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Diabetes Mellitus Medications

Oral Diabetes Medications Summary Chart

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 >>

History Of Current Non-insulin Medications For Diabetes Mellitus

History Of Current Non-insulin Medications For Diabetes Mellitus

History of current non-insulin medications for diabetes mellitus Celeste C. L. Quianzon , MD and Issam E. Cheikh , MD* Division of Endocrinology, Department of Medicine, Union Memorial Hospital, Baltimore, MD, USA *Issam E. Cheikh, Division of Endocrinology, Department of Medicine, Union Memorial Hospital 201 E. University Parkway, Baltimore, MD 21218, USA. Email: [email protected] Received 2012 Jun 29; Accepted 2012 Jul 3. Copyright 2012 Celeste C. L. Quianzon and Issam E. Cheikh This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. This article has been cited by other articles in PMC. This article is a brief review of the current non-insulin agents for diabetes mellitus in the United States, namely, sulfonylureas, biguanides, thiazolidinediones, meglitinides, -glucosidase inhibitors, glucacon-like peptide-1 receptor agonists, dipeptidyl-peptidase-4 inhibitors, amylin agonists, bromocriptine, and colesevelam. Keywords: diabetes medication, history, review Since the introduction of sulfonylureas, multiple medications have been introduced for the treatment of diabetes mellitus type 2, substituting or supplementing insulin. A short review of these medications is presented in this article. Sulfonylureas stimulate pancreatic -cells to secrete insulin by binding to receptors that block the potassium ATP-dependent channels, leading to cell depolarization and subsequently insulin exocytosis. The hypoglycemic activity of synthetic sulfur compounds was noted by Ruiz and his colleagues in 1937 ( 1 ). In 1942, Janbon, a French physician, and his colleagues confirmed hypoglycemia in patients treated wit Continue reading >>

Type 2 Diabetes Mellitus Medication

Type 2 Diabetes Mellitus Medication

Medication Summary Pharmacologic therapy of type 2 diabetes has changed dramatically in the last 10 years, with new drugs and drug classes becoming available. These drugs allow for the use of combination oral therapy, often with improvement in glycemic control that was previously beyond the reach of medical therapy. Agents used in diabetic therapy include the following: Traditionally, diet modification has been the cornerstone of diabetes management. Weight loss is more likely to control glycemia in patients with recent onset of the disease than in patients who are significantly insulinopenic. Medications that induce weight loss, such as orlistat, may be effective in highly selected patients but are not generally indicated in the treatment of the average patient with type 2 diabetes mellitus. Patients who are symptomatic at initial presentation with diabetes may require transient treatment with insulin to reduce glucose toxicity (which may reduce beta-cell insulin secretion and worsen insulin resistance) or an insulin secretagogue to rapidly relieve symptoms such as polyuria and polydipsia. Continue reading >>

List Of Medications Available For Diabetes

List Of Medications Available For Diabetes

Diabetes is a disorder of blood sugar levels. There are two main types of diabetes, plus rarer forms such as diabetes that can happen during pregnancy, known as gestational diabetes. Type 1 diabetes results in high blood sugar levels because the body stops producing insulin, the hormone that regulates sugar levels. Type 2 diabetes leads to high blood sugars because the insulin in the body does not work effectively. The broad differences in treatment between the two types are: Type 1 diabetes is treated with insulin injection. Careful diet and activity planning is needed to avoid complications of treatment. Type 2 diabetes is treated with lifestyle measures, drugs taken by mouth, and sometimes also insulin if the other treatments fail. Medications for type 1 diabetes Treatment for type 1 diabetes is always with insulin, to replace the body's absent insulin and keep blood sugar levels under control. Insulin treatments Insulin is usually given by injection - by patients themselves, injecting it under the skin, or if hospitalized, sometimes directly into the blood. It is also available as a powder that patients can breathe in. Insulin injections vary by how quickly they act, their peak action, and how long they last. The aim is to mimic how the body would produce insulin throughout the day and in relation to energy intake. 1. Rapid-acting injections take effect within 5 to 15 minutes but last for a shorter time of 3 to 5 hours: Insulin lispro (Humalog) Insulin aspart (NovoLog) Insulin glulisine (Apidra) 2. Short-acting injections take effect from between 30 minutes and 1 hour, and last for 6 to 8 hours: Regular insulin (Humulin R and Novolin R) 3. Intermediate-acting injections take effect after about 2 hours, and last for 18 to 26 hours: Insulin isophane, also called NPH i Continue reading >>

