Type 2 Non Insulin Therapies
Pramlintide is an injected medicine for people with diabetes. In type 1 diabetes, Pramlintide can be taken in addition to insulin to help control mealtime blood sugars. If you have type 2 diabetes, and lifestyle changes are not enough to control your blood sugar, typically, your provider will first start you on a single medicine. For people who are overweight, metformin is usually the first medicine prescribed. If the single therapy doesn’t work, additional medicines can be added. Many people require treatment with 2, 3 or more different medicines. If pill combinations don’t work, an injected medicine such as an incretin-based medicine, amylin analog or insulin may be prescribed. Medicine combinations are used because different drugs target different parts of your body’s sugar regulation system. Rarely, and usually due to other medical conditions, it may be necessary to start medical treatment of type 2 diabetes with insulin therapy. Usually, however, insulin therapy is the last treatment prescribed and is added only after the oral medications or non-insulin injections don’t work. There are six types of non-insulin medicines used to treat type 2 diabetes: Incretin based therapies: Pills and injections that reduce sugar production in the liver and slow the absorption of food In this section, you also can review: A Table of Non-Insulin Medications: A summary of all the oral medications and non insulin injected therapies including the common doses and side effects. Self-assessment Quiz Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Treatment of Type 2 Diabetes, take our self assessment quiz when you have completed this section. The quiz is multiple choice. Please choose the single best answer to Continue reading >>
Breaking Down Diabetes: Drugs For Diabetes, Starting With The Best Metformin
Stanford University School of Medicine blog Breaking down diabetes: Drugs for diabetes, starting with the best metformin Metformin is physician-researcher Randall Stafford's go-to drug for diabetes. He explains why in this installment in the series, Breaking down diabetes. A huge assortment of 100 medications are available to treat high blood sugar in Type 2 diabetes, including two historical breakthrough drugs, insulin and metformin . The pharmaceutical industry has successfully added a few new, innovative drugs, but the most effective drugs remain the older, less expensive medications. Let's make some sense out of this mess of medications. Most are given by mouth (oral), but injected insulin, which I'll address in a future blog post, remains a key medication. In addition, oral drugs have limited impact, so they are often used in combinations (including tablets containing two drugs). Patients frequently try multiple oral drugs before starting insulin. With very few exceptions, I start patients on metformin first. To illustrate a patient's experience with diabetes drugs, let's check in on with Mrs. R., a 70-year-old with diabetes: When she was first diagnosed 19 years ago, she started on metformin at 500 mg twice per day. These large tablets initially caused intestinal discomfort (a common side effect). Over time, the mild abdominal pain went away. This drug worked well for a few years, but Mrs. R gained some additional weight and the metformin was no longer adequate. The drug, glipizide was added. This also worked for many years, but in 2012, she needed a third drug, sitagliptin . Eventually, she would need insulin. To understand Mrs. R's experience, or the medications taken by you or a friend or family member, lets start with the best medication, metformin. Approved Continue reading >>
What Is The Best Medicine For Diabetes?
For type 1 Diabetes Mellitus, Insulin is the drug of choice. For type 2 Diabetes Mellitus, current recommendations are the use of Metformin with either a gliptin(e.g. saxagliptin or vildagliptin) or a SGLT2 inhibitor (e.g. canagliflozin or dapagliflozin). Some may even start with Metformin and a Sulfonylurea like glibenclamide as it is a cost effective combination. Also, use of Insulin is advocated in early T2DM. And also, diabetics have to be put on ACE inhibitors or ARBs like Telmisartan or Lisinopril as they serve to protect the kidneys. Hope this answers your question. Continue reading >>
Diabetes Drug Found To Reduce Heart And Kidney Disease Risk
Type 2 diabetes is becoming more and more widespread, and with it the risk of associated conditions such as stroke and kidney disease. A new study reveals that a commonly prescribed drug for lowering blood sugar in patients with type 2 diabetes also lowers the risk of cardiovascular and kidney disease. New research, conducted by scientists at the George Institute for Global Health in Sydney, Australia, suggests that a drug that has so far only been used to lower blood sugar in patients with type 2 diabetes has more than just one therapeutic effect. In fact, according to the new study - published in the New England Journal of Medicine - the drug canagliflozin is a "three in one" type of medication; besides helping to treat type 2 diabetes, it also seems to significantly lower the risk of cardiovascular disease (CVD) and kidney disease in patients with diabetes. Finding a way to tackle CVD among patients with diabetes is particularly important given the high incidence of CVD-related deaths in this population group. The American Heart Association (AHA) estimate that almost 70 percent of seniors with diabetes eventually die from some form of CVD. The AHA also report that compared with healthy individuals, people with diabetes are "two to four times more likely to die from some form of heart disease." "Type 2 diabetes is growing rapidly all over the world, and we need drugs that not only deal with glucose levels, but that also protect the many millions of people from the very real risks of stroke and heart attack," says Prof. Bruce Neal of the George Institute for Global Health. The new study reviewed the clinical data on more than 10,000 patients across 30 countries and confirmed the results of previous research, which had indicated that glucose-lowering medication can sign Continue reading >>
There are different types of medications available for diabetes mellitus with each having their own mechanism of action and side effects. The best drug should be chosen by a doctor assessing the condition of the patient – please note all these are prescription medicines and need to be taken properly, under medical-supervision and with correct dosage and at the right timings. You must, at all times, follow instructions from your doctor. Never self-medicate. Basically, anti-diabetic drugs can be categorized into two classes: A. Oral anti-diabetic drugs: This includes the following classes: Insulin secretagogues: sulphonylureas and non-sulphonylureas(Glinides/Meglitinide) Biguanides Thiazolidinediones a-glucosidase inhibitors Di-peptydyl Peptidase-4 (DPP-4) inhibitors/gliptins Sodium-glucose co-transporter 2 (SGLT2) inhibitors B. Injectable anti-diabetic drugs: Insulin preparations Glucagon-like peptide 1 (GLP1) agonists According to A consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes, a tier system is used to prescribe medicines depending on how validated (tested) the medication is. The tier is divided into steps depending on the stage of diabetes and how the patient responds to the lifestyle changes and medicines. Tier 1: This includes the best established, most-effective and most cost effective therapeutic strategies to control blood sugar. This is also the most preferred strategy for patients with type 2 diabetes. The tier is divided into 3 steps. Step 1: These are prescribed at when someone is diagnosed with type 2 diabetes. Apart from a lifestyle change, a mild medication that is well tested, has low and less severe side-effects and is cheap is prescribed. Step 2: A second medication is added when step 1 Continue reading >>
The Top 10 Best-selling Diabetes Drugs Of 2013
Everybody knows that diabetes is an epidemic in this country that is costing lives and money. New stats from the U.S. Centers for Disease Control and Prevention (CDC) peg at 29.1 million the number of people in the U.S. who have either Type 1 or Type 2 diabetes, with roughly 9 million of those undiagnosed. Most have Type 2 diabetes, which is more prevalent among minorities. On the other hand, a study found that non-Hispanic white children are diagnosed more often with Type 1 diabetes than other groups. And that is just in the U.S. The rest of the world also is developing diabetes at what many see as alarming rates. Pharma, seeing opportunity, has responded. There are pills as well as injected drugs. Many are incretin mimetics. There are now 12 classes of drugs, including the GLP-1 class drugs like AstraZeneca's ($AZN) Byetta and Novo Nordisk's ($NVO) blockbuster Victoza, and DPP-4 inhibitors like Merck's ($MRK) Januvia, Eli Lilly ($LLY) and Boehringer Ingelheim's Tradjenta/Trajenta and AstraZeneca's Onglyza. These widely used drugs, some of which are on this list, have stirred safety concerns. The FDA and European regulators announced in February that a new round of safety reviews found little evidence that they cause pancreatitis or pancreatic cancer, as some have suggested. But criticism persists, and this month consumer advocacy group Public Citizen again asked the FDA to pull Victoza from the market, saying the FDA's review of adverse reports was not as extensive as its own. What is perhaps becoming a bigger deal for Big Pharma, however, is that with so many treatment options, and more coming, the market has gotten crowded and doctors and patients a bit confused. That has led to some studies to sort out which drugs work the best, and that in turn has led some resear Continue reading >>
Which Diabetes Medication Is The Best?
With so many products on the market, it can be difficult to choose the most effective diabetes medication for your needs. Type 2 diabetes is often referred to as the silent killer, and many people dont even know they have the disease until it is too late. According to the World Health Organisation (WHO), in 2012 1.5 million deaths were directly caused by this serious metabolic disorder. Type 2 diabetes is preceded by insulin resistance and progressive insulin secretory defects, whereas type 1 is usually diagnosed in children, occurring when the body does not produce any insulin. Fortunately there are many treatment options for type 2 diabetes, and we compared the most common diabetes medications. How it works: This is the most common medication for type 2 diabetes. It works by decreasing the amount of glucose that your liver releases and helps to restore a natural response to insulin. Effectiveness: Most experts agree it might be an old drug, but its still the most widely used and probably the most effective medication. A recent study from the State University of Rio de Janeiro found its still the first line of treatment, even when used in combination with other medication. Possible side-effects: An upset stomach, vomiting, nausea iStock How it works: These medications lower blood glucose levels and increase the amount of insulin produced by the pancreas. Effectiveness: Sulfonylurea drugs have been in use since the 1950s and a lot of newer medications have similar workings (and are generally cheaper). But many physicians still prescribe these medications when Biguanides are either not as effective, or when the side-effects of the latter are too severe. Possible side-effects: Hypoglycaemia, weight gain iStock How it works: These medications stop an enzyme called DPP-4 f Continue reading >>
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Type 2 Diabetes
Print Diagnosis To diagnose type 2 diabetes, you'll be given a: Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. Normal levels are below 5.7 percent. If the A1C test isn't available, or if you have certain conditions — such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) — that can make the A1C test inaccurate, your doctor may use the following tests to diagnose diabetes: Random blood sugar test. A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood s Continue reading >>
New Drug Appears To Eliminate Type 2 Diabetes For First Time
Type 2 diabetes, although influenced by a person’s genes, is largely thought to be brought about by a poor diet and being overweight for prolonged periods of time, particularly at an old age. The pancreas is either unable to produce enough insulin, or the body’s cells simply don’t react to insulin, which leads to dangerously high blood sugar levels. This is known as insulin resistance, and at present, there is no medical way to treat this. A new drug forged by a team at the University of California, however, might prove to be a veritable game-changer. As reported by New Scientist, a daily dose of the drug, given to mice with insulin resistance, canceled out the harmful condition. This is the first time that any treatment has effectively “cured” type 2 diabetes. The team of researchers had an inkling that a particular enzyme was responsible for bringing about insulin resistance. The enzyme – cacophonously known as low molecular weight protein tyrosine phosphate, or LMPTP – can be found in the liver, and it appears to interact with cells in such a way that they become resistance to the presence of insulin. Conjuring up a brand new drug that was specifically designed to hinder the progress of LMPTP, the team thought that it would allow the cells’ insulin receptors to once again be able to react to insulin as they normally would. Much to their delight, they found that they were correct. “Our findings suggest that LMPTP is a key promoter of insulin resistance and that LMPTP inhibitors would be beneficial for treating type 2 diabetes,” the team noted in their Nature study. For this study, their drug was orally administered to a few unfortunate laboratory mice. These mice had been fed an extremely high-fat diet, and they had developed obesity and type 2 dia Continue reading >>
A Complete List Of Diabetes Medications
Diabetes is a condition that leads to high levels of blood glucose (or sugar) in the body. This happens when your body can’t make or use insulin like it’s supposed to. Insulin is a substance that helps your body use the sugar from the food you eat. There are two different types of diabetes: type 1 diabetes and type 2 diabetes. People with both types of diabetes need medications to help keep their blood sugar levels normal. The types of drugs that can treat you depend on the type of diabetes you have. This article gives you information about drugs that treat both types of diabetes to help give you an idea of the treatment options available to you. Insulin Insulin is the most common type of medication used in type 1 diabetes treatment. It’s also used in type 2 diabetes treatment. It’s given by injection and comes in different types. The type of insulin you need depends on how severe your insulin depletion is. Options include: Short-acting insulin regular insulin (Humulin and Novolin) Rapid-acting insulins Intermediate-acting insulin Long-acting insulins Combination insulins NovoLog Mix 70/30 (insulin aspart protamine-insulin aspart) Humalog Mix 75/25 (insulin lispro protamine-insulin lispro) Humalog Mix 50/50 (insulin lispro protamine-insulin lispro) Humulin 70/30 (human insulin NPH-human insulin regular) Novolin 70/30 (human insulin NPH-human insulin regular) Ryzodeg (insulin degludec-insulin aspart) Amylinomimetic drug Pramlintide (SymlinPen 120, SymlinPen 60) is an amylinomimetic drug. It’s an injectable drug used before meals. It works by delaying the time your stomach takes to empty itself. It reduces glucagon secretion after meals. This lowers your blood sugar. It also reduces appetite through a central mechanism. Most medications for type 2 diabetes are o Continue reading >>
Which Diabetes Drug Is Best?
HealthDay Reporter TUESDAY, July 19, 2016 (HealthDay News) -- No single drug to treat type 2 diabetes stands out from the pack when it comes to reducing the risks of heart disease, stroke or premature death, a new research review finds. The analysis of hundreds of clinical trials found no evidence that any one diabetes drug, or drug combination, beats out the others. Researchers said the results bolster current recommendations to first try an older, cheaper drug -- metformin (Glumetza, Glucophage) -- for most patients with type 2 diabetes. "There are very few things experts agree on, but this is one of them," said Dr. Kevin Pantalone, a diabetes specialist at the Cleveland Clinic and a member of the Endocrine Society. "Metformin, in the absence of contraindications or intolerability, should be the first-line agent to treat patients with type 2 diabetes," he said. Metformin can cause upset stomach and diarrhea, so some patients are unable to stick with it day to day, explained Pantalone, who wasn't involved in the study. And people with kidney disease generally shouldn't take it, he said. More than 29 million Americans have diabetes -- mostly type 2, according to the U.S. Centers for Disease Control and Prevention. The disease, which is often linked to obesity, causes blood sugar levels to be chronically high. Over time, that can lead to complications, such as heart disease, stroke, kidney failure and nerve damage, the CDC says. There are numerous classes of medications that lower blood sugar levels. What's been unclear is whether any of those drugs work better than others in warding off diabetes complications and extending people's lives. The new analysis found no obvious winners. But the researchers also cautioned against drawing conclusions: The trials in the review w Continue reading >>
Oral Diabetes Medications Summary Chart
What Oral Medications Are Available for Type 2 Diabetes? Type 2 diabetes results when the body is unable to produce the amount of insulin it needs to convert food into energy or when it is unable to use insulin appropriately. Sometimes the body is actually producing more insulin than is needed by a person to keep blood glucose in a normal range. Yet blood glucose remains high, because the body's cells are resistant to the effects of insulin. Physicians and scientists believe that type 2 diabetes is caused by many factors, including insufficient insulin and insulin resistance. They increasingly believe that the relative contribution each factor makes toward causing diabetes varies from person to person. It is important to know the name of your diabetes medicine (or medicines), how it is taken, the reasons for taking it and possible side-effects. Diabetes Pills How to Take How They Work Side Effects Of Note Biguanides Metformin (Glucophage) Metformin liquid ( Riomet) Metformin extended release (Glucophage XR, Fortamet, Glumetza) Metformin: usually taken twice a day with breakfast and evening meal. Metformin extended release: usually taken once a day in the morning. Decreases amount of glucose released from liver. Bloating, gas, diarrhea, upset stomach, loss of appetite (usually within the first few weeks of starting). Take with food to minimize symptoms. Metformin is not likely to cause low blood glucose. In rare cases, lactic acidosis may occur in people with abnormal kidney or liver function. Always tell healthcare providers that it may need to be stopped when you are having a dye study or surgical procedure. Sulfonylureas Glimepiride (Amaryl) Glyburide (Diabeta, Micronase) Glipizide (Glucotrol, Glucotrol XL) Micronized glyburide (Glynase) Take with a meal once or twice Continue reading >>
Top 6 Breakthrough Diabetes Treatments You May Have Missed
Are you concerned you might be diagnosed with diabetes one day? You are not alone. Diabetes and prediabetes are two of the top pressing health issues in the nation. The number of Americans who are at risk for diabetes is astounding: it is reported that close to 86 million people in the U.S. have prediabetes, meaning their blood sugar levels are higher than normal but not yet high enough to be classified as type 2 diabetes. The American Diabetes Association (ADA) estimates a person diagnosed at age 50 dies six years earlier than a person without diabetes. One in three American adults will have diabetes in the year 2050 if current trends continue. Close to 29 million Americans, or 9% of the population, currently have diabetes. The vast majority of people, about 90 to 95 percent of those diagnosed with diabetes, have type 2 diabetes, according to the ADA. Insulin is a