Which Diabetes Drug Is Best?
HealthDay Reporter TUESDAY, July 19, 2016 (HealthDay News) -- No single drug to treat type 2 diabetes stands out from the pack when it comes to reducing the risks of heart disease, stroke or premature death, a new research review finds. The analysis of hundreds of clinical trials found no evidence that any one diabetes drug, or drug combination, beats out the others. Researchers said the results bolster current recommendations to first try an older, cheaper drug -- metformin (Glumetza, Glucophage) -- for most patients with type 2 diabetes. "There are very few things experts agree on, but this is one of them," said Dr. Kevin Pantalone, a diabetes specialist at the Cleveland Clinic and a member of the Endocrine Society. "Metformin, in the absence of contraindications or intolerability, should be the first-line agent to treat patients with type 2 diabetes," he said. Metformin can cause upset stomach and diarrhea, so some patients are unable to stick with it day to day, explained Pantalone, who wasn't involved in the study. And people with kidney disease generally shouldn't take it, he said. More than 29 million Americans have diabetes -- mostly type 2, according to the U.S. Centers for Disease Control and Prevention. The disease, which is often linked to obesity, causes blood sugar levels to be chronically high. Over time, that can lead to complications, such as heart disease, stroke, kidney failure and nerve damage, the CDC says. There are numerous classes of medications that lower blood sugar levels. What's been unclear is whether any of those drugs work better than others in warding off diabetes complications and extending people's lives. The new analysis found no obvious winners. But the researchers also cautioned against drawing conclusions: The trials in the review w Continue reading >>
Breaking Down Diabetes: Drugs For Diabetes, Starting With The Best Metformin
Stanford University School of Medicine blog Breaking down diabetes: Drugs for diabetes, starting with the best metformin Metformin is physician-researcher Randall Stafford's go-to drug for diabetes. He explains why in this installment in the series, Breaking down diabetes. A huge assortment of 100 medications are available to treat high blood sugar in Type 2 diabetes, including two historical breakthrough drugs, insulin and metformin . The pharmaceutical industry has successfully added a few new, innovative drugs, but the most effective drugs remain the older, less expensive medications. Let's make some sense out of this mess of medications. Most are given by mouth (oral), but injected insulin, which I'll address in a future blog post, remains a key medication. In addition, oral drugs have limited impact, so they are often used in combinations (including tablets containing two drugs). Patients frequently try multiple oral drugs before starting insulin. With very few exceptions, I start patients on metformin first. To illustrate a patient's experience with diabetes drugs, let's check in on with Mrs. R., a 70-year-old with diabetes: When she was first diagnosed 19 years ago, she started on metformin at 500 mg twice per day. These large tablets initially caused intestinal discomfort (a common side effect). Over time, the mild abdominal pain went away. This drug worked well for a few years, but Mrs. R gained some additional weight and the metformin was no longer adequate. The drug, glipizide was added. This also worked for many years, but in 2012, she needed a third drug, sitagliptin . Eventually, she would need insulin. To understand Mrs. R's experience, or the medications taken by you or a friend or family member, lets start with the best medication, metformin. Approved Continue reading >>
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 >>
New Drug Appears To Eliminate Type 2 Diabetes For First Time
Type 2 diabetes, although influenced by a person’s genes, is largely thought to be brought about by a poor diet and being overweight for prolonged periods of time, particularly at an old age. The pancreas is either unable to produce enough insulin, or the body’s cells simply don’t react to insulin, which leads to dangerously high blood sugar levels. This is known as insulin resistance, and at present, there is no medical way to treat this. A new drug forged by a team at the University of California, however, might prove to be a veritable game-changer. As reported by New Scientist, a daily dose of the drug, given to mice with insulin resistance, canceled out the harmful condition. This is the first time that any treatment has effectively “cured” type 2 diabetes. The team of researchers had an inkling that a particular enzyme was responsible for bringing about insulin resistance. The enzyme – cacophonously known as low molecular weight protein tyrosine phosphate, or LMPTP – can be found in the liver, and it appears to interact with cells in such a way that they become resistance to the presence of insulin. Conjuring up a brand new drug that was specifically designed to hinder the progress of LMPTP, the team thought that it would allow the cells’ insulin receptors to once again be able to react to insulin as they normally would. Much to their delight, they found that they were correct. “Our findings suggest that LMPTP is a key promoter of insulin resistance and that LMPTP inhibitors would be beneficial for treating type 2 diabetes,” the team noted in their Nature study. For this study, their drug was orally administered to a few unfortunate laboratory mice. These mice had been fed an extremely high-fat diet, and they had developed obesity and type 2 dia Continue reading >>
Cold Medicines That Are Safe For Diabetes
Searching for relief for your runny nose, sore throat, or cough? Many over-the-counter cough, cold, and flu remedies list diabetes as an underlying condition that may indicate you should leave the medication on the shelf. The warnings are clear: "Ask a doctor before use if you have: heart disease, high blood pressure, diabetes." Unfortunately, your doctor is not along for the trip to the pharmacy. Because illness causes your body to release stress hormones that naturally raise blood glucose, you'll want to be sure that over-the-counter medications won't increase blood glucose levels, too. Simple Is Best for Cold Medicines Keep it simple by choosing an over-the-counter medication based on the types of ingredients proven to relieve your particular symptoms. Often a medication with just one ingredient is all you need to treat your symptoms rather than agents with multiple ingredients. "To choose the correct medication, take time to speak to a pharmacist," says Jerry Meece, R.Ph., CDE, of Gainesville, Texas. "The proper remedies may not only make you feel better, but also cut the length of the illness and possibly save you a trip to the doctor." Oral cold and flu pills are often a better choice than syrups with the same ingredients because the pills may contain no carbohydrate. If you decide to use a syrup, look for one that is sugar-free. If you can't find one, the small amount of sugar in a syrup will likely affect your blood sugar less than the illness itself, Meece says. Safe OTC Cold Medicines Various over-the-counter medications are designed to treat specific symptoms. Many pharmacists recommend these products for people with diabetes. Symptom: Cough Best option: Anti-tussive dextromethorphan (Delsym, Diabetic Tussin NT [includes acetaminophen, diphenhydramine]) Sympt Continue reading >>