Diabetes Mellitus Treatment

Diabetes Mellitus Treatment

In patients diagnosed with diabetes mellitus (DM), the therapeutic focus is on preventing complications caused by hyperglycemia. In the United States, 57.9% of patients with diabetes have one or more diabetes-related complications and 14.3% have three or more.[1] Strict control of glycemia within the established recommended values is the primary method for reducing the development and progression of many complications associated with microvascular effects of diabetes (eg, retinopathy, nephropathy, and neuropathy), while aggressive treatment of dyslipidemia and hypertension further decreases the cardiovascular complications associated macrovascular effects.[2-4] See the chapter on diabetes: Macro- and microvascular effects. Glycemic Control Two primary techniques are available to assess a patient's glycemic control: Self-monitoring of blood glucose (SMBG) and interval measurement of hemoglobin A1c (HbA1c). Self-Monitoring of Blood Glucose Use of SMBG is an effective method to evaluate short-term glycemic control. It helps patients and physicians assess the effects of food, medications, stress, and activity on blood glucose levels. For patients with type 1 DM or insulin-dependent type 2 DM, clinical trials have demonstrated that SMBG plays a role in effective glycemic control because it helps to refine and adjust insulin doses by monitoring for and preventing asymptomatic hypoglycemia as well as preprandial and postprandial hyperglycemia.[2,5-7] The frequency of SMBG depends on the type of medical therapy, risk for hypoglycemia, and need for short-term adjustment of therapy. The current American Diabetes Association (ADA) guidelines recommend that patients with diabetes self-monitor their glucose at least three times per day.[8] Those who use basal-bolus regimens should s Continue reading >>

Oral Pharmacologic Treatment Of Type 2 Diabetes Mellitus: A Clinical Practice Guideline Update From The American College Of Physicians Free

Oral Pharmacologic Treatment Of Type 2 Diabetes Mellitus: A Clinical Practice Guideline Update From The American College Of Physicians Free

Abstract Description: The American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on oral pharmacologic treatment of type 2 diabetes in adults. This guideline serves as an update to the 2012 ACP guideline on the same topic. This guideline is endorsed by the American Academy of Family Physicians. Methods: This guideline is based on a systematic review of randomized, controlled trials and observational studies published through December 2015 on the comparative effectiveness of oral medications for type 2 diabetes. Evaluated interventions included metformin, thiazolidinediones, sulfonylureas, dipeptidyl peptidase-4 (DPP-4) inhibitors, and sodium–glucose cotransporter-2 (SGLT-2) inhibitors. Study quality was assessed, data were extracted, and results were summarized qualitatively on the basis of the totality of evidence identified by using several databases. Evaluated outcomes included intermediate outcomes of hemoglobin A1c, weight, systolic blood pressure, and heart rate; all-cause mortality; cardiovascular and cerebrovascular morbidity and mortality; retinopathy, nephropathy, and neuropathy; and harms. This guideline grades the recommendations by using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. Target Audience and Patient Population: The target audience for this guideline includes all clinicians, and the target patient population includes adults with type 2 diabetes. Recommendation 1: ACP recommends that clinicians prescribe metformin to patients with type 2 diabetes when pharmacologic therapy is needed to improve glycemic control. (Grade: strong recommendation; moderate-quality evidence) Recommendation 2: ACP recommends that clinicians consider adding either a Continue reading >>

