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Cyrus Desouza, MBBS, Q6: Prescribing Sulfonylureas

Aug 26, 2013

Dr. Cyrus Desouza, MBBS, reveals the dark secret behind why patients still use sulfonylureas. Although very effective inititally, the drug is only effective for a limited amount of time and there is beta cell burnout. Dr. Desouza tries not to start patients on sulfonylureas as a second-line; instead he’d rather start with basal insulin along with metformin. However, the one advantage of sulfonylureas is that they are very cheap; some patients can only afford metformin and sulfs. Some places are even giving them out free; versus $50 for insulin or hundreds for other drugs. This is a very powerful reason why many patients are still using these drugs.

Dr. Desouza is currently Professor and Chief of the Division of Diabetes, Endocrinology and Metabolism, Department of Internal Medicine at the University of Nebraska Medical Center. He is also the Director of the Diabetes and Obesity Program for the VA Nebraska-Western Iowa Healthcare System (NWIHCS). He is a board-certified clinical endocrinologist with research interests related to cardiovascular disease in insulin resistance and diabetes and improving outcomes in diabetes and obesity.

Dr. Desouza received his medical degree from St. Johns Medical College, Bangalore, India. He completed a rotating internship at St. Johns Medical College, Bangalore, India, senior house officer, internal medicine, Nair Hospital, Topiwala National Medical College, Bombay, India, residency, internal medicine, St. Barnabas Hospital, Bronx, New York, and a fellowship in the Division of Endocrinology, Diabetes and Metabolism at Tulane University, New Orleans, Louisiana.

Dr. Desouza is a member of numerous professional organizations including the American Diabetes Association, American College of Clinical Endocrinologists, The Endocrine Society, and American College of Physicians. He currently serves on the National Professional Practice Committee of the American Diabetes Association. He is also an editorial advisor for the Diabetes and Endocrinology Editorial Advisory Board for WebMD, LLC. He is a member of the editorial board for Diabetes Care as well as the Journal of Diabetes and its Complications. He is also a reviewer for the Journal of Endocrine PracticeDiabetes CareJCEMNature ReviewsEndocrinologyTranslation Research, and Clinical Chemistry.

Dr. Desouza has authored and co-authored several articles in major journals and presented at national meetings. He is the PI for several grants including a VA Merit Review grant looking at glycemic control. He is a site PI and an ancillary study committee member for a large NIH study: The Glycemic Reduction Approaches for Diabetes: A Comparative Effectiveness Study (GRADE) which is a national study comparing current medications and protocols used in diabetes treatment for an overall assessment of what is more effective. He is also the Vice Chair of the ancillary studies committee in a large NIH trial using Vitamin D to prevent type 2 diabetes (D2d) in people with pre-diabetes.