Medicines For Diabetes
Whether your child takes insulin or pills or both to control diabetes, it's important to follow the diabetes management plan prescribed by the diabetes health care team to avoid problems and reduce the risk of side effects. Insulin is a hormone that allows sugar, or glucose , to get into the body's cells to be used for energy. All people with type 1 diabetes and many people with type 2 diabetes need to take insulin every day. The overall goal of treatment with insulin (and other diabetes medicines) is to achieve the best match possible between the amounts of insulin given and the person's individual needs for insulin throughout the day and night. In this way, blood sugar levels can be kept as close to normal as possible to help avoid both short- and long-term problems from diabetes. Treatment plans are designed around the pattern of insulin normally supplied by the pancreas throughout the day in someone without diabetes. In general, this involves providing a fairly steady "background" level of insulin to control blood sugar levels between meals and overnight, along with doses of rapid- or short-acting insulin to handle the fast rises in blood sugar that occur with meals. The types of insulin used and the amount taken each day will vary depending on your child's diabetes management plan. Some plans include two injections each day, while others involve several more or the use of an insulin pump to keep blood sugar levels under control. The diabetes health care team will help you find the best treatment plan for your child. There are a few different kinds of insulin. They differ from one another based on: when they work their hardest to lower blood sugar The table below outlines the types of insulin and how they work. Remember that the actual time it takes for insulin to Continue reading >>
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 >>
Oral Medicines For Diabetes
What medicines could my doctor prescribe? Six kinds of diabetes medicine are available in pill form: metformin (a biguanide), sulfonylureas, thiazolidinediones, meglitinides, biguanides, thiazolidinediones, alpha-glucosidase inhibitors and dipeptidyl peptidase-4 (DPP-4) inhibitors. Each medicine has good points and bad points. Your doctor will decide which medicine is right for you. Metformin is a type of biguanide and it is currently the only biguanide available in the United States. It is often the first oral medicine prescribed for someone newly diagnosed with diabetes. It has the advantage of not causing low blood sugar. Metformin does not cause your pancreas to make insulin, but it helps your body use insulin better. Metformin can cause side effects such as nausea or diarrhea in some people. Your doctor may prescribe metformin in combination with another oral diabetes medicine. Sulfonylureas Sulfonylureas are the most commonly prescribed diabetes medicines. These medicines help your pancreas make insulin. They are inexpensive and have few side effects. There are 3 types of sulfonyureas: glipizide, glimepiride and glyburide. Side effects may include weight gain and low level of sodium in the blood. Sulfonylureas can be taken alone or with metformin, pioglitazone (a thiazolidinedione) or insulin. If you’re allergic to sulfa, you can’t take a sulfonylurea. This class of medicines includes rosiglitazone and pioglitazone. These medicines help your body respond better to insulin. Rosiglitazone and pioglitazone can be used alone or in combination with other diabetes medicines. Side effects may include weight gain, fluid retention and an increase in LDL (“bad”) cholesterol. People taking rosiglitazone and pioglitazone also need periodic liver tests. Continue reading >>
Top 6 Breakthrough Diabetes Treatments You May Have Missed
Are you concerned you might be diagnosed with diabetes one day? You are not alone. Diabetes and prediabetes are two of the top pressing health issues in the nation. The number of Americans who are at risk for diabetes is astounding: it is reported that close to 86 million people in the U.S. have prediabetes, meaning their blood sugar levels are higher than normal but not yet high enough to be classified as type 2 diabetes. The American Diabetes Association (ADA) estimates a person diagnosed at age 50 dies six years earlier than a person without diabetes. One in three American adults will have diabetes in the year 2050 if current trends continue. Close to 29 million Americans, or 9% of the population, currently have diabetes. The vast majority of people, about 90 to 95 percent of those diagnosed with diabetes, have type 2 diabetes, according to the ADA. Insulin is a hormone the body needs to utilize the glucose (sugar) from food to provide energy for the body. In type 2 diabetes, the pancreas either doesn't make enough insulin, there is resistance to the effects of insulin, or both. Treatment typically begins with oral metformin, a veteran drug that is the backbone of many diabetes treatment regimens. From there, different drug classes may be added to metformin, and for some patients, the use of insulin may become necessary. However, the latest diabetes news is encouraging. New drugs, improved monitoring devices and an understanding of how diet and exercise can impact diabetes is adding up to positive outcomes for patients. As reported in August 2014 from research in The Lancet Diabetes & Endocrinology, the vast majority of people with type 2 diabetes are living longer lives due to better medications and treatments for both the disease and the numerous complications that Continue reading >>
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 >>
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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Which Diabetes Medication Is The Best?
With so many products on the market, it can be difficult to choose the most effective diabetes medication for your needs. Type 2 diabetes is often referred to as the silent killer, and many people dont even know they have the disease until it is too late. According to the World Health Organisation (WHO), in 2012 1.5 million deaths were directly caused by this serious metabolic disorder. Type 2 diabetes is preceded by insulin resistance and progressive insulin secretory defects, whereas type 1 is usually diagnosed in children, occurring when the body does not produce any insulin. Fortunately there are many treatment options for type 2 diabetes, and we compared the most common diabetes medications. How it works: This is the most common medication for type 2 diabetes. It works by decreasing the amount of glucose that your liver releases and helps to restore a natural response to insulin. Effectiveness: Most experts agree it might be an old drug, but its still the most widely used and probably the most effective medication. A recent study from the State University of Rio de Janeiro found its still the first line of treatment, even when used in combination with other medication. Possible side-effects: An upset stomach, vomiting, nausea iStock How it works: These medications lower blood glucose levels and increase the amount of insulin produced by the pancreas. Effectiveness: Sulfonylurea drugs have been in use since the 1950s and a lot of newer medications have similar workings (and are generally cheaper). But many physicians still prescribe these medications when Biguanides are either not as effective, or when the side-effects of the latter are too severe. Possible side-effects: Hypoglycaemia, weight gain iStock How it works: These medications stop an enzyme called DPP-4 f Continue reading >>
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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 >>
The Top 10 Best-selling Diabetes Drugs Of 2013
Everybody knows that diabetes is an epidemic in this country that is costing lives and money. New stats from the U.S. Centers for Disease Control and Prevention (CDC) peg at 29.1 million the number of people in the U.S. who have either Type 1 or Type 2 diabetes, with roughly 9 million of those undiagnosed. Most have Type 2 diabetes, which is more prevalent among minorities. On the other hand, a study found that non-Hispanic white children are diagnosed more often with Type 1 diabetes than other groups. And that is just in the U.S. The rest of the world also is developing diabetes at what many see as alarming rates. Pharma, seeing opportunity, has responded. There are pills as well as injected drugs. Many are incretin mimetics. There are now 12 classes of drugs, including the GLP-1 class drugs like AstraZeneca's ($AZN) Byetta and Novo Nordisk's ($NVO) blockbuster Victoza, and DPP-4 inhibitors like Merck's ($MRK) Januvia, Eli Lilly ($LLY) and Boehringer Ingelheim's Tradjenta/Trajenta and AstraZeneca's Onglyza. These widely used drugs, some of which are on this list, have stirred safety concerns. The FDA and European regulators announced in February that a new round of safety reviews found little evidence that they cause pancreatitis or pancreatic cancer, as some have suggested. But criticism persists, and this month consumer advocacy group Public Citizen again asked the FDA to pull Victoza from the market, saying the FDA's review of adverse reports was not as extensive as its own. What is perhaps becoming a bigger deal for Big Pharma, however, is that with so many treatment options, and more coming, the market has gotten crowded and doctors and patients a bit confused. That has led to some studies to sort out which drugs work the best, and that in turn has led some resear Continue reading >>
What Is The Best Medicine For Diabetes?
For type 1 Diabetes Mellitus, Insulin is the drug of choice. For type 2 Diabetes Mellitus, current recommendations are the use of Metformin with either a gliptin(e.g. saxagliptin or vildagliptin) or a SGLT2 inhibitor (e.g. canagliflozin or dapagliflozin). Some may even start with Metformin and a Sulfonylurea like glibenclamide as it is a cost effective combination. Also, use of Insulin is advocated in early T2DM. And also, diabetics have to be put on ACE inhibitors or ARBs like Telmisartan or Lisinopril as they serve to protect the kidneys. Hope this answers your question. Continue reading >>
