Diabetes Medication
There are many types of medicines used to treat diabetes. Which medication is best for you depends on the type of diabetes you have and your own health and lifestyle. Diabetes medicines aim to keep your blood glucose levels within a healthy range so you feel well and prevent complications. Insulin Insulin is a hormone that helps move glucose from your blood into the cells of your body, where it can be used for energy. People with type 1 diabetes produce little or no insulin, so need lifelong insulin replacement. Some people with type 2 diabetes, and a some women with gestational diabetes (diabetes during pregnancy), also need to use insulin. Medicines for type 2 diabetes Most people with type 2 diabetes are able at first to manage their condition through healthy eating, regular physical activity and controlling their weight. Over time, things change and most people need medicines to control their blood glucose levels and prevent long term complications. There are many types of diabetes medicines that work in different ways, and have different benefits and side effects. Metformin Most people with type 2 diabetes start treatment with metformin, a drug that reduces the amount of glucose released into your blood, and increases the amount taken up by your cells. Sulphonylureas Sulphonylureas stimulate the pancreas to produce more insulin. Sometime a sulfonylurea may be prescribed for people with type 2 diabetes as an alternative to metformin, but it is usually used as well as metformin, if diet, exercise and metformin alone do not control blood glucose levels adequately. Both metformin and sulphonylureas have been used for many years and are known to successfully reduce the complications of diabetes. Other medicines Other, newer medicines for type 2 diabetes include: gliptin Continue reading >>
Treatment Options For Type 2 Diabetes
Diet and exercise After initially being diagnosed with Type 2 diabetes, your doctor may prescribe a diet and exercise regime if your diagnosis was caught early. They may also refer you to diabetes educator or dietician who can support your regime, to assist you in keeping your glucose levels under control. However, lifestyle changes may not be enough to control your glucose levels and it may be necessary to take oral medication or insulin. Find out more about carbohydrate counting, nutrition and eating with diabetes. If your doctor has prescribed a diet and exercise plan and it has not led to better glucose control or your diagnosis was later, oral medication may be used. There are a number of oral medications available to manage Type 2 diabetes. Some oral medications may lower the level of glucose in your blood, increase your insulin levels or do both. Sometimes your doctor might prescribe a combination of these medications and could prescribe insulin in addition to oral medication. Types of medications for Type 2 diabetes include: Metformin (Biguanides) reduces the amount of glucose released by the liver. This leads to your body becoming more sensitive to insulin and creates a more effective uptake of glucose. Metformin is less likely to cause weight-gain than other medications. Sulphonylureas stimulate the pancreas to release more insulin to lower blood glucose levels. Sulphonylureas are referred to as anti-diabetic agents and can be prescribed in addition to metformin if the maximum dose is unable to regulate blood glucose levels. Glitinides are an alternative for people allergic to sulphonylureas. Like sulphonylureas, glitinides stimulate the pancreas to release more insulin. Acarbose (Alpha Glucosidase Inhibitors) can also be prescribed with metformin or with sulp Continue reading >>
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Taking Medical Equipment And Medications On Board
Medical Equipment If you need to use Medical Support Equipment on board, as well as providing a Travel Clearance Form, your equipment must be authorised as safe for use on Qantas aircraft. More information on Qantas authorised medical equipment can be obtained from the medical support equipment list. No other equipment can be accepted. Any medical equipment used on Qantas domestic services must be battery operated. Note: On-board use of Continuous Positive Airways Pressure (CPAP) devices (both battery operated and electric) requires Qantas clearance, but does not require clearance from a medical practitioner. Simply download and complete the CPAP Travel Clearance form and fax to +61 (2) 9490 1830 and we'll review and make the necessary arrangements. Strict safety rules govern the operation of electronic equipment on board aircraft. Hearing aids and heart pacemakers are allowed. Inspection prior to your flight: Medical equipment to be used on board must be made available for inspection a few hours before departure and approved for use on board. Normal carry-on baggage regulations apply to any medical support equipment to be used in flight. Notice periods: Qantas needs time to process clearances and make arrangement for special equipment. You must inform Qantas and provide any clearances for travel up to 72 hours before your intended travel. Supply of equipment: You must supply all medical equipment that you require to travel safely. Remember to bring any medication that may be needed in your carry-on baggage. Back to list Stretchers Qantas can provide stretchers onboard most aircraft. All charges (including the cost of ambulance transfers, change fees and cancellation fees etc) are the responsibility of the passenger. Customers requiring stretcher services must: Contact Continue reading >>
