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 >>
Management Of Blood Glucose With Noninsulin Therapies In Type 2 Diabetes
A comprehensive, collaborative approach is necessary for optimal treatment of patients with type 2 diabetes mellitus. Treatment guidelines focus on nutrition, exercise, and pharmacologic therapies to prevent and manage complications. Patients with prediabetes or new-onset diabetes should receive individualized medical nutrition therapy, preferably from a registered dietitian, as needed to achieve treatment goals. Patients should be treated initially with metformin because it is the only medication shown in randomized controlled trials to reduce mortality and complications. Additional medications such as sulfonylureas, dipeptidyl-peptidase-4 inhibitors, thiazolidinediones, and glucagon-like peptide-1 receptor agonists should be added as needed in a patient-centered fashion. However, there is no evidence that any of these medications reduce the risk of diabetes-related complications, cardiovascular mortality, or all-cause mortality. There is insufficient evidence on which combination of hypoglycemic agents best improves health outcomes before escalating to insulin therapy. The American Diabetes Association recommends an A1C goal of less than 7% for many nonpregnant adults, with the option of a less stringent goal of less than 8% for patients with short life expectancy, cardiovascular risk factors, or long-standing diabetes. Randomized trials in middle-aged patients with cardiovascular risk factors have shown no mortality benefit and in some cases increased mortality with more stringent A1C targets. Clinical recommendation Evidence rating References Metformin should be used as first-line therapy to reduce microvascular complications, assist in weight management, reduce the risk of cardiovascular events, and reduce the risk of mortality in patients with type 2 diabetes mell Continue reading >>
Diabetes Medication - Guides And Information
Tweet Diabetes medications are a common form of treatment for people with diabetes. There are many different types of diabetes medicines, or anti-diabetic drugs, and this includes insulin, which has its own area within the site. Whilst each drug is unique in the way it works to help patients with diabetes keep their condition under control, some act similarly to one other and are grouped in the same class of drugs. The way in which they are administered can also differ, with some medicines taken orally and others injected directly into the blood. Are diabetes drugs suitable for all diabetics? Most diabetes drugs are designed for people with type 2 diabetes who are unable to control their blood sugar levels through strict diet and exercise alone. But some, such as metformin, are sometimes taken alongside insulin treatment for people with type 1 diabetes. Medication guides Explore the 18 most common medications for diabetes: Assists insulin in controlling post-meal glucose levels. Can more than one drug be taken at the same time? Depending on individual circumstances, a GP may prescribe more than one anti-diabetic drug to help treat a patient’s diabetes. Watch the video below for more information on the types of diabetes medication available. What are the side effects of anti-diabetic medicines? As with any type of medication, blood glucose-lowering drugs can have a number of side effects. These potentially harmful effects are listed in the patient information leaflet that accompanies the medication, so make sure you check this before starting your drug treatment. You may not experience any of the adverse effects listed, but if you do, consult your doctor and/or diabetes care team as they may be able to suggest another suitable medication for your condition. They will a Continue reading >>
Type 2 Diabetes Symptoms, Signs, Diet, And Treatment
Type 2 diabetes is a condition in which cells cannot use blood sugar (glucose) efficiently for energy. This happens when the cells become insensitive to insulin and the blood sugar gradually gets too high. There are two types of diabetes mellitus, type 1 and type 2. In type 2, the pancreas still makes insulin, but the cells cannot use it very efficiently. In type 1 diabetes, the pancreas cannot make insulin due to auto-immune destruction of the insulin-producing beta cells. Type 2 can be caused by: Lack of activity (sedentary behavior) Genetics Risk factors include: Being overweight Being sedentary including watching more than 2 hours of TV per day Drinking soda Consuming too much sugar and processed food The signs and symptoms of this type of this type of diabetes are sometimes subtle. The major symptom is often being overweight. Other symptoms and signs include: Urinating a lot Gaining or losing weight unintentionally Dark skin under armpits, chin, or groin Unusual odor to urine Blurry vision Often there are no specific symptoms of the condition and it goes undiagnosed until routine blood tests are ordered. A blood sugar level more than 125 when fasting or more than 200 randomly is a diagnosis for diabetes. Treatment is with diet and lifestyle changes that include eating less sugary foods, and foods that are high in simple carbohydrates (sugar, bread, and pasta.) Sometimes a person will need to take drugs, for example, metformin (Glucophage). People with both types of diabetes need monitor their blood sugar levels often to avoid high (hyperglycemia) and low blood sugar levels (hypoglycemia). Complications include heart and kidney disease, neuropathy, sexual and/or urinary problems, foot problems, and eye problems. This health condition can be prevented by following a Continue reading >>
Using Type 2 Diabetes Medication To Treat Type 1 Diabetes
There have been a number of new developments in the treatment of type 2 diabetes, and a question often asked is whether some of the type 2 therapies might be beneficial for people with type 1 diabetes. For example, several years ago, one of my patients with type 1 diabetes was having trouble with weight and with blood glucose control on a basal-bolus insulin combination. We added metformin, and his blood sugars appeared to get a bit better. Then we added exenatide (Byetta) before breakfast and dinner, and he started to get much better control, lost some weight, and felt much better. The first thing to think about here is that there is nothing about having type 1 diabetes which inherently prevents one from having features of type 2. If we think about it, the prevalence of type 2 is about one tenth among all adults, and about one quarter among those age 65 and older. Features of insulin resistance – what has been called “metabolic syndrome” – are even more common. So, surely a substantial number of adults with type 1 will have features of type 2. In fact, the EURODIAB study, which followed more than 3000 people with type 1 diabetes, and the DCCT study of intensive control of more than 1000 people with type 1 diabetes, both found that features of type 2 diabetes and of metabolic syndrome such as weight gain, elevated triglycerides, and elevated blood pressure all track together. Furthermore, many of the drugs used in treating type 2 diabetes work to lower the blood glucose level to some extent independent of insulin – and so we might wonder whether, regardless of the “type” of diabetes, they could have generally beneficial effect. What are some of the interesting potential approaches? First, metformin. This is generally regarded as a basic treatment for type Continue reading >>
A Complete List Of Diabetes Medications
Diabetes is a condition that leads to high levels of blood glucose (or sugar) in the body. This happens when your body can’t make or use insulin like it’s supposed to. Insulin is a substance that helps your body use the sugar from the food you eat. There are two different types of diabetes: type 1 diabetes and type 2 diabetes. People with both types of diabetes need medications to help keep their blood sugar levels normal. The types of drugs that can treat you depend on the type of diabetes you have. This article gives you information about drugs that treat both types of diabetes to help give you an idea of the treatment options available to you. Insulin Insulin is the most common type of medication used in type 1 diabetes treatment. It’s also used in type 2 diabetes treatment. It’s given by injection and comes in different types. The type of insulin you need depends on how severe your insulin depletion is. Options include: Short-acting insulin regular insulin (Humulin and Novolin) Rapid-acting insulins Intermediate-acting insulin Long-acting insulins Combination insulins NovoLog Mix 70/30 (insulin aspart protamine-insulin aspart) Humalog Mix 75/25 (insulin lispro protamine-insulin lispro) Humalog Mix 50/50 (insulin lispro protamine-insulin lispro) Humulin 70/30 (human insulin NPH-human insulin regular) Novolin 70/30 (human insulin NPH-human insulin regular) Ryzodeg (insulin degludec-insulin aspart) Amylinomimetic drug Pramlintide (SymlinPen 120, SymlinPen 60) is an amylinomimetic drug. It’s an injectable drug used before meals. It works by delaying the time your stomach takes to empty itself. It reduces glucagon secretion after meals. This lowers your blood sugar. It also reduces appetite through a central mechanism. Most medications for type 2 diabetes are o Continue reading >>
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 >>
Diabetes Type 2
Many people with type 2 diabetes are prescribed tablets to help control their blood glucose levels. Metformin is the first-line medication for diabetes in the UK but there are many more types of medication for type 2 diabetes discussed below. Most people had tried initially to control their blood glucose with a regimen of diet and exercise before being given oral medication. Many people took metformin alone to control blood glucose, and some were taking metformin and gliclazide. Both medications help to reduce blood glucose but work differently. Metformin reduces the amount of glucose produced in the liver, and also makes muscle tissue absorb more glucose; gliclazide increases the amount of insulin produced by the pancreas. While people found that the medication they took had helped reduce and control their blood glucose, many had experienced side effects. Metformin can cause diarrhoea and other digestive problems and many people went back to their GPs for advice. Some people felt concerned about the risks they might face from certain drugs after reading negative reports in the media (see 'Misunderstandings about diabetes'). Rosiglitazone has been linked to an increased risk of heart attack and stroke. Since these interviews were conducted in 2008, there has been growing concern about the potential harmful effects of rosiglitazone (Avandia, but also contained in Avandamet and Avaglim) and from September 2010 in the UK and Europe, new prescribing of this drug has stopped, and most people who were taking the drug have been changed to alternative medication. Most people we interviewed had been prescribed higher dosages of medication to control their blood glucose as their diabetes got worse over time. Some people had transferred to insulin while continuing on metformin (se Continue reading >>
Is It Possible To Survive Type 2 Diabetes Without Artificial Insulin Or Medication?
Disclaimer: My answer incorporates parts of my answer to a previous question: “Is it safe to stop taking your insulin?” Type 2 diabetes is characterised by insulin resistance, meaning that cells don’t act in the normal capacity to insulin, which is usually taking up the glucose and producing energy. At the start this may only be partial in effect, so glucose may be taken up, but you need more and more insulin to do the same thing. You may have a temporary condition that makes this happen more easily, like pregnancy (gestational diabetes) or steroid use. You can initially treat this with lifestyle changes. BUT the Diabetes Prevention Program recorded some important results when testing lifestyle and/vs metformin (the commonest oral medication). The following wikipedia stub is the clearest way to read it. Metformin - Wikipedia However the pancreas will eventually be unable to cope especially if the blood sugars remain high despite these measures (especially in combination with aging). That’s when and why you need insulin. Insulin can occasionally be stopped in with type 2 diabetes. If any of the temporary situations listed above resolve, insulin might be stopped. Dramatically lowering blood sugar through weight reduction and /or exercise can allow insulin to be stopped. Its especially important to monitor your blood sugars as these measures may not hold your blood glucose sufficiently low. I am going to say that- if you were started on insulin in Type 2 diabetes, it means that all these other measures were instituted but did not work sufficiently. In this case, if you stop insulin and “live with” high blood sugars, the complications associated with Type 2 Diabetes like blindness, kidney failure, heart disease and stroke will be more likely. Continue reading >>
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 >>
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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 >>
A Brief History Of The Development Of Diabetes Medications
In Brief This article provides an overview of the development of insulins, oral agents, and noninsulin injectable agents used in the management of hyperglycemia in patients with diabetes. It also briefly reviews the pharmacological impact and salient side effects of these medications. The management of diabetes has changed dramatically during the past several thousand years. The option preferred by “experts” of the pharaoh of Egypt 3,500 years ago was a mixture of “water from the bird pond,” elderberry, fibers from the asit plant, milk, beer, cucumber flower, and green dates.1 Although our therapeutic options today are significantly more effective, they will likely be considered arcane by our successors 100 years from now if the current trajectory in treatment development continues. Clearly, however, the current pharmacological armamentarium used to manage diabetes has resulted in a dramatic reduction in morbidity and mortality. This article provides a brief overview of the development history and effectiveness of various agents used in the pharmacological management of diabetes. Insulin Before the 1920s, there were no effective pharmacological agents for the management of diabetes. Because of this, type 1 diabetes was a fatal malady. This changed dramatically with Frederick Banting's work. Dr. Banting served as a surgeon in World War I. Captain Banting initially spent some time in hospitals in England, but later was sent to the front as a battalion medical officer, where he was wounded by shrapnel. He received a Military Cross for his courage in action.2 After returning from the war, Dr. Banting opened an office outside of Toronto, Canada. After seeing only one patient in the first month of his practice (a patient seeking a prescription for ethanol), Banting em Continue reading >>
Why Are Some People With Type 2 Diabetes Treated With Medications Other Than Insulin?
As opposed to type 1 diabetes, where due to auto-imunity the insulin producing beta-cells in the islets of Langhans in the pancreas are destroyed, so no insulin is produced anymore (±10% of all diabetics) in type 2 diabetes in the beginning due to insulin resistance there is a too high level of insulin, later on the insulin production will go down. So in the first period we start treating with metformin, the only anti-diabetic having been shown to lower insulin resistance, inhibit the formation of glucose in the liver, and maybe partly block carbohydrate absorption, like rightly observed in Allison Marie Rosenswipe's answer and has been shown be correlated with a lower (cardiovascular) mortality in diabetes, so is the preferred anti-diabetic. Unfortunately many have gastro-intestinal side effects like stomach cramps, nausea, diarrhea op metformin. Another older group of med the sulfonyl-ureas (SU) work by elevating the level of insulin further, this has been shown to be correlated with a higher mortality. Please see Can people with type 2 diabetes live longer than those without? A comparison of mortality in people initiated with metformin or sulphonylurea monotherapy and matched, non-diabetic controls - Bannister - 2014 - Diabetes, Obesity and Metabolism - Wiley Online Library Later on when insulin production fails we need to add insulin to the metformin therapy. 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 >>
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Type 2 Diabetes Medication Used For Type 1
Do people with Type 1 diabetes take medications for Type 2 diabetes? The other day, Myra came to my clinic for her initial assessment for Diabetes Self-Management Education. As we were going through her list of medications, I discovered that she was taking liraglutide (Victoza), but her diagnosis was clearly Type 1 diabetes. Myra stated that her endocrinologist had prescribed the medication. He informed her that this was becoming more common. I had heard that patients with Type 1 diabetes were being prescribed GLP-1 non-insulin injections for their Type 1 Diabetes, specifically liraglutide. I had also heard about SGLT2 inhibitors were being used for Type 1 diabetes, but I had heard about an increased incidence of diabetic ketoacidosis (DKA) with these medications for Type 1 and Type 2 diabetes patients. Since inquiring minds want to know, I decided to investigate both. Liraglutide for Type 1 diabetes in the news In August, 2015, Novo Nordisk made a decision not to pursue liraglutide for Type 1 diabetes with the Federal Drug Administration (FDA). This decision came after the second trial for the FDA approval was completed. In the trial, researchers compared the addition of liraglutide to insulin therapy with a control group on standard insulin therapy. Novo Nordisk concluded that the results were not quite good enough, and decided not to pursue the FDA approval for liraglutide for Type 1 diabetes. Benefits of liraglutide in Type 1 patients In the study, when taking liraglutide, Type 2 patients saw a lower A1C, significant weight loss, and decreased number of episodes of hypoglycemia. Conversely, Type 1 patients taking liraglutide did not fare as well with A1C reduction, showing only a slight reduction in A1C (0.5% reduction compared with 0.3% reduction in control group). Continue reading >>
