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Type 2 Diabetes Drugs

Understanding Oral Diabetes Medications

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 >>

Medications That Actually Help With Type 2 Diabetes

Medications That Actually Help With Type 2 Diabetes

Medications that actually help with Type 2 Diabetes As we saw in our previous post, standard medications such as insulin, sulphonylureas, metformin and DPP4’s can reduce blood glucose but do not reduce cardiovascular disease or death. Yes, your sugars will be lower, but no, you will not be healthier. Whether you take the medications or not, you will suffer the same risk of kidney disease, heart disease, stroke and death. So why take these medications at all? Well, that is a good question, for which I do not have a good answer. But why don’t these drugs work? It gets back to understanding what, exactly, insulin resistance is. High insulin resistance leads to high blood glucose, which is called type 2 diabetes. But it can be most easily understand as overflow of sugar (both glucose and fructose) in the body. Not just the blood, mind you. The entire body. Our body is like the barrel in the picture. As we eat glucose and fructose, it can hold a certain amount. Glucose may be stored as glycogen in the liver or turned into fat via de novo lipogenesis. However, if the amount coming in far exceeds the amount going out, soon, the storage capacity of the barrel and will spill out. We have two compartments for the glucose. In our body, and in our blood. If our body is full, incoming glucose spills out into the blood, which is now detectable as high blood glucose. So, what happens when your doctor prescribes insulin? Does it get rid of the sugar from the body? No, not at all. It merely takes the sugar in the blood, and shoves it into the body. Sure, the blood has less glucose, but there’s more in the body. And the next time you eat, the same thing happens. Glucose comes in, spills out into the blood. If you consider the rain barrel analogy, then insulin neither reduces the in Continue reading >>

Can People With Type 1 Use Type 2 Drugs?

Can People With Type 1 Use Type 2 Drugs?

I've heard about people with type 1 using drugs meant for type 2 diabetes in addition to insulin. Is there a benefit to doing this? Continue reading >>

Medication For Type 2 Diabetes

Medication For Type 2 Diabetes

People with type 2 diabetes have an increased risk of heart attacks and strokes. Depending on age and lifestyle, different medications and treatment goals can be important. It also depends on whether people have any other health problems. Since high blood sugar levels (hypoglycemia) are the main sign of type 2 diabetes, it seems logical to use blood-sugar lowering medication. But that is not always necessary. Medication is only needed if blood sugar levels cannot be regulated any other way, for example by changing your diet, losing weight or exercising more. Blood sugar levels that are permanently high can cause damage to the retina or the kidneys, and can also harm the blood vessels. The risk of stroke or heart attack may also increase. But the age at which type 2 diabetes begins also plays a role. Many older people with type 2 diabetes do not have any problems caused by an increased blood sugar level. For them, other conditions like high blood pressure are more serious. But if you are diagnosed with type 2 diabetes in your forties, you will probably live with the condition for quite a long time. Complications can occur even if your blood sugar levels are only slightly too high over a long period of time. It is therefore very important for younger people with diabetes to keep their blood sugar levels low. Drugs for lowering the risk of cardiac diseases Type 2 diabetes increases the risk of cardiovascular diseases. But people with diabetes often have other risk factors as well, like high blood pressure. It is then quite likely that treating those other factors may be more effective at lowering the risk of heart attack or stroke than keeping blood sugar levels low. The main drugs are: All of those drugs can have side effects. It is a good idea to talk to your doctor befo Continue reading >>

Is This Popular Medication Causing Your Joint Pain?

Is This Popular Medication Causing Your Joint Pain?

Medications are intended to make us better. We go to see our doctor, we explain our symptoms, and they offer a diagnosis and a medication in hopes of fixing the problem. Some of us take medications temporarily, but many of us take medications for a chronic condition like diabetes. Recently, a study found that a class of widely prescribed medications for type 2 diabetes was linked to joint pain. Joint pain is commonly felt by older adults but is often overlooked as a normal part of aging. Joint pain can be debilitating and affect a person’s daily life, so if a medication used to treat one condition also results in joint pain, it can worsen a person’s quality of life. Type 2 diabetes drug linked to joint pain The drugs associated with joint pain are sitagliptin (Januvia®), saxagliptin (Onglyza®), linagliptin (Tradjenta®) and alogliptin (Nesina) – a class of drugs known as DPP-4 inhibitors. These drugs can either be taken alone or in combination with other diabetic medications. DPP-4 inhibitors help boost insulin after a meal is consumed – that is when blood sugar is typically at its highest. The U.S. Food and Drug Administration (FDA) said the medications, “may cause joint pain that can be severe and disabling,” and they have “added a new Warning and Precaution about this risk to the labels of all medicines in this drug class.” The FDA went on to say those taking DPP-4 inhibitors should not stop their medication, “but should contact their health care professional right away if they experience severe and persistent joint pain.” Furthermore, the FDA suggests that doctors should consider DPP-4 inhibitors as a plausible cause for joint pain and take their patients off the drugs if the pain becomes severe. It is important to get diabetes under control as Continue reading >>

A Comprehensive Review Of The Fda-approved Labels Of Diabetes Drugs: Indications, Safety, And Emerging Cardiovascular Safety Data

A Comprehensive Review Of The Fda-approved Labels Of Diabetes Drugs: Indications, Safety, And Emerging Cardiovascular Safety Data

1. Introduction Approximately 30 million American children and adults have type 1 or type 2 diabetes mellitus and the incidence keeps increasing (T1DM or T2DM).1 Major complications of diabetes include hypertension, dyslipidemia, cardiovascular disease (CVD), stroke, blindness, kidney disease, and amputation.2 In 2012 the estimated annual cost of diabetes in the U.S. was $245 billion mainly due to expenses related to management of diabetic complications.3 Therefore, achieving optimal glycemic control in patients with diabetes is critical.4,5 However, it is estimated that only 30% of adult patients with T1DM, 17% of adolescents with T1DM, and 50% of adults with any type of diabetes achieve optimal glycemic control with current management.6 Therefore, there is a need for effective and safe medications that can improve the management of diabetes and decrease complications. The physicians refer to the drug labels as an important source of information to prescribe medications to improve glycemic control of diabetes. Furthermore, in 2008, FDA published a Guidance for Industry recommending that new drug applications (NDAs) for diabetes should include evidence that the therapy does not increase the risk of cardiovascular events.7 Given the significant burden of diabetes and the importance of drug labels to guide physicians in the management of diabetes, we undertook this study to evaluate all FDA-approved medications for the treatment diabetes. The aims of this research were to (1) overview the different classes of medications that are FDA approved for use in patients with type 1 and type 2 diabetes, (2) examine the different indications for pediatric patients versus adults with diabetes, (3) review adverse events and warnings and precautions per class of drugs, and (4) investi Continue reading >>

For Adults With Type 2 Diabetes, In Addition To Diet And Exercise. See More.

For Adults With Type 2 Diabetes, In Addition To Diet And Exercise. See More.

Your browser does not support the video tag. Who should not take FARXIGA? are allergic to dapagliflozin or any of the ingredients in FARXIGA. Symptoms of a serious allergic reaction may include skin rash, raised red patches on your skin (hives), swelling of the face, lips, tongue, and throat that may cause difficulty in breathing or swallowing. If you have any of these symptoms, stop taking FARXIGA and contact your healthcare provider or go to the nearest hospital emergency room right away have severe kidney problems or are on dialysis. Your healthcare provider should do blood tests to check how well your kidneys are working before and during your treatment with FARXIGA What are the possible side effects of FARXIGA? Dehydration (the loss of body water and salt), which may cause you to feel dizzy, faint, lightheaded, or weak, especially when you stand up (orthostatic hypotension). You may be at a higher risk of dehydration if you have low blood pressure; take medicines to lower your blood pressure, including water pills (diuretics); are 65 years of age or older; are on a low salt diet, or have kidney problems Ketoacidosis occurred in people with type 1 and type 2 diabetes during treatment with FARXIGA. Ketoacidosis is a serious condition which may require hospitalization and may lead to death. Symptoms may include nausea, tiredness, vomiting, trouble breathing, and abdominal pain. If you get any of these symptoms, stop taking FARXIGA and call your healthcare provider right away. If possible, check for ketones in your urine or blood, even if your blood sugar is less than 250 mg/dL Kidney problems. Sudden kidney injury occurred in people taking FARXIGA. Talk to your doctor right away if you reduce the amount you eat or drink, or if you lose liquids; for example, from vomit Continue reading >>

Medications For Type 2 Diabetes

Medications For Type 2 Diabetes

The information provided here is meant to give you a general idea about each of the medications listed below. Only the most general side effects are included. Ask your doctor if you need to take any special precautions. Use each of these medications only as recommended by your doctor, and according to the instructions provided. If you have further questions about usage or side effects, contact your doctor. Some people are able to manage type 2 diabetes with diet and exercise alone. But, in many cases, medications are added to this treatment plan to help you control your blood glucose (sugar) levels. Anti-diabetes medications that are taken by mouth, often referred to as oral agents, are used to treat type 2 diabetes. They lower blood glucose levels in a variety of ways. Since each class works differently, these medications may be used in combination. All of these drugs work best when they are part of a total treatment program that includes healthy eating and regular exercise. Despite diet, exercise, and oral medications, some people with long-standing type 2 diabetes may need to take insulin or other medications to control their glucose levels. Prescription Medications Biguanides Sulfonylurea drugs Meglitinides Thiazolidinediones Alpha-glucosidase inhibitors Dipeptidyl peptidase-4 (DPP-4) inhibitors Glucagon-like peptide-1 receptor agonists Pramlintide Sodium-glucose co-transporter 2 (SGLT-2) inhibitors Bile acid binders Dopamine agonist Insulin Biguanides Metformin Metformin works in the liver to make it produce less glucose and make your body more sensitive to insulin. Metformin can also lower blood fat levels and possibly lead to minor weight loss, which can ultimately help with blood glucose control. Metformin is usually taken 1-2 times a day with meals. Metformin d Continue reading >>

9 Types Of Medication That Help Control Type 2 Diabetes

9 Types Of Medication That Help Control Type 2 Diabetes

Sometimes people with type 2 diabetes are able to bring their blood glucose levels under control through a combination of weight loss, diet, and exercise, but many people with diabetes take medication to manage their condition. For some, a single diabetes medication is effective, while in other cases a combination of drugs works better. “If diabetes control is suboptimal on the maximum dose of one medication, it’s prudent to add on a second agent,” says Deepashree Gupta, MD, assistant professor of endocrinology at Saint Louis University in Missouri. There are many drugs available to treat type 2 diabetes. Your diabetes care team can help you understand the differences among the types of medication on this long list, and will explain how you take them, what they do, and what side effects they may cause. Your doctor will discuss your specific situation and your options for adding one or more types of medication to your treatment. Types of Medication for Type 2 Diabetes In type 2 diabetes, even though insulin resistance is what leads to the condition, injections of insulin are not the first resort. Instead, other drugs are used to help boost insulin production and the body’s regulation of it. Insulin resistance occurs when the body’s cells don’t respond properly to insulin, which is a hormone made in the pancreas that’s responsible for ferrying glucose to cells for energy. When cells are resistant to insulin, they don’t use the insulin effectively to bring the glucose from the bloodstream into the cell. The pancreas needs to produce more insulin to overcome this resistance in an effort to normalize blood sugar levels. When the pancreas can’t keep up with the insulin demands in a person with insulin resistance, that person develops diabetes. Below is an ov Continue reading >>

Diabetes Pill Might Replace Injection To Control Blood Sugar

Diabetes Pill Might Replace Injection To Control Blood Sugar

An injectable class of diabetes medication — called glucagon-like peptide-1 or GLP-1 — might one day be available in pill form, research suggests. Based on the results of a global phase 2 clinical trial, the study authors reported a significant drop in blood sugar levels for people on the oral medication, and no significant increase in low blood sugar levels (hypoglycemia) compared to a placebo over six months. The findings also showed that people taking the highest dose of the pill lost a large amount of weight — about 15 pounds — compared to a weight loss of fewer than 3 pounds for people on the inactive placebo pill. The research was funded by Novo Nordisk, the company that makes the drug, called oral semaglutide. "Semaglutide could transform diabetes treatment," said Dr. Robert Courgi, an endocrinologist at Southside Hospital in Bay Shore, N.Y. "Glucagon-like peptide receptor agonists are agents that are highly recommended according to diabetes guidelines, but rarely used because they require injection. Most patients prefer a pill," Courgi explained. Dr. Joel Zonszein, director of the clinical diabetes center at Montefiore Medical Center in New York City, agreed that these new findings were exciting. "This medication looks pretty good. The high dose matched the [injection] version. There was low hypoglycemia. It controls blood glucose. There was weight loss and it's not an injection. This is the same molecule that's been shown [as an injection] to decrease cardiovascular mortality," Zonszein said. "It has all the ingredients for an excellent medication. If this comes to market, it would be very good for people with type 2 diabetes," he added. Zonszein and Courgi were not involved in the current study. The study included just over 1,100 people with type 2 dia Continue reading >>

Indian Drugmakers Combine 2 Diabetes Drugs In 1 Pill, Raising Concern : Goats And Soda : Npr

Indian Drugmakers Combine 2 Diabetes Drugs In 1 Pill, Raising Concern : Goats And Soda : Npr

Metformin pills they're a go-to drug for type 2 diabetics move through a sorting machine at a pharmaceutical plant in India. Sara Hylton/Bloomberg via Getty Images hide caption Metformin pills they're a go-to drug for type 2 diabetics move through a sorting machine at a pharmaceutical plant in India. "India is the diabetes capital of the world!" How Diabetes Got To Be The No. 1 Killer In Mexico That was a headline two years ago in the Times of India. And that's not a case of media hype. India has a huge diabetes problem: nearly 70 million people are grappling with the disease. India also has a prolific pharmaceutical industry pumping out hundreds of innovative drugs to treat diabetes and other ailments. But researchers say it's unclear how well some of these medicines work, or even if they're safe, because the drugs haven't gone through adequate clinical trials. "We're really puzzled as to why many of these medicines are available," says Allyson Pollock , the director of the Institute of Health and Society at Newcastle University in England, "because some of these weren't even approved by the medicines regulator in India." Pollock and her colleagues have just come out with an analysis of regulatory approval procedures for diabetes drugs in the Indian state of Maharashtra. The findings reinforce her skepticism. One example involves the drug metformin, a workhorse of diabetes treatment. According to the Mayo Clinic metformin is usually the first medicine prescribed to people with type 2 diabetes, helping control high blood sugar. In the U.S. most metformin comes in pills in which metformin is the only active ingredient. But not in India. "To our absolute amazement we found that metformin was not the most frequently available medicine," she says. "Instead we found huge nu Continue reading >>

Type 2 Diabetes Drug Helps Psoriasis, Too

Type 2 Diabetes Drug Helps Psoriasis, Too

A type 2 diabetes drug may do double-duty as a psoriasis treatment. According to a recent review, some people with psoriasis who took a kind of drug called a glucagon-like peptide-1 (GLP-1) agonist for their diabetes also experienced an unexpected improvement in their psoriasis. The review, which discussed five studies and case reports, was published in the July issue of Therapeutic Advances in Endocrinology and Metabolism. GLP-1, the researchers explain, is a peptide, or amino acid chain, that increases insulin secretion. GLP-1 agonists help activate this process. According to the researchers, GLP-1 agonists can help regulate the immune system by reducing systemic inflammation. Previous studies have shown that GLP-1 agonists inhibit tumor necrosis factor-alpha (TNF-alpha), the researchers report. TNF-alpha is a cytokine, or protein, involved in psoriatic disease inflammation. Many biologic treatments for psoriasis, such as Enbrel (etanercept) and Humira (adalimumab), work by blocking TNF-alpha. Type 2 diabetes, a comorbidity of psoriasis, is associated with inflammation, the researchers note. Previous research has found that obesity, a risk factor for type 2 diabetes and psoriasis, can lead to an increase in inflammation, because fat cells secrete pro-inflammatory cytokines. In one study analyzed by the researchers, a patient taking both the GLP-agonist and Soriatane (acitretin), a systemic medication for psoriasis, experienced a reduction in psoriasis area and severity index score (PASI) from 14.2 to 7.6. Psoriasis disease severity is determined by assessing the degree of redness, shedding, plaque thickness and affected body surface area, degree of itching, and the impact of psoriasis on quality of life. Psoriasis with a PASI score under 10 is generally considered to Continue reading >>

