\u2019<\/span><a href=\"https:\/\/beyondtype2.org\/hypoglycemia-and-how-to-treat-it\/\"><span style=\"font-weight: 400\">hypoglyc\u00e9mie<\/span><\/a><span style=\"font-weight: 400\">, le choix le plus repr\u00e9sentatif \u00e9tant le glim\u00e9piride et le gliclazide \u00e0 lib\u00e9ration modifi\u00e9e (lib\u00e9ration pendant une p\u00e9riode de 24 heures). Les lignes directrices de Diabetes Canada, parues en 2020, comprennent un <a href=\"https:\/\/guidelines.diabetes.ca\/CDACPG\/media\/images\/Ch13-2020-Fig2A-Reviewing-adjusting-or-advancing-therapy-in-type-2-diabetes.png\">tableau qui indique dans quelles situations les sulfonylur\u00e9es et d\u2019autres m\u00e9dicaments doivent \u00eatre recommand\u00e9s aux patients<\/a>.<\/span><\/p>\n<h3><b>Comment les sulfonylur\u00e9es agissent-elles?<\/b><\/h3>\n<p><span style=\"font-weight: 400\">Les sulfonylur\u00e9es agissent en stimulant la s\u00e9cr\u00e9tion d\u2019insuline \u00e0 partir des cellules b\u00eata du pancr\u00e9as, peu importe la concentration de glucose. Cela signifie qu\u2019elles feront en sorte que votre pancr\u00e9as produira (s\u00e9cr\u00e9tera) de l\u2019insuline, quelle que soit votre glyc\u00e9mie (sucre). Toutefois, certaines \u00e9tudes montrent qu\u2019\u00e0 certaines concentrations th\u00e9rapeutiques, les sulfonylur\u00e9es stimulent la s\u00e9cr\u00e9tion d\u2019insuline en fonction de la glyc\u00e9mie.<\/span><\/p>\n<h3><b>Classification des sulfonylur\u00e9es<\/b><\/h3>\n<p><span style=\"font-weight: 400\">Les sulfonylur\u00e9es sont divis\u00e9es ou class\u00e9es par \u00ab\u00a0g\u00e9n\u00e9rations\u00a0\u00bb\u00a0:<\/span><\/p>\n<ol>\n<li><span style=\"font-weight: 400\">a)\u00a0Sulonylur\u00e9es de premi\u00e8re g\u00e9n\u00e9ration\u00a0: Cette cat\u00e9gorie comprend notamment le tolbutamide, le tolazamide et le chlorpropamide. Ces m\u00e9dicaments \u00e9taient utilis\u00e9s au milieu du si\u00e8cle dernier.<\/span><\/li>\n<li><span style=\"font-weight: 400\">b) Sulonylur\u00e9es de deuxi\u00e8me g\u00e9n\u00e9ration : Cette cat\u00e9gorie comprend le\u00a0 glyburide et le gliclazide. Ces m\u00e9dicaments sont plus puissants et donnent de meilleurs r\u00e9sultats.<\/span><\/li>\n<li><span style=\"font-weight: 400\">c) Sulonylur\u00e9es de troisi\u00e8me g\u00e9n\u00e9ration : Cette cat\u00e9gorie comprend notamment le glim\u00e9piride.<\/span><\/li>\n<\/ol>\n<h3><b>Effets secondaires et risques<\/b><\/h3>\n<p><span style=\"font-weight: 400\">Les sulfonylur\u00e9es ne sont pas indiqu\u00e9es pour le traitement du pr\u00e9diab\u00e8te en raison de leurs effets ind\u00e9sirables potentiels et du risque d\u2019<\/span><a href=\"https:\/\/beyondtype2.org\/hypoglycemia-and-how-to-treat-it\/\"><span style=\"font-weight: 400\">hypoglyc\u00e9mie<\/span><\/a><span style=\"font-weight: 400\">, et parce que les donn\u00e9es probantes sur leur efficacit\u00e9 pour la pr\u00e9vention du diab\u00e8te sont insuffisantes. Les autres effets secondaires sont la prise de poids et l\u2019\u00e9puisement de la r\u00e9serve pancr\u00e9atique (diminution de la fonction pancr\u00e9atique).<\/span><\/p>\n<h3><b>Bienfaits \u00e9prouv\u00e9s<\/b><\/h3>\n<p><span style=\"font-weight: 400\">Les sulfonylur\u00e9es se sont av\u00e9r\u00e9es utiles pour abaisser la glyc\u00e9mie et le taux d\u2019<\/span><a href=\"https:\/\/beyondtype2.org\/understanding-your-a1c\/\"><span style=\"font-weight: 400\">h\u00e9moglobine glyqu\u00e9e (HbA<\/span><span style=\"font-weight: 400\">1c<\/span><span style=\"font-weight: 400\">)<\/span><\/a><span style=\"font-weight: 400\"> entre 1,5 % et 2 %. Les r\u00e9sultats d\u00e9pendent toutefois de plusieurs facteurs.<\/span><\/p>\n<h3><b>Qui devrait envisager d\u2019utiliser des sulfonylur\u00e9es?<\/b><\/h3>\n<p><span style=\"font-weight: 400\">Les sulfonylur\u00e9es sont indiqu\u00e9es pour le traitement du diab\u00e8te de type\u00a02, en particulier chez les personnes qui pr\u00e9sentent les caract\u00e9ristiques suivantes\u00a0:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Diagnostic r\u00e9cent (moins de 5\u00a0ans).<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Manifestation de la maladie apr\u00e8s l\u2019\u00e2ge de 30\u00a0ans.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Personnes ayant un poids ad\u00e9quat ou en surpoids.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Personnes ayant une fonction pancr\u00e9atique acceptable (peptide\u00a0C pr\u00e9serv\u00e9).<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Personnes qui n\u2019ont pas r\u00e9ussi \u00e0 prendre en charge leur glyc\u00e9mie de fa\u00e7on optimale, m\u00eame en \u00e9tant actives et en suivant un r\u00e9gime alimentaire.<\/span><\/li>\n<li style=\"font-weight: 400\"><span style=\"font-weight: 400\">Personnes qui n\u2019ont pas pris d\u2019insuline ou qui, \u00e0 tout le moins, re\u00e7oivent une dose quotidienne de moins de 30\u00a0unit\u00e9s et pr\u00e9sentent une glyc\u00e9mie basale &lt;\u00a013,9\u00a0mmol\/L (250\u00a0mg\/dL).<\/span><\/li>\n<\/ul>\n<h3><b>Qui ne devrait pas utiliser de sulfonylur\u00e9es?<\/b><\/h3>\n<p><span style=\"font-weight: 400\">Ne prenez pas de sulfonylur\u00e9es :<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400\">si vous souffrez de diab\u00e8te de type 1;<\/li>\n<li style=\"font-weight: 400\">en pr\u00e9sence d\u2019acidoc\u00e9tose diab\u00e9tique (\u00e9tat d\u2019urgence cause par une glyc\u00e9mie \u00e9lev\u00e9e, un manque d\u2019insuline et une accumulation de c\u00e9tones [compos\u00e9s chimiques] dans le sang et l\u2019urine); cet \u00e9tat doit \u00eatre trait\u00e9 au moyen<br \/>\nd\u2019insuline;<\/li>\n<li style=\"font-weight: 400\">en pr\u00e9sence d\u2019un \u00e9tat de stress li\u00e9 \u00e0 une infection grave, \u00e0 un traumatisme ou \u00e0 une op\u00e9ration;<\/li>\n<li style=\"font-weight: 400\">si vous avez une maladie du foie, une jaunisse \u00e9vidente ou une maladie du rein;<\/li>\n<li style=\"font-weight: 400\">si vous prenez du bosentan;<\/li>\n<li style=\"font-weight: 400\">si vous \u00eates enceinte ou allaitez votre enfant.<\/li>\n<\/ul>\n<h3><b>Points \u00e0 retenir<\/b><\/h3>\n<p><span style=\"font-weight: 400\">En conclusion, on peut dire que les sulfonylur\u00e9es ont des effets diff\u00e9rents selon la g\u00e9n\u00e9ration et la cat\u00e9gorie auxquelles elles appartiennent. La v\u00e9rit\u00e9, c\u2019est que la connaissance des m\u00e9dicaments oraux peut aider \u00e0 dissiper les doutes avec les \u00e9quipes de soins de sant\u00e9. Il existe divers m\u00e9dicaments qui ont diff\u00e9rentes fonctions, et chacun a le droit de trouver le bon m\u00e9dicament.<\/span><\/p>\n<p><span style=\"font-weight: 400\">Discutez avec votre m\u00e9decin des options qui s\u2019offrent \u00e0 vous. N\u2019oubliez pas que les renseignements que nous communiquons ne remplacent pas de v\u00e9ritables conseils m\u00e9dicaux.<\/span><\/p>\n<h3><b>R\u00e9f\u00e9rences<\/b><\/h3>\n<p><span style=\"font-weight: 400\">Pharmacological treatment of prediabetes | <\/span><i><span style=\"font-weight: 400\">Rev. Cuba. endocrinol<\/span><\/i><span style=\"font-weight: 400\">; 22 (1): 36-45, janv.-avr.\u00a02011. | LILACS. (nd). https:\/\/pesquisa.bvsalud.org\/portal\/resource\/es\/lil-615034<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tous les types de diab\u00e8te n\u00e9cessitent un traitement personnalis\u00e9. Cela signifie qu\u2019il faut suivre un plan et un traitement pr\u00e9cis qui r\u00e9pondent aux exigences et aux besoins du patient. Il existe divers m\u00e9dicaments, appel\u00e9s m\u00e9dicaments oraux, qui ont diff\u00e9rentes fonctions. L\u2019article d\u2019aujourd\u2019hui porte sur les sulfonylur\u00e9es, les premiers m\u00e9dicaments oraux qui, outre la metformine, ont [&hellip;]<\/p>\n","protected":false},"author":10,"featured_media":219,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[38,40],"tags":[],"invisible":[8,5],"class_list":["post-217","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-insuline-et-medicaments-diabete","category-medicaments-courants-pour-le-diabete","invisible-core-evergreen-resource","invisible-thebasicbasics"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.9 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Tout sur les sulfonylur\u00e9es - Beyond Type 2 Canada<\/title>\n<meta name=\"description\" content=\"Outre la metformine, les premiers m\u00e9dicaments oraux qui ont \u00e9t\u00e9 utilis\u00e9s \u00e0 grande \u00e9chelle pour la prise en charge du diab\u00e8te \u00e9taient les sulfonylur\u00e9es. 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