A New Blood Glucose Management Algorithm For Type 2 Diabetes: A Position Statement Of The Australian Diabetes Society
A new blood glucose management algorithm for type 2 diabetes: a position statement of the Australian Diabetes Society Jenny E Gunton, N Wah Cheung, Timothy ME Davis, Sophia Zoungas and Stephen Colagiuri Med J Aust 2014; 201 (11): 650-653. || doi: 10.5694/mja14.01187 Lowering blood glucose levels in people with type 2 diabetes has clear benefits for preventing microvascular complications and potential benefits for reducing macrovascular complications and death. Treatment needs to be individualised for each person with diabetes. This should start with selecting appropriate glucose and glycated haemoglobin targets, taking into account life expectancy and the patient's wishes. For most people, early use of glucose-lowering therapies is warranted. A range of recently available therapies has added to the options for lowering glucose levels, but this has made the clinical pathway for treating diabetes more complicated. This position statement from the Australian Diabetes Society outlines the risks, benefits and costs of the available therapies and suggests a treatment algorithm incorporating the older and newer agents. Large randomised controlled trials (RCTs) have demonstrated that controlling blood glucose level (BGL) in people with type 2 diabetes (T2D) is important for preventing microvascular complications. 1 , 2 Lowering BGL may also reduce myocardial infarction, though not necessarily stroke or all-cause mortality. 3 In 2009, the Australian Diabetes Society (ADS) published a position statement recommending individualisation of glycaemic targets. 4 The general glycated haemoglobin (HbA1c) target for most people with T2D is 53mmol/mol (7%), however: in people without known cardiovascular disease, a long duration of diabetes, severe hypoglycaemia or another contraindicati Continue reading >>
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Diabetes: Tablets For Type 2 Diabetes
Tablets that are used to treat type 2 diabetes mellitus are known as oral hypoglycaemics or antihyperglycaemics. There are a number of different types of oral hypoglycaemics available for treating type 2 diabetes, and they work in different ways. They may be used on their own and some can be used in conjunction with each other, or with insulin. Biguanides Metformin (e.g. Diabex, Glucophage) is the only biguanide currently available in Australia. Metformin is generally the first choice hypoglycaemic medication prescribed for people with type 2 diabetes. There are several combination medicines that contain metformin plus another type of oral hypoglycaemic medicine in one tablet. These include: metformin plus a sulfonylurea — glibenclamide (brand name Glucovance); metformin plus a glitazone — rosiglitazone (brand name Avandamet); and metformin plus incretin enhancers — DPP-4 inhibitors, including sitagliptin (brand name Janumet), vildagliptin (brand name Galvumet), saxagliptin (brand name Kombiglyze), alogliptin (Nesina Met) and linagliptin (brand name Trajentamet). How do they work? Biguanides work by reducing the amount of glucose produced by the liver, increasing the uptake of glucose by muscle and fat cells, and slowing the absorption of glucose by the intestine. This in turn reduces the level of glucose in the bloodstream. Side effects Lactic acidosis The most serious complication associated with metformin is lactic acidosis. This happens when lactic acid builds up in the body faster than it can be metabolised. It is a potentially fatal condition but is very rare. When lactic acidosis occurs in people treated with metformin it is generally associated with old age, or people with kidney, liver or heart problems, those taking more than 2 grams of metformin per day Continue reading >>
Medications For Type 2 Diabetes
Many people with type 2 diabetes need medications to help manage their blood glucose levels. When you are first diagnosed with type 2 diabetes, you may not need medication. However, as diabetes progresses, most people will eventually need medications to help lower their blood glucose levels. This may include tablets or injectable medications, or in some cases, insulin. Read more in our Medications for type 2 diabetes factsheet. Continue reading >>
Breakthrough 'once-a-week' Diabetes Treatment Now On Pbs
