Oral Diabetes Medications
Importance of diabetes medications
People with type 2 diabetes have to make lifestyle changes (healthy eating and exercise), they often need additional treatment such as medication to control blood sugar level. Do remember that diabetes medications is not a substitute for healthy eating and exercise.
There are a few types of diabetes medications which will help control blood sugar and they work differently in the body. Diabetes medication cannot cure diabetes, it is only used to manage the blood sugar level in order to have a better control.
The best type of diabetes medications will be prescribed from doctors or healthcare team. It is important to take the diabetes medications regularly and correctly. Do not stop the medication on your own.
Types of diabetes medications
1. Biguanide
The only biguanide used is metformin and metformin usually is the first medication that will be prescribed for type 2 diabetes. It is often for people who are overweight as it does not promote weight gain.
It has anti-hyperglycaemia effect, lowering both basal and post-prandial (after meal) blood sugar. Besides that, it will decrease glucose production by the liver and delays intestinal absorption of glucose. Other than that, metformin will improve insulin sensitivity toward the cells, thus the body is able to use the insulin more effectively.
The side effect of metformin is nausea and vomiting, usually these side effects will go away as the body is get used to the medication.
Metformin should be taken with food. Correct dosage is important as over-dosage will cause hypoglycaemia which is low blood sugar level. Besides that, concomitant use with alcohol will increase the risk of hypoglycaemia.
2. Sulphonylureas
The examples of medication in this class are glyburide (DiaBeta, Glynase), glipizide (Glucotrol), gliclazide (Diamicron) and glimepiride (Amaryl).
It is suitable for people who are not overweight as this type of medication will promote weight gain.
Gliclazide will stimulate insulin secretion from pancreatic beta cells which will reduces insulin uptake and glucose output by the liver. It also increases insulin sensitivity at peripheral target sites.
The side effect of this medications are hypoglycaemia, GI disturbances including diarrhoea, constipation, abdominal pain and gastroenteritis. The other rare side effects are hypertension, chest pain, headache, dizziness, skin disorder, back pain, weakness and so on.
This type of medication should be taken with food. It is important to monitor the risk of hypoglycaemia.
3. Alpha Glucosidase Inhibitor
Only one type of tablet is used in this group which is called acarbose. Sometimes it will be used together with sulphonylurea.
Acarbose (Glucobay) works by slowing down the absorption of carbohydrate containing food from the intestine. This means that the blood sugar will rise slowly after a meal. Besides that, it will inhibits the metabolism of sucrose to glucose and fructose.
The adverse drug interaction of this medication is flatulence, abdominal pain, distension, diarrhoea, nausea and vomiting. Rare side effects are ileus, jaundice (yellowing of skin and eyes), hepatitis, skin reaction and oedema.
This medication should be taken with food, especially with the first bite of each meal.
4. Meglitinides
The example of this group of medication is repaglinide (Prandin) and nateglinide (Starlix). These type of medication works like sulphonylureas by stimulating the pancreas to produce and secrete more insulin. The duration of the effect is shorter, because they are short acting.
The side effect of this medication is hypoglycaemia, nausea, diarrhoea, constipation, vomiting, dyspepsia, back pain, rash and visual disturbances.
This diabetes medications should be taken with food and it is usually taken 15 min before the meals, but the time may vary from immediately to 30 minutes before the meal.
5. Thiazolidinediones
Rosiglitazone (Avandia) and pioglitazone (Actos) are examples of thiazolidinediones.
Rosiglitazone will improve insulin sensitivity by reducing blood glucose level without increasing pancreatic insulin secretion.
This type of medication will cause weight gain (dose-related), hyperglycaemia, increased appetite, headache, muscle cramps and increased risk of bone fractures in women. Rosiglitazone can be taken with or without food.
6. DPP-4 inhibitor (Gliptins)
Examples of these medications are sitagliptin (Januvia), saxagliptin (Onglyza) and linagliptin (Tradjenta).
These types of medications will help to decrease blood sugar level, but modest effects. Januvia, if it is used by itself, it is able to improve glycaemia control in type 2 diabetes patient if he/she adhere to proper diet and exercise. It also can be used with metformin or sulphonylurea.
The adverse effect of this medication is abdominal pain, nausea, vomiting, diarrhoea, flatulence, hypoglycaemia and headache.
This medication may be taken with or without food.
Conclusion
There are a few types of diabetes medications available. It is important to consult a doctor and eat the medication correctly (dosage and timing). Do not skip any of the medication. Besides that, if you are experiencing any side effect, please consult a doctor or healthcare professional as well.
All of these pills work best when used with meal planning and exercise. Three types of therapies will work together to reduce the blood sugar and have a better control to avoid any complications.
References
- http://www.mims.com/malaysia/drug/info/metformin?mtype=generic
- https://www.diabetes.org.uk/Guide-to-diabetes/What-is-diabetes/Diabetes-treatments/Sulphonylureas/
- http://www.mims.com/malaysia/drug/info/gliclazide?mtype=generic
- http://www.mims.com/malaysia/drug/info/repaglinide?mtype=generic
- http://www.mims.com/malaysia/drug/info/acarbose?mtype=generic
- http://www.mims.com/malaysia/drug/info/rosiglitazone?mtype=generic
- http://www.mims.com/malaysia/drug/info/januvia
