Can Oral Diabetic Medications Cause Hypoglycemia?

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 >>

Risk Of Hypoglycaemia With Oral Antidiabetic Agents In Patients With Type 2 Diabetes.

Risk of hypoglycaemia with oral antidiabetic agents in patients with Type 2 diabetes. 1st Department of Medicine, Klinikum Lippe-Detmold, Detmold, Germany. [email protected] In patients with Type 2 diabetes, the appropriate intensity of glucose control is determined by age, life expectancy, and the presence of concomitant disease. Geriatric patients are especially susceptible to hypoglycaemia and therefore particular care should be taken in this group characterized by polypharmacy, renal or hepatic dysfunction, cardiovascular multimorbidity and malnutrition. As hypoglycaemia is a significant cause of morbidity and mortality, treatment regimens for diabetes should minimize the occurrence of hypoglycaemic episodes and be tailored to the patient's individual needs. The pharmacological options for treating Type 2 diabetes have increased considerably and the risk of hypoglycaemia of the currently available drugs varies considerably. Metformin, thiazolidinediones, and acarbose, oral antidiabetic drugs that decrease insulin resistance or postprandial glucose absorption, are associated with a low risk of hypoglycaemia. These drugs can also be used effectively in various combination regimens; however, by improving insulin sensitivity, combinations of metformin and thiolidinediones with sulphonylureas or meglitinides may considerably increase the risk of hypoglycaemia. On account of its complex pharmacoprofile glibenclamide is a problematic substance carrying a high risk of hypoglycaemia. There are limited preliminary data indicating that, under routine conditions, glimepiride may be associated with a lower risk of hypoglycaemia than glibenclamide and is no more likely to cause hypoglycaemia than other shorter-acting agents such as gliclazide and glipizide. Nateglinid Continue reading >>

Diabetic Medications And Exercise, Part 1: Oral Medications

Sheri Colberg, Ph.D., FACSM, has been helping patients with diabetes successfully increase physical activity for many years and has written numerous books that patients and clinicians use. Most of her work recently has been about insulin and exercise, but many of you have written me to ask, “What about oral medications?” This week Dr. Colberg begins explaining oral medications in Diabetic Medications and Exercise, Part 1: Oral Medications. Diabetic Medications and Exercise, Part 1: Oral Medications By Sheri Colberg, Ph.D., FACSM If you use any of the oral diabetes medications, knowing their potential glucose-lowering effects is important. In general, oral medications for diabetes target one or more of three metabolic disorders found in diabetes; decreased insulin production by the beta cells of the pancreas, elevations in the production of glucose by the liver, or increased insulin resistance in muscle and fat tissues. Their many classes, differing actions, and names are listed in table 3.3. If you ever experience a change in your exercise routine, you may need to consult with your doctor about adjusting the doses of oral medications that you take, particularly if you begin to engage regularly in more physical activity than you did before. Key Point: An increase in your activity level may require you to lower your doses, even of oral diabetes medications that do not usually cause exercise-related low blood sugars. Sulfonylureas A class of drugs called sulfonylureas was the only one available to treat Type 2 diabetes for many years. They work by stimulating insulin release from the pancreas and decreasing insulin resistance. The only first-generation one still on the market is Diabinese (generic name: chloropropamide), which can last for up to 72 hours. Its long dura Continue reading >>

Drug-induced Low Blood Sugar

Low blood sugar (hypoglycemia) is common in people with diabetes who are taking insulin or other medicines to control their diabetes. All of the following can cause blood sugar (glucose) level to drop: Drinking alcohol Getting too much activity Intentionally or unintentionally overdosing on the medicines used to treat diabetes Missing meals Even when diabetes is managed very carefully, the medicines used to treat diabetes can result in drug-induced low blood sugar. The condition may also occur when someone without diabetes takes a medicine used to treat diabetes. In rare cases, non-diabetes-related medicines can cause low blood sugar. Medicines that can cause drug-induced low blood sugar include: Bactrim (an antibiotic) Beta-blockers Haloperidol Insulin MAO inhibitors Metformin when used with sulfonylureas Pentamidine Quinidine Quinine SGLT2 inhibitors (such as dapagliflozin and empagliflozin) Sulfonylureas Thiazolidinediones (such as Actos and Avandia) Continue reading >>

Which Diabetes Drugs Cause Hypoglycemia?

Hypoglycemia—aka low blood sugar—can kill you. The most common cause is medications taken by people with diabetes. DRUGS THAT RARELY, IF EVER, CAUSE HYPOGLYCEMIA Diabetics not being treated with pills or insulin rarely need to worry about hypoglycemia. That’s usually true also for prediabetics. Yes, some type 2 diabetics control their condition with diet and exercise alone, without drugs. Similarly, diabetics treated only with diet, metformin, colesevalam, sodium-glucose co-transport 2 inhibitor (SGLT2 inhibitor), and/or an alpha-glucosidase inhibitor (acarbose, miglitol) should not have much, if any, trouble with hypoglycemia. The DPP4-inhibitors (sitagliptan and saxagliptin) do not seem to cause low glucose levels, whether used alone or combined with metformin or a thiazoladinedione. Thiazolidinediones by themselves cause hypoglycemia in only 1 to 3% of users, but might cause a higher percentage in people on a reduced calorie diet. Bromocriptine may slightly increase the risk of hypoglycemia. GLP-1 analogues rarely cause hypoglycemia, but they can. DRUGS THAT CAUSE HYPOGLYCEMIA Regardless of diet, diabetics are at risk for hypoglycemia if they use any of the following drug classes. Also listed are a few of the individual drugs in some classes: insulins sulfonylureas: glipizide, glyburide, glimiperide, chlorpropamide, acetohexamide, tolbutamide meglitinides: repaglinide, nateglinide pramlintide plus insulin possibly GLP-1 analogues GLP-1 analogues (exanatide, liragultide, albiglutide, dulaglutide) when used with insulin, sufonylureas, or meglitinides possibly thiazolidinediones: pioglitazone, rosiglitazone possibly bromocriptine BECOME THE EXPERT ON YOUR OWN DRUGS If you take drugs for diabetes, you need to be your own pharmaceutical expert. Don’t depend solely Continue reading >>

Diabetic Hypoglycemia

Print Overview For people with diabetes, low blood sugar (hypoglycemia) occurs when there's too much insulin and not enough sugar (glucose) in the blood. Hypoglycemia is defined as blood sugar below 70 milligrams per deciliter (mg/dL), or 3.9 millimoles per liter (mmol/L). Several factors can cause hypoglycemia in people with diabetes, including taking too much insulin or other diabetes medications, skipping a meal, or exercising harder than usual. Pay attention to early warning signs, so you can treat low blood sugar promptly. Treatment involves short-term solutions — such as taking glucose tablets — to raise your blood sugar into a normal range. Untreated, diabetic hypoglycemia can lead to seizures and loss of consciousness — a medical emergency. Rarely, it can be deadly. Tell family and friends what symptoms to look for and what to do in case you're not able to treat the condition yourself. Symptoms Early warning signs and symptoms Early signs and symptoms of diabetic hypoglycemia include: Shakiness Dizziness Sweating Hunger Irritability or moodiness Anxiety or nervousness Headache Nighttime symptoms Diabetic hypoglycemia can also occur while you sleep. Signs and symptoms, which can awaken you, include: Damp sheets or bedclothes due to perspiration Nightmares Tiredness, irritability or confusion upon waking Severe symptoms If diabetic hypoglycemia goes untreated, signs and symptoms of severe hypoglycemia can occur. These include: Clumsiness or jerky movements Muscle weakness Difficulty speaking or slurred speech Blurry or double vision Drowsiness Confusion Convulsions or seizures Unconsciousness Death Take your symptoms seriously. Diabetic hypoglycemia can increase the risk of serious — even deadly — accidents. Identifying and correcting the factors contrib Continue reading >>

Type 2 Oral Diabetes Medications Side Effects, Differences, And Effectiveness

What are the types of oral diabetes medications? Currently, there are nine drug classes of oral diabetes medications approved for the treatment of type 2 diabetes. α-glucosidase inhibitors Biguanides Sulfonylureas Meglitinides Thiazolidinediones DPP-4 inhibitors Sodium-glucose cotransporter (SGLT)-2 inhibitors These medications differ in the way they function in the body to reduce blood glucose. Metformin (Glucophage) is the only biguanide available in the United States and is generally the first choice for oral treatment of type 2 diabetes mellitus. Metformin improves Sulfonylureas are the oldest classes of oral diabetes medications. Sulfonylureas work primarily by stimulating the release of insulin. Insulin is the hormone responsible for regulating blood glucose by increasing the uptake of blood glucose by tissues and increasing storage of glucose in the liver. Meglitinides and sulfonylureas have a similar mechanism of action. Meglitinides are short acting glucose lowering medications. They stimulate the secretion of insulin from the pancreas. Thiazolidinediones enhance insulin sensitivity meaning that the effect of a given amount of insulin is greater. Thiazolidinediones also are referred to as peroxisome proliferator-activated receptor ? or PPAR-? agonists. α-glucosidase inhibitors delay the digestion and absorption of starch or carbohydrates by inhibiting enzymes in the small intestine which help breakdown these molecules. The starches and carbohydrates are broken down into glucose, which then is absorbed from the intestine and increases the level in the blood. DPP-4 inhibitors help lower blood glucose by increasing the production of insulin from the pancreas and reducing the release of glucose from the liver. SGLT2 inhibitors or sodium-glucose cotransporter 2 in Continue reading >>

Oral Diabetes Medications

A list of oral diabetes medications with advantages, disadvantages, and side effects. Click on the name of a drug for more information. Biguanides Glucophage (generic name: metformin) Glucophage XR (generic name: metformin hydrochloride) extended release Fortamet (generic name: metformin hydrochloride) extended release Glumetza (generic name: metformin hydrochloride) extended release Riomet (generic name: metformin hydrochloride liquid) What are Biguanides? Metformin is the only member of the biguanides family in use today. Metformin (met-FOR-min) helps lower blood glucose by making sure your liver does not put extra glucose into the system when it is not needed. The ADA Standards of Medical Care in Diabetes recommend the inclusion of metformin (along with diet and exercise) in initial diabetes treatment. A good thing about metformin is that it does not cause blood glucose to get too low (hypoglycemia) when it is the only diabetes medicine you take. Who can take this medicine? Adults with type 2 diabetes can take metformin with their doctor’s approval and supervision. You should avoid metformin if you have liver or kidney problems, lung or heart disease, or conditions that cause low blood oxygen levels. Who should not take this medicine? People with certain types of heart problems, such as congestive heart failure, should use caution with this medicine. People with reduced kidney function or kidney disease should probably not take metformin. It should be used with caution if you regularly consume more than two to three drinks daily, so check with your doctor about that. Advantages Metformin, when used alone, is unlikely to cause low blood sugar. It is one of those medicines that always seems to help even after people have had diabetes for a while, and, for this reason Continue reading >>

Metformin, Sulfonylureas, Or Other Antidiabetes Drugs And The Risk Of Lactic Acidosis Or Hypoglycemia

Metformin, Sulfonylureas, or Other Antidiabetes Drugs and the Risk of Lactic Acidosis or Hypoglycemia 3Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, Massachusetts 4Department of Epidemiology, School of Public Health, Boston University, Massachusetts 3Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, Massachusetts 4Department of Epidemiology, School of Public Health, Boston University, Massachusetts 5Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland 1Division of Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland 2Division of Endocrinology, Diabetes, and Clinical Nutrition, University Hospital Basel, Basel, Switzerland 3Boston Collaborative Drug Surveillance Program, Boston University School of Medicine, Lexington, Massachusetts 4Department of Epidemiology, School of Public Health, Boston University, Massachusetts 5Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacology and Toxicology, University Hospital Basel, Basel, Switzerland Corresponding author: Christoph R. Meier, hc.sbhu@hcreiem Received 2008 Jun 27; Accepted 2008 Aug 10. Copyright 2008, American Diabetes Association Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See for details. This article has been cited by other articles in PMC. OBJECTIVELactic acidosis has been associated with use of metformin. Hypoglycemia is a major concern using sulfonylureas. The aim of this study was to compare the risk of lactic acidosis and hypoglycemia among patients with type 2 diabetes using oral antidiabetes drugs. RESEAR Continue reading >>

Oral Diabetes Medications Fact Sheet

Summa Health System developed this fact sheet for patients who need to take oral medicine to manage their diabetes. Care providers give it to patients during diabetes planned visits, and it is part of the Diabetes Planned Visit Notebook. Oral Diabetes Medications Family Medicine Center of Akron Copyright © 2006 American Diabetes Association Adapted from the ADA Patient Information The first treatment for type 2 diabetes is often meal planning for blood glucose (sugar) control, weight loss, and exercising. Sometimes these measures are not enough to bring blood glucose levels down near the normal range. The next step is taking a medicine that lowers blood glucose levels. How they work In people with diabetes, blood glucose levels are too high. These high levels occur because glucose remains in the blood rather than entering cells, where it belongs. But for glucose to pass into a cell, insulin must be present and the cell must be "hungry" for glucose. People with type 1 diabetes don't make insulin. For them, insulin shots are the only way to keep blood glucose levels down. People with type 2 diabetes tend to have two problems: they don't make quite enough insulin and the cells of their bodies don't seem to take in glucose as eagerly as they should. All diabetes pills sold today in the United States are members of five classes of drugs: sulfonylureas, meglitinides, biguanides, thiazolidinediones, and alpha-glucosidase inhibitors. These five classes of drugs work in different ways to lower blood glucose levels. Can diabetes pills help me? Only people with type 2 diabetes can use pills to manage their diabetes. These pills work best when used with meal planning and exercise. This way you have three therapies working together to lower your blood glucose levels. Diabetes pills Continue reading >>

390 Drugs That Can Affect Blood Glucose Levels

Knowing the drugs that can affect blood glucose levels is essential in properly caring for your diabetes patients. Some medicines raise blood sugar in patients while others might lower their levels. However, not all drugs affect patients the same way. 390 Drugs that Can Affect Blood Glucose Levels is also available for purchase in ebook format. 390 Drugs that can affect blood glucose Level Table of Contents: Drugs that May Cause Hyper- or Hypoglycemia Drugs That May Cause Hyperglycemia (High Blood Sugar) (GENERIC NAME | BRAND NAME) Abacavir | (Ziagen®) Abacavir + lamivudine,zidovudine | (Trizivir®) Abacavir + dolutegravir + lamivudine | (Triumeq®) Abiraterone | (Zytiga®) Acetazolamide | (Diamox®) Acitretin | (Soriatane®) Aletinib | (Alecensa®) Albuterol | (Ventolin®, Proventil®) Albuterol + ipratropium | (Combivent®) Aliskiren + amlodipine + hydrochlorothiazide | (Amturnide®) Aliskiren + amlodipine | (Tekamlo®) Ammonium chloride Amphotericin B | (Amphocin®, Fungizone®) Amphotericin B lipid formulations IV | (Abelcet®) Amprenavir | (Agenerase®) Anidulafungin | (Eraxis®) Aripiprazole | (Abilify®) Arsenic trioxide | (Trisenox®) Asparaginase | (Elspar®, Erwinaze®) Atazanavir | (Reyataz ®) Atazanavir + cobistat | (Evotaz®) Atenolol + chlorthalidone | (Tenoretic®) Atorvastatin | (Lipitor®) Atovaquone | (Mepron®) Baclofen | (Lioresal®) Belatacept | (Nulojix®) Benazepril + hydrochlorothiazide | (Lotension®) Drugs That May Cause Hyperglycemia (High Blood Sugar) – Continued (GENERIC NAME | BRAND NAME) Betamethasone topical | (Alphatrex®, Betatrex®, Beta-Val®, Diprolene®, Diprolene® AF, Diprolene® Lotion, Luxiq®, Maxivate®) Betamethasone +clotrimazole | (Lotrisone® topical) Betaxolol Betoptic® eyedrops, | (Kerlone® oral) Bexarotene | (Targ Continue reading >>

Diabetes Medication

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 >>

Hypoglycemia

Print Overview Hypoglycemia is a condition characterized by an abnormally low level of blood sugar (glucose), your body's main energy source. Hypoglycemia is commonly associated with the treatment of diabetes. However, a variety of conditions, many of them rare, can cause low blood sugar in people without diabetes. Like fever, hypoglycemia isn't a disease itself — it's an indicator of a health problem. Immediate treatment of hypoglycemia involves quick steps to get your blood sugar level back into a normal range — about 70 to 110 milligrams per deciliter, or mg/dL (3.9 to 6.1 millimoles per liter, or mmol/L) — either with high-sugar foods or medications. Long-term treatment requires identifying and treating the underlying cause of hypoglycemia. Symptoms Similar to the way a car needs gas to run, your body and brain need a constant supply of sugar (glucose) to function properly. If glucose levels become too low, as occurs with hypoglycemia, it can cause these signs and symptoms: Heart palpitations Fatigue Pale skin Shakiness Anxiety Sweating Hunger Irritability Tingling sensation around the mouth Crying out during sleep As hypoglycemia worsens, signs and symptoms may include: Confusion, abnormal behavior or both, such as the inability to complete routine tasks Visual disturbances, such as blurred vision Seizures Loss of consciousness People with severe hypoglycemia may appear as if they're intoxicated. They may slur their words and move clumsily. Many conditions other than hypoglycemia may cause these signs and symptoms. A blood sample to test your blood sugar level at the time of these signs and symptoms is how to know for sure that hypoglycemia is the cause. When to see a doctor Seek a doctor's help immediately if: You have what may be symptoms of hypoglycemia an Continue reading >>

Understanding Oral Diabetes Medications

by Gail Brashers-Krug Today, almost 21 million Americans have diabetes, and more than 90 percent of those have type 2, or insulin resistant diabetes. Doctors often prescribe oral medications to treat type 2 diabetes, either alone or combination with insulin therapy. This article provides a guide to those oral medications. Which Diabetics Use Pills? With a few exceptions, diabetes comes in two types. Type 1 diabetes occurs when the body does not produce enough insulin on its own. To treat type 1, you must restore the proper amount of insulin—either by taking insulin (through injection or inhalation), or by receiving a transplant, either of an entire pancreas or of specialized pancreas cells, called islet cells. Type 1 cannot be treated with oral medications. Type 2 diabetes occurs when the body produces enough insulin, but gradually becomes insulin resistant—that is, loses the ability to process insulin. Type 2 is usually controlled first through diet and exercise, which improve your body’s ability to process its insulin. For most type 2 diabetics, however, diet and exercise changes are not enough. The next step is oral diabetes medication. Moreover, most type 2 diabetics eventually stop producing enough insulin, and often cease insulin production altogether. As a result, many type 2 diabetics will ultimately need insulin therapy in combination with their pills. How Do the Different Pills Work? Oral diabetes medications attack the problem in three ways. More insulin: Some pills stimulate your pancreas to produce more insulin. The first successful “diabetes pills” were the sulfonylureas (glyburide, glipizide, glimepiride, tolazamide, chlorpropamide, and tolbutamide). These are insulin secretagogues, that is, chemicals that cause your pancreas to produce more ins Continue reading >>

Understanding Hypoglycemia

When you think about diabetes and blood glucose control, the first thing that comes to mind is probably avoiding high blood glucose levels. After all, the hallmark of diabetes is high blood glucose, or hyperglycemia. But controlling blood glucose is more than just managing the “highs”; it also involves preventing and managing the “lows,” or hypoglycemia. Most people are aware that keeping blood glucose levels as close to normal as possible helps prevent damage to the blood vessels and nerves in the body. But keeping blood glucose levels near normal can carry some risks as well. People who maintain “tight” blood glucose control are more likely to experience episodes of hypoglycemia, and frequent episodes of hypoglycemia — even mild hypoglycemia and even in people who don’t keep blood glucose levels close to normal — deplete the liver of stored glucose (called glycogen), which is what the body normally draws upon to raise blood glucose levels when they are low. Once liver stores of glycogen are low, severe hypoglycemia is more likely to develop, and research shows that severe hypoglycemia can be harmful. In children, frequent severe hypoglycemia can lead to impairment of intellectual function. In children and adults, severe hypoglycemia can lead to accidents. And in adults with cardiovascular disease, it can lead to strokes and heart attacks. To keep yourself as healthy as possible, you need to learn how to balance food intake, physical activity, and any diabetes medicines or insulin you use to keep your blood glucose as close to normal as is safe for you without going too low. This article explains how hypoglycemia develops and how to treat and prevent it. What is hypoglycemia? Blood glucose levels vary throughout the day depending on what you eat, how Continue reading >>