14/08/2016 10:25 AM AEST | Updated 14/08/2016 12:06 PM AEST Breakthrough 'Once-A-Week' Diabetes Treatment Now On PBS The government has given thousands of Aussies easier access to a breakthrough diabetes drug. Treatment for people with type 2 diabetes just got cheaper and less intrusive with a once-a-week injection now on the Pharmaceutical Benefits Scheme (PBS). The listing of the drug Bydureon will mean about 250,000 Australians living with type 2 diabetes can now more easily access the one-jab-per-week treatment instead of having to inject a number of times each day. That's because the PBS listing vastly lowers the cost of Bydureon , saving about $1600 per year. Health Minister Sussan Ley will reportedly announce the listing of the new diabetes treatment today, which is part of a $70 million suite of new medicines to be included on the PBS. New listings on the PBS Sept 1 for Type 2 diabetes - make this life changing medication affordable and available pic.twitter.com/EAI0bfQGqB Sussan Ley (@sussanley) August 14, 2016 The added drugs are also said to include treatments for cervical cancer and other life-threatening illnesses. Senior coalition minister Steve Ciobo was confident the changes would have a big positive health impact for many Australians. "We are bringing into place new medicines that will have a beneficial impact, especially around type 2 diabetes, we will see patients potentially going from having to have two injections a day to only one per week," he told ABC television. "The impact ... on the Australian community is of course very significant." Thousands of Australians will have access to new drug which will make management of Type 2 diabetes easier. #9News Nine News Australia (@9NewsAUS) August 13, 2016 Bydureon is the brand name for the drug Exenatid Continue reading >>
Glucose-lowering Medicines For Type 2 Diabetes
Background There is an increasing array of medicines available to improve blood glucose control in type 2 diabetes. Finding the best com-bination for an individual patient requires an assessment of the patient’s characteristics and understanding the mechanism of action for each drug. Objective/s The aim of this article is to provide a rational approach for choosing between the various blood glucose-lowering medicines available for treatment of patients with type 2 diabetes mellitus. Discussion Metformin is the first choice of glucose-lowering medicines for most patients with type 2 diabetes. Sulphonylureas have proven benefits in long-term trials. Insulin is required in patients with symptoms of insulin deficiency. Glucagon-like peptide 1 agonists and sodium-glucose co-transporter 2 inhibitors provide some assistance in weight loss as well as improving blood glucose con-trol. Dipeptidyl peptidase 4 inhibitors provide an alternative to metformin and sulphonylureas, especially when side effects of those drugs limit their use. Re-assessing blood glucose control after an appropriate trial period before deciding on continuing use is appropriate. In recent years, pharmacological options for treating type 2 diabetes have expanded substantially. The place of metformin as the drug of first choice is unquestioned. Sulphonylureas have a long history and their use is supported by outcome data from the UK Prospective Diabetes Study (UKPDS).1 Choosing agents other than metformin or sulphonylureas is more difficult, apart from the use of insulin in patients who are clearly insulin-deficient. Most pharmacological options will reduce glycosylated haemoglobin (HbA1c) by 0.5–1.0%, on average, either as monotherapy, compared to placebo, or in addition to metformin and or a sulphonylure Continue reading >>
Racgp - More Diabetes Medications Available Through The Pbs
More diabetes medications available through the PBS Australians with diabetes will be able to access a broader range of medicines via the Pharmaceutical Benefits Scheme from 1 April. One of the new diabetes drugs on the PBS is a new form of insulin glargine, which is designed to provide more stable levels of blood glucose and a reduction in night-time hypoglycaemia. Australians with diabetes will be able to access a broader range of medicines through the Pharmaceutical Benefits Scheme from 1 April. Eleven new and expanded listings have been added to the Pharmaceutical Benefits Scheme (PBS), including a number of medicines designed to treat diabetes. As of 1 April, well be a world leader in diabetes treatment, Federal Health Minister Greg Hunt said. What this means is that medicines that would have been beyond ability of so many Australians to afford, will now be available and affordable. Medicines that will be available through the PBS includea new form of insulin glargine, that releases more gradually, providing patients with more stable levels of blood glucose and a reduction in night-time hypoglycaemia. Patients will also be able to access a new combination tablet that assists in lowering their blood sugar levels. In addition, a number of current medicines for diabetes will also be made easily available to patients through the PBS, at the maximum cost of $39.50 per script, with concessional patients paying $6.40. Dr Gary Deed, GP and Chair of the RACGP Diabetes Specific Interest network, told newsGP he is pleased about the possibilities presented by these changes to the PBS. New choices allow GPs to be able to pick solutions that can fit a wide range of patients, he said. However, greater choice in treatment options can also be difficult to navigate. Dr Deed advises Continue reading >>
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Weekly Dose: Metformin, The Diabetes Drug Developed From French Lilac
Metformin is the most widely used drug to treat type 2 diabetes globally. In Australia, approximately two-thirds of patients with type 2 diabetes are prescribed metformin, either alone or in combination with other pills, or with insulin injections. Alongside diet and exercise, metformin is considered the first-choice drug to improve glucose control in type 2 diabetes. Metformin hydrochloride is the scientific or generic name for the active ingredient in tablets sold in Australia under 40 different proprietary or brand names. History Metformin was originally developed from natural compounds found in the plant Galega officinalis, known as French lilac or goat’s rue. Synthetic biguanides were developed in the 1920s in Germany, but their use was limited due to side effects. During the 1940s, however, French physician Jean Sterne examined a new biguanide called dimethylbiguanide or metformin. At the time, it was being studied for the treatment of influenza, but Sterne recognised it had glucose-lowering properties. He proposed calling it glucophage, meaning glucose eater, a name with which it is still commercially associated today. Metformin has been used to treat diabetes since the late 1950s. It is now on the World Health Organisation’s List of Essential Medicines needed for a basic health care system. How does it work? Insulin suppresses the production of glucose by the liver. One reason glucose levels remain high in those with type 2 diabetes is due to insufficient insulin. The liver continues to inappropriately make large amounts of glucose, even when glucose levels are already high. Metformin is able to reduce glucose production by the liver by approximately one-third, through mechanisms that remain to be fully understood. When taken as directed, it will reduce the Continue reading >>
New Type 2 Diabetes Treatment Reduces Blood Sugar Levels And Aids In Weight Loss
/display/newscorpaustralia.com/Web/NewsNetwork/Lifestyle - syndicated/Health/ A diet with too much free sugar can lead to obesity problems, which in turn increases the risk of developing type II diabetes. Picture: iStockSource:istock A PILL taken once a day may significantly improve the health and waistlines of people with type 2 diabetes, researchers in England have found. Scientists from the Leicester Diabetes Centre at the University of Leicester have reported that a semaglutide pill has been shown to lower blood glucose levels by almost two per cent and help patients to lose weight. The pill will enable patients to better control their condition and reduce the need for insulin injections. Unlike many of the current treatments, semaglutide doesnt carry the risk of causing low blood sugar or weight gain. A pill could be the answer diabetes sufferers have been waiting for. Picture: iStockSource:Supplied Semaglutide works by stimulating insulin production while suppressing both glucagon (the hormone that raises glucose levels) and appetite. Of the 632 participants in the 26-week study, 90 per cent of those receiving the drug were able to lower their blood sugar levels to a target level of less than seven per cent, reducing the need for insulin. Weight loss also occurred in 71 per cent of patients taking the pill. The results of the phase II trial were published in the medical journal JAMA. Type 2 diabetes, the most common form of diabetes, develops as the body becomes resistant to the effects of insulin and/or the pancreas becomes less effective at producing insulin. According to Diabetes Australia, 280 Aussies develop diabetes every day. Currently about 1.7 million Australian have diabetes (this includes all types, both diagnosed and undiagnosed). Study leader Profess Continue reading >>
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Medication For Type 2 Diabetes
People with type 2 diabetes are often given medications including insulin to help control their blood glucose levels. Most of these medications are in the form of tablets, but some are given by injection. Tablets or injections are intended to be used in conjunction with healthy eating and regular physical activity, not as a substitute. Diabetes tablets are not an oral form of insulin.Speak with your doctor or pharmacist if you experience any problems. An alternative medication is usually available. All people with diabetes need to check their glucose levels on a regular basis. When taking medication, you may need to check your glucose levels more often to keep you safe and to ensure the medication is having the desired effect. In Australia there are seven classes of medicines used to treat type 2 diabetes: Biguanides Sulphonylureas Thiazolidinediones (Glitazones) Alpha-glucosidase Inhibitors. Dipeptidyl peptidase 4 (DPP4) inhibitors Incretin mimetics Sodium-glucose transporter (SGLT2) inhibitors Your doctor will talk to you about which tablets are right for you, when to take your tablets and how much to take. Your doctor can also tell you about any possible side effects. You should speak to your doctor or pharmacist if you experience any problems. Chemical name: METFORMIN , METFORMIN ER Points to remember about biguanides This group of insulin tablets helps to lower blood glucose levels by reducing the amount of stored glucose released by the liver, slowing the absorption of glucose from the intestine, and helping the body to become more sensitive to insulin so that your own insulin works better They need to be started at a low dose and increased slowly Metformin is often prescribed as the first diabetes tablet for people with type 2 diabetes who are overweight. It gene Continue reading >>
Australia - Diabetes Traveller's Guide
Around 620,000 British people visit Australia every year Among the world-renowned attractions of Australia include the Sydney Opera House, Sydney Harbour Bridge and the spectacular sights of natural wonder the Great Barrier Reef. Around 620,000 British nationals visit Australia every year, which can only be travelled to by airplane due to its 15,196 km distance from the United Kingdom. It will take roughly a day to travel to Australia, so travellers with diabetes are urged to devise a management routine beforehand with your diabetes team that allows for the greatest control of your blood sugar levels . Flying from London to Sydney will require around 21 hours of travelling time, on average, although travelling to Perth, which resides on the opposite side of Australia to Sydney, will take roughly 18 hours from London. Australia has 13 time zones, so researching how far ahead the time is in your destination will be crucial in assessing how to manage your diabetes upon arriving. Sydney is 11 hours ahead of Greenwich Mean Time (GMT), whereas Brisbane is 10 hours ahead. Wherever your destination in Australia, you should be prepared for a lengthy time difference. You should discuss how best to medicate your diabetes with a member of your diabetes team, while monitoring your blood sugar more often will be necessary for the first few days. Australia's seasons are opposite to those in the northern hemisphere. December to February is summer, which sees an average temperature of 20C , while June to August is more comparable to the UK winter and has an average of 12C. If travelling during Australias winter, diabetes medication may not be affected, but greater considerations may be required for people visiting during the summer. Insulin absorption can be affected by warm weather, s Continue reading >>
Pharmacological Therapies In Australia For Type 2 Diabetes
Guidelines recommend a stepwise approach to management of type 2 diabetes mellitus.1-3 Lifestyle changes are recommended as the first step and should be reinforced throughout the treatment program.1-4 These include a healthy diet, regular exercise, and weight loss in overweight or obese individuals.1, 3 Start pharmacotherapy in patients who do not achieve treatment targets with lifestyle changes.1‐3 Consider starting medicines earlier in patients who are experiencing symptoms or have a consistently high blood glucose level. 4 Pharmacotherapy typically involves starting with an oral glucose-lowering medicine and progressively intensifying therapy by adding medicines if treatment targets are not met despite adequate adherence and titration.1, 2 Second-line treatment There is limited comparative evidence for various combinations of medicines to inform prescribing of a second or third glucose-lowering medicine.2 Subsequent add-on therapies should be individualised, taking into consideration patient characteristics and preferences, synergistic effects of differing medicine combinations and licensed combinations.1-3 Long-term clinical experience and data for sulfonylureas, as well as cost-effectiveness, makes them the usual second-line add-on agent to metformin.2, 3 Consider an alternative agent for patients in whom sulfonylureas are contraindicated or not tolerated and for those who experience problematic hypoglycaemia or weight gain.2 Dipeptidyl peptidase-4 (DPP-4) inhibitors and sodium–glucose co-transporter-2 (SGLT2) inhibitors are alternative second-line add-on medicines and are PBS subsidised for use with either metformin or a sulfonylurea.1, 2, 5 Glucagon-like peptide-1 (GLP-1) analogues and thiazolidinediones are also PBS subsidised as dual therapy with metformin Continue reading >>
Impact On Medication Use And Adherence Of Australian Pharmacists' Diabetes Careservices.
1. J Am Pharm Assoc (2003). 2005 Jan-Feb;45(1):33-40. Impact on medication use and adherence of Australian pharmacists' diabetes careservices. Krass I(1), Taylor SJ, Smith C, Armour CL. (1)Faculty of Pharmacy, University of Sydney, Camperdown, New South Wales, Australia. [email protected] OBJECTIVE: To assess the effect of a specialized service implemented in communitypharmacies for patients with type 2 diabetes on medication use andmedication-related problems.DESIGN: Parallel group, multisite, control versus intervention, repeated measuresdesign, with three different regions in New South Wales, Australia, used asintervention regions, then matched with control regions as much as possible.INTERVENTION: After initial training, pharmacists followed a clinical protocolfor more than 9 months, with patient contact approximately monthly. Each patient received an adherence assessment at the beginning and end of the study, adherencesupport, and a medication review as part of the intervention.MAIN OUTCOME MEASURES: Risk of nonadherence using Brief Medication Questionnaire (BMQ) scores and changes to medication regimen.RESULTS: Compared with 82 control patients, 106 intervention patients withsimilar demographic and clinical characteristics had significantly improvedself-reported nonadherence as reflected in total BMQ scores after 9 months. Themean (+/-SD) number of medications prescribed at follow-up in interventionparticipants decreased significantly, from 8.2+/-3.0 to 7.7+/-2.7. No reductionwas observed among the control patients (7.6+/-2.4 and 7.3+/-2.4). The overallprevalence of changes to the regimen was also significantly higher in theintervention group (51%) compared with controls (40%).CONCLUSION: Community pharmacists trained in medication review and usingprotocols Continue reading >>
