Diabetes Medicines You Don’t Inject
When you think about diabetes drugs, you may think of insulin or other medications that you get from a shot or a pump. But there are others that you take as a pill or that you inhale. Your doctor will consider exactly what you need, which may include more than one type of diabetes medicine. The goal is to get your best blood sugar control, and the oral drugs do that in several ways. How it works: Blocks enzymes that help digest starches, slowing the rise in blood sugar. It belongs to a group of drugs called “alpha-glucosidase inhibitors.” Side effects for these kinds of drugs include stomach upset (gas, diarrhea, nausea, cramps). Alogliptin (Nesina) How it works: Boosts insulin levels when blood sugars are too high, and tells the liver to cut back on making sugars. Your doctor may call this type of drug a “DPP-IV inhibitor.” These drugs do not cause weight gain. You may take them alone or with another drug, like metformin. Bromocriptine mesylate (Cycloset, Parlodel) How it works: This tablet raises the level of dopamine, a brain chemical. It’s approved help improve blood sugar control in adults with type 2 diabetes, along with diet and exercise. It’s not used to treat type 1 diabetes. Canagliflozin (Invokana) How it works: Boosts how much glucose leaves your body in urine, and blocks your kidney from reabsorbing glucose. Your doctor may call this type of drug a “SGLT2 inhibitor.” Side effects can include: Urinary tract infections Dizziness, fainting Ketoacidosis or ketosis Increased risk of bone fracture Decreased bone mineral density Chlorpropamide (Diabinese) How it works: Lowers blood sugar by prompting the pancreas to release more insulin. Your doctor may call this type of drug “sulfonylureas.” This drug is not used as often as newer sulfonylurea Continue reading >>
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 >>
Feline Diabetes
Insulin injections are the preferred method of managing diabetes in cats. Figure 1: To administer an injection, pull the loose skin between the shoulder blades with one hand. With the other hand, insert the needle directly into the indentation made by holding up the skin, draw back on the plunger slightly, and if no blood appears in the syringe, inject gently. Tips for Treatment 1. You can do it! Treating your cat may sound difficult, but for most owners it soon becomes routine. 2. Work very closely with your veterinarian to get the best results for your cat. 3. Once your cat has been diagnosed, it's best to start insulin therapy as soon as possible. 4. Home glucose monitoring can be very helpful. 5. Tracking your cat's water intake, activity level, appetite, and weight can be beneficial. 6. A low carbohydrate diet helps diabetic cats maintain proper glucose levels. 7. With careful treatment, your cat's diabetes may well go into remission. 8. If your cat shows signs of hypoglycemia (lethargy, weakness, tremors, seizures, vomiting) apply honey, a glucose solution, or dextrose gel to the gums and immediately contact a veterinarian. Possible Complications Insulin therapy lowers blood glucose, possibly to dangerously low levels. Signs of hypoglycemia include weakness, lethargy, vomiting, lack of coordination, seizures, and coma. Hypoglycemia can be fatal if left untreated, so any diabetic cat that shows any of these signs should be offered its regular food immediately. If the cat does not eat voluntarily, it should be given oral glucose in the form of honey, corn syrup, or proprietary dextrose gels (available at most pharmacies) and brought to a veterinarian immediately. It is important, however, that owners not attempt to force fingers, food, or fluids into the mouth of a Continue reading >>
Pharmacology Chapter 14
Sort Non - Insulin - dependent diabetes mellitus (NIDDM) Adult - onset diabetes mellitus Middle age Obesity, heredity Diabetic diet, weight control, exercise, antidiabetic drugs, sometimes insulin Type 2 Sulfonylurea Oral Antidiabetic Drugs First type of antidiabetic drugs that could be given orally. Chlorpropamide (Diabinese) Glimepiride (Amaryl) Glipizide (Glucotrol, Glucotrol XL) Glyburide (DiaBeta, Micronase) Tolazamide Tolbutamide (Orinase) Stimulate the beta cells of the pancreas to produce more insulin. Combination Oral Antidiabetic Drugs ActoPlus Met (metformin, pioglitazone) Advandamet (metformin, rosiglitazone) Avandaryl (glimepiride, rosiglitazone) Duetact (glimepiride, pioglitazone) Glucovance (metformin, glyburide) Janumet (metformin, sitagliptin) Metaglip (metformin, glipizide) PrandiMet (metformin, repaglinide) Continue reading >>
Management Of Hospitalized Type 2 Diabetes Mellitus Patients
Go to: Introduction Both hyperglycemia and hypoglycemia in hospitalized patients are associated with adverse outcