My husband takes Amaryl along with insulin on a sliding scale basis according to what he eats, and yesterday he was low after lunch, but by dinner he was over 200 mg/dl [11.1 mmol/L]. How does Amaryl work? When does it peak? How long is it active?

Amaryl [glimepiride] is a second-generation long-acting sulfonylurea. It is taken once a day in the morning with the first meal and lasts about 24 hours. It works in people with type 2 diabetes by stimulating the beta cells in the pancreas to make more insulin.

You didn’t say whether the insulin your husband took was long- or short-acting and what he had to eat and when, so there is no way I can evaluate why he had a low sugar mid-day and a high sugar later. Blood sugars levels in people with diabetes are greatly influenced by meals, physical activity, medication and stress. All of these factors have to be taken into consideration.

JS