hormone the body needs to utilize the glucose (sugar) from food to provide energy for the body. In type 2 diabetes, the pancreas either doesn't make enough insulin, there is resistance to the effects of insulin, or both. Treatment typically begins with oral metformin, a veteran drug that is the backbone of many diabetes treatment regimens. From there, different drug classes may be added to metformin, and for some patients, the use of insulin may become necessary. However, the latest diabetes news is encouraging. New drugs, improved monitoring devices and an understanding of how diet and exercise can impact diabetes is adding up to positive outcomes for patients. As reported in August 2014 from research in The Lancet Diabetes & Endocrinology, the vast majority of people with type 2 diabetes are living longer lives due to better medications and treatments for both the disease and the numerous complications that Continue reading >>
The Latest In Diabetes Drugs: Less Hypoglycemia, More Weight Loss
By Emma Ryan and Payal Marathe Research presented at EASD 2017 showcased drugs, both new and old, that improve blood sugar management, weight loss, heart health, and even blood pressure New research presented at the recent European Association for the Study of Diabetes (EASD) conference showed promising results, including lower A1c, better heart health, weight loss, and less hypoglycemia (low blood sugar). Click to read more about the most notable updates on new therapies: Semaglutide – a once-weekly GLP-1 injection for type 2 diabetes (under FDA review after a very positive Advisory Committee meeting in which four diaTribe Foundation volunteers participated) Bydureon – a once-weekly GLP-1 injection for type 2 diabetes (available now, with a newly-approved, easier way to take it) Add-on pills for type 1 – SGLT “class” Farxiga (available now) and sotagliflozin (in development) Tresiba – a once-daily basal insulin for type 1 and type 2 (available now) Sulfonylureas versus pioglitazone – type 2 diabetes pills (available now) Glimepiride versus ertugliflozin – type 2 diabetes pills (available now and in development, respectively) The EASD meeting also included discussions of much more than diabetes drug therapies. You can read diaTribe’s coverage of a study showing improved outcomes from CGM use during pregnancy and The diaTribe Foundation’s event on “Solvable Problems in Diabetes.” Semaglutide– a once-weekly injection for type 2 diabetes (under FDA review) Researchers presented new weight loss data on semaglutide, a once-weekly GLP-1 agonist that is currently under FDA review. The SUSTAIN 6 trial showed that people with type 2 diabetes on the lower dose of semaglutide lost more weight – an average of 8 pounds (4% of their body weight) – compar Continue reading >>
Top 10 Diabetes Drugs By 2016 Sales
To say there’s a lot going on in the U.S. diabetes space right now would be an understatement. The formulary exclusions and payer pressure that have taken a toll on so many medications are continuing in full force, and thanks to new and forthcoming biosimilars, that likely won’t change anytime soon. Value-based pricing has arrived on the diabetes scene, too, shaking payer relationships up even further. And price hikes, which some drugmakers have relied on for their long off-patent drugs, are no longer OK as far as the public and many lawmakers are concerned. All three of the diabetes giants—Novo Nordisk, Sanofi and Eli Lilly—have taken steps to allay the price-increase controversy, with Novo and Sanofi each pledging caps on their hikes, but all three are facing legal difficulties for their historical insulin pricing, too. Then there’s the cardiovascular outcomes data that’s taken the arena by storm. These days, it’s no longer enough to show that your diabetes fighter doesn’t increase heart risks; to compete at the top of its game, a drug has to show it can pare down cardiovascular risks—or face potential upstaging by a rival that can. And while diabetes is growing in prevalence, it’s still unclear just how well newer classes such as SGLT2 can keep up their growth acts. With all of those factors in mind, it’ll be no surprise if 2016’s list of top 10 U.S. diabetes sellers sees something of a shake-up in the near future—and in fact, it’ll be pretty surprising if it doesn’t. But nevertheless, we’ve compiled last year’s sales rankings for you based on data from Evaluate Pharma, along with some insight into what to expect for each of the top medications going forward. We focused on U.S. sales, because that’s where diabetes drugmakers are fe Continue reading >>