Table Of Medications

Table Of Medications

Medications used to treat type 2 diabetes include: Use this table to look up the different medications that can be used to treat type 2 diabetes. Use the links below to find medications within the table quickly, or click the name of the drug to link to expanded information about the drug. Table of oral medications, incretion-based therapy and amylin analog therapy: Medicine FDA Approval Formulations (color indicated if available by Brand only) Dosing Comments (SE = possible side effects) STIMULATORS OF INSULIN RELEASE (Insulin Secretagogues) – increase insulin secretion from the pancreas1 SULFONYLUREAS (SFUs) Tolbutamide Orinase® various generics 1957 500 mg tablets Initial: 1000-2000 mg daily Range: 250-3000 mg (seldom need >2000 mg/day) Dose: Taken two or three times daily SE: hypoglycemia, weight gain Preferred SFU for elderly Must be taken 2-3 times daily Glimepiride Amaryl® various generics 11/95 1 mg, 2 mg, 4 mg tablets Initial: 1-2 mg daily Range: 1-8 mg Dose: Taken once daily SE: hypoglycemia, weight gain Need to take only once daily Glipizide Glucotrol® Glucotrol XL® various generics 5/84 4/94 5 mg, 10 mg tablets ER: 2.5 mg, 5 mg, 10 mg tablets Initial: 5 mg daily Range: 2.5-40 mg2 (20 mg for XL) Dose: Taken once or twice (if >15 mg) daily SE: hypoglycemia, weight gain Preferred SFU for elderly ER = extended release/take once a day Glyburide Micronase®, DiaBeta® various generics 5/84 1.25 mg, 2.5 mg, 5 mg tablets Initial: 2.5-5 mg daily Range: 1.25-20 mg2 Dose: Taken once or twice daily SE: hypoglycemia, weight gain Glyburide, micronized Glynase PresTab® various generics 3/92 1.5 mg, 3 mg, 4.5 mg, 6 mg micronized tablets Initial: 1.5-3 mg daily Range: 0.75-12 mg Dose: Taken once or twice (if >6 mg) daily SE: hypoglycemia, weight gain GLINIDES Repaglini Continue reading >>

Drug Treatment Of Diabetes Mellitus

Drug Treatment Of Diabetes Mellitus

Insulin is required for all patients with type 1 DM if they become ketoacidotic without it; it is also helpful for management of many patients with type 2 DM. Insulin replacement in type 1 DM should ideally mimic beta-cell function using 2 insulin types to provide basal and prandial requirements (physiologic replacement); this approach requires close attention to diet and exercise as well as to insulin timing and dose. When insulin is needed for patients with type 2 DM, glycemic control can often be achieved with basal insulin combined with non-insulin anti-hyperglycemic drugs, although prandial insulin may be needed in some patients. Except for use of regular insulin, which is given IV in hospitalized patients, insulin is almost always administered subcutaneously. Recently, an inhaled insulin preparation has also become available. Most insulin preparations are now recombinant human, practically eliminating the once-common allergic reactions to the drug when it was extracted from animal sources. A number of analogs are available. These analogs were created by modifying the human insulin molecule that alters absorption rates and duration and time to action. Insulin types are commonly categorized by their time to onset and duration of action (see Table: Onset, Peak, and Duration of Action of Human Insulin Preparations*). However, these parameters vary within and among patients, depending on many factors (eg, site and technique of injection, amount of subcutaneous fat, blood flow at the injection site). Rapid-acting insulins, including lispro and aspart, are rapidly absorbed because reversal of an amino acid pair prevents the insulin molecule from associating into dimers and polymers. They begin to reduce plasma glucose often within 15 min but have short duration of action Continue reading >>

Oral Medications For Diabetes Mellitus

Oral Medications For Diabetes Mellitus

Acarbose (Precose) 25-100 mg tid before meals Miglitol (Glyset) 25-100 mg tid before meals These drugs are reversible inhibitors of intestinal alphaglucosidase enzymes, which result in delayed breakdown of ingested carbohydrates, and which delay glucose absorption. They reduce postprandial hyperglycemia. Adverse effects include flatulence, bloating, and other gastrointestinal (GI) complaints. Alpha-glucosidase inhibitors should be titrated gradually to limit GI intolerance. These drugs will decrease postprandial hyperglycemia and rarely produce symptomatic hypoglycemia. They should not be used in patients with inflammatory bowel disease, colonic ulceration, partial intestinal obstruction, or chronic intestinal disease associated with disorders of digestion or absorption. Tolbutamide (Orinase) 1000-2000 mg/day Glyburide (DiaBeta, Micronase) 2.5-20 mg/day Micronized glyburide (Glynase) 1.5-12 mg/day These drugs increase pancreatic insulin secretion, in part by inactivating potassium (K+) channels on beta cells. Sulfonylurea use may result in a gradual but limited increase in endogenous insulin receptor sensitivity. Hypoglycemia, weight gain, allergic reactions, pruritus, rash, hepatotoxicity, and photosensitivity are possible. Side effects of chlorpropamide include syndrome of inappropriate antidiuretic hormone and alcohol intolerance (it produces a disulfiram-like reaction). Metformin (Glucophage) 500-2250 mg/day Metformin increases hepatic and peripheral sensitivity to insulin. It also may inhibit gluconeogenesis, stimulate glucose uptake by skeletal muscle, and increase insulin receptor binding. Metformin may cause nausea, diarrhea, flatulence, or lactic acidosis (rare). This drug should not be used in patients with significant renal impairment. It should be avoided i Continue reading >>

Type 2 Diabetes

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 >>

Anti-diabetic Medication

Anti-diabetic Medication

Drugs used in diabetes treat diabetes mellitus by lowering glucose levels in the blood. With the exceptions of Insulin, exenatide, liraglutide and pramlintide, all are administered orally and are thus also called oral hypoglycemic agents or oral antihyperglycemic agents. There are different classes of anti-diabetic drugs, and their selection depends on the nature of the diabetes, age and situation of the person, as well as other factors. Diabetes mellitus type 1 is a disease caused by the lack of insulin. Insulin must be used in Type I, which must be injected. Diabetes mellitus type 2 is a disease of insulin resistance by cells. Type 2 diabetes mellitus is the most common type of diabetes. Treatments include (1) agents that increase the amount of insulin secreted by the pancreas, (2) agents that increase the sensitivity of target organs to insulin, and (3) agents that decrease the rate at which glucose is absorbed from the gastrointestinal tract. Several groups of drugs, mostly given by mouth, are effective in Type II, often in combination. The therapeutic combination in Type II may include insulin, not necessarily because oral agents have failed completely, but in search of a desired combination of effects. The great advantage of injected insulin in Type II is that a well-educated patient can adjust the dose, or even take additional doses, when blood glucose levels measured by the patient, usually with a simple meter, as needed by the measured amount of sugar in the blood. Insulin[edit] Main article: insulin (medication) Insulin is usually given subcutaneously, either by injections or by an insulin pump. Research of other routes of administration is underway. In acute-care settings, insulin may also be given intravenously. In general, there are three types of insulin, Continue reading >>

Patient Education: Diabetes Mellitus Type 2: Treatment (beyond The Basics)

Patient Education: Diabetes Mellitus Type 2: Treatment (beyond The Basics)

TYPE 2 DIABETES OVERVIEW Type 2 diabetes mellitus occurs when the pancreas (an organ in the abdomen) produces insufficient amounts of the hormone insulin and/or the body becomes resistant to normal or even high levels of insulin. This causes high blood sugar (glucose) levels, which can lead to a number of complications if untreated. People with type 2 diabetes require regular monitoring and ongoing treatment to maintain normal or near-normal blood sugar levels. Treatment includes lifestyle adjustments, self-care measures, and medicines, which can minimize the risk of diabetes and cardiovascular (heart-related) complications. This topic review will discuss the treatment of type 2 diabetes. Topics that discuss other aspects of type 2 diabetes are also available: (See "Patient education: Diabetes mellitus type 2: Overview (Beyond the Basics)".) (See "Patient education: Diabetes mellitus type 2: Alcohol, exercise, and medical care (Beyond the Basics)".) TYPE 2 DIABETES TREATMENT GOALS Blood sugar control — The goal of treatment in type 2 diabetes is to keep blood sugar levels at normal or near-normal levels. Careful control of blood sugars can help prevent the long-term effects of poorly controlled blood sugar (diabetic complications of the eye, kidney, nervous system, and cardiovascular system). Home blood sugar testing — In people with type 2 diabetes, home blood sugar testing might be recommended, especially in those who take certain oral diabetes medicines or insulin. Home blood sugar testing is not usually necessary for people who are diet controlled. (See "Patient education: Self-monitoring of blood glucose in diabetes mellitus (Beyond the Basics)".) A normal fasting blood sugar is less than 100 mg/dL (5.6 mmol/L), although some people will have a different goal. Continue reading >>

Management Of Diabetes Mellitus Medications In The Nursing Home.

Management Of Diabetes Mellitus Medications In The Nursing Home.

Management of diabetes mellitus medications in the nursing home. Veterans Affairs Puget Sound Health Care System, Seattle Division, Seattle, Washington 98108, USA. [email protected] Nursing home staff are well aware of the increasing number of residents who experience diabetes mellitus. These residents consume an inordinate amount of resources and often have major disabilities and co-morbidities. Although nonpharmacological therapies, such as consistent carbohydrate intake and increased activity levels, are always indicated in diabetes management, pharmacological therapies are often necessary to prevent the acute complications of diabetes and delay some of the long-term complications. Residents with type 2 diabetes may be managed with oral antidiabetic agents and insulin, whereas residents with type 1 diabetes will always require insulin. Oral antidiabetic agents include insulin secretagogues, which stimulate endogenous insulin secretion and are most effective in leaner persons with type 2 diabetes. Metformin is another oral antidiabetic agent; this decreases inappropriate hepatic glucose release and is most effective in obese residents with high fasting blood glucose levels. The thiazolidinediones, also called glitazones, are insulin sensitisers that enable peripheral tissues to utilise insulin more effectively. The alpha-glucosidase inhibitors delay intestinal absorption of ingested carbohydrates. In addition to oral antidiabetic agents, insulin is frequently used in diabetes management. Insulin is always indicated in type 1 diabetes and is often necessary for residents with type 2 diabetes to optimise glycaemic control. Insulin can be rapid, fast, intermediate or long acting. In addition, basal insulin is now available. These insulins can be combined with each o Continue reading >>

Diabetes Mellitus Medications

Diabetes Mellitus Medications

The Human insulin whose onset of action occurs within__________minutes is humalog (lispro)? fast acting insulin the new formula can be injected 15 minutes before meal The physician orders an 1800- calorie diabetic diet and 40 units of (Humulin N) insulin U-100 subcutaneously daily for a patient with diabetes mellitus. A mid- afternoon snack of mill and crackers is given to? Humilin N insulin starts to peak in 4 hours. the nurse should be monitor for hypoglycemia reaction A patient has type 1 diabetes (IDDM). the nurse is teaching her early signs and symptoms of insulin reaction, which include? the patient needs to alert the nurse for hypoglycemic reaction The Physician prescribes Glyburide (Micronase, DiaBeta, Gllynase) for a patient, age 57 when diet and excercise have been able to control her type II Diabetes. Which Information does the nurse include when teaching her about the Glyburide? Glyburide and other hypoglycemic agents are thought to stimulate insulin production and increase sensitivity to insulin at receptor sites. oral hypoglycemic are compounds that stimulate the beta cells in the pancreas to increase insulin release To prevent lipodistrophy, the nurse should administer insulin? at room temperature and rotate injection site not straight from the refrigerator to prevent lipodistrophy. Continue reading >>

Clinical Review Of Antidiabetic Drugs: Implications For Type 2 Diabetes Mellitus Management

Clinical Review Of Antidiabetic Drugs: Implications For Type 2 Diabetes Mellitus Management

Go to: Diabetes mellitus (DM) is a complex chronic illness associated with a state of high blood glucose level, or hyperglycemia, occurring from deficiencies in insulin secretion, action, or both. The chronic metabolic imbalance associated with this disease puts patients at high risk for long-term macro- and microvascular complications, which if not provided with high quality care, lead to frequent hospitalization and complications, including elevated risk for cardiovascular diseases (CVDs) (1). The clinical diagnosis of diabetes is reliant on either one of the four plasma glucose (PG) criteria: elevated (i) fasting plasma glucose (FPG) (>126 mg/dL), (ii) 2 h PG during a 75-g oral glucose tolerance test (OGTT) (>200 mg/dL), (iii) random PG (>200 mg/dL) with classic signs and symptoms of hyperglycemia, or (iv) hemoglobin A1C level >6.5%. Recent American Diabetes Association (ADA) guidelines have advocated that no one test may be preferred over another for diagnosis. The recommendation is to test all adults beginning at age 45 years, regardless of body weight, and to test asymptomatic adults of any age who are overweight or obese, present with a diagnostic symptom, and have at least an additional risk factor for development of diabetes. Furthermore, a condition called prediabetes or impaired fasting glucose (IFG), in which the fasting blood glucose is raised more than normal but does not reach the threshold to be considered diabetes (110–126 mg/dL), predisposes patients to diabetes, insulin resistance, and higher risk of cardiovascular (CV) and neurological pathologies (2, 3). Type 2 diabetes mellitus (T2DM) can co-occur with other medical conditions, such as gestational diabetes occurring during the second or third trimester of pregnancy or pancreatic disease associate Continue reading >>

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