Glyburide vs. Afrezza for Diabetes Type 2 and Gestational Diabetes: Important Differences and Potential Risks.

Key takeaways

Glyburide (Glynase) and Afrezza (insulin human) are both medications used to manage diabetes, but they belong to different medication classes and have distinct characteristics. Glyburide is a sulfonylurea that works by stimulating the pancreas to release insulin, and it is taken orally, usually once or twice a day with meals. Afrezza, on the other hand, is an ultra rapid-acting insulin that is inhaled at the start of meals to help control blood sugar levels. While glyburide is only approved for Type 2 diabetes, Afrezza is approved for both Type 1 and Type 2 diabetes in adults. Glyburide is available in a generic form, whereas Afrezza does not have a lower-cost generic option. Common side effects of glyburide include low blood sugar, nausea, and weight gain, while Afrezza can cause low blood sugar, cough, and throat irritation. Glyburide may interact with other medications that lower blood sugar, and Afrezza is not recommended for people with lung conditions like asthma or chronic obstructive pulmonary disease (COPD).

Glyburide

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Afrezza

(insulin)

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Summary for Glyburide

Prescription only

Glyburide is taken by mouth to lower blood sugar levels for people who have Type 2 diabetes. This medication isn't meant to be taken alone, but in addition to eating a healthy diet and engaging in regular exercise. Glyburide is typically taken once or twice daily, depending on your dose.

Indications for Glyburide

Type 2 diabetes

Pros and Cons for Glyburide

Pros

Usually taken only once daily with largest meal
Can lower A1C levels by 1.5%
Taken by mouth, so good option for people who don't like injections
Can be taken with some other blood sugar medications, such as metformin

Cons

Risk of low blood sugar (hypoglycemia), especially if you have kidney or liver problems
More likely to cause low blood sugar than other blood sugar medications, such as metformin
Can cause some weight gain
Not approved for Type 1 diabetes

Common Side Effects for Glyburide

Feeling bloated
Nausea
Heartburn

Warnings for Glyburide

Low blood sugar (hypoglycemia)
Possible risk of heart problems
Breakdown of red blood cells

Summary for Afrezza

Prescription only

Afrezza is an ultra rapid-acting inhaled insulin for adults with diabetes. It helps manage blood sugar levels from meals. You breathe in the medication through the mouth using the Afrezza inhaler usually at the start of meals. Common side effects are low blood sugar and cough. There's also a risk of bronchospasm (sudden narrowing of the airways), which can make it hard to breathe. So Afrezza (insulin) isn't for people with breathing problems like asthma or chronic obstructive pulmonary disease (COPD).

Indications for Afrezza

Type 1 diabetes (T1D) in adults
Type 2 diabetes (T2D) in adults

Pros and Cons for Afrezza

Pros

A good choice for people who don't want to use injectable insulin
Can help people with either Type 1 or Type 2 diabetes manage blood sugar
Starts to work in about 12 minutes and lasts between 1.5 and 3 hours, depending on your dose

Cons

Might need to use more than one cartridge of insulin for your dose (if you need more than 12 units of insulin)
Not for people who smoke or for people with breathing problems (e.g., asthma, COPD)
Not approved for children

Common Side Effects for Afrezza

Low blood sugar (up to 67%)
Cough (up to 29%)
Throat pain or irritation (up to 6%)
Headache (up to 5%)

Warnings for Afrezza

Breathing problems
Low blood sugar levels (hypoglycemia)
Changes in blood sugar levels with changes to your insulin routine
Diabetic ketoacidosis
Low potassium levels
Swelling from fluid buildup and risk of heart failure when taken with certain diabetes medications