New Type 2 Diabetes Once-weekly Drug Omarigliptin Lowered A1c Levels

New Type 2 Diabetes Once-weekly Drug Omarigliptin Lowered A1c Levels

There are more type 2 diabetes drugs than ever now and researchers are always working to assess the safety and effectiveness of the different medications. Omarigliptin is a long-acting oral drug from the class of diabetes drugs called DPP-4 inhibitor. It’s intended as a once-weekly drug that works to lower blood sugar levels by increasing incretin levels that block the body’s release of glucagon, increasing insulin secretion and slowing gastric emptying. According to Wikipedia Merck is developing the drug which is currently only available in Japan. In this study, researchers looked at the safety and effectiveness of a once-weekly type 2 diabetes drug called omarigliptin. They took participants with type 2 diabetes who were currently not on any glucose-lowering drugs and conducted a randomized double-blind study giving 25 mg of omarigliptin to 165 participants or an omarigliptin placebo to 164 participants for 24 weeks, followed by a period of 30 weeks to assess the more long-term aspects of omarigliptin. During the follow up period of 30 weeks the placebo group was given metformin and the group taking omarigliptin was given a metformin placebo. Regarding adverse events, the groups were similar at 24 and 54 weeks. Over the course of 54 weeks there were no reported adverse events of symptomatic hypoglycemia (low blood sugar) in those taking omarigliptin. By comparison, there were 5 symptomatic hypoglycemic adverse events int he placebo group. The researchers stated in their study abstract that “Over 54 weeks, a majority of the omarigliptin treatment had a persistent reduction in HbA1c, remaining rescue-free.” They concluded that in those with type 2 diabetes, taking omarigliptin alone as a mono-therapy “improved glycemic control over 54 weeks and was generally w 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 >>

Amputation Risk Possible With Diabetes Drugs, Fda Warns

Amputation Risk Possible With Diabetes Drugs, Fda Warns

Based on new data from 2 large clinical trials, FDA is warning that the blockbuster type 2 diabetes medications Invokana, Invokamet, Invokamet XR (canagliflozin, Janssen) cause an increased risk of leg and foot amputations. Read: Diabetic patients challeng insulin makers FDA is requiring new warnings, including the most prominent Boxed Warning, to be added to the drugs’ labels to describe the risk. “Health care professionals should, before starting canagliflozin, consider factors that may predispose patients to the need for amputations,” FDA said in its Drug Safety Communication. “These factors include a history of prior amputation, peripheral vascular disease, neuropathy, and diabetic foot ulcers.” In addition, healthcare professionals should monitor patients on canagliflozin for symptoms described above and discontinue the drug if the complications occur, FDA said. Patients taking canagliflozin should notify their healthcare professionals right away if they develop new pain or tenderness, sores or ulcers, or infections in their legs or feet, FDA said in the Drug Safety Communication. “Talk to your health care professional if you have questions or concerns. Do not stop taking your diabetes medicine without first talking to your health care professional.” Final results from 2 clinical trials—the CANVAS (Canagliflozin Cardiovascular Assessment Study) and CANVAS-R (A Study of the Effects of Canagliflozin on Renal Endpoints in Adult Participants With Type 2 Diabetes Mellitus)— showed that leg and foot amputations occurred about twice as often in patients treated with canagliflozin compared to patients treated with placebo, according to FDA. Amputations of the toe and middle of the foot were the most common; however, amputations involving the leg, below an Continue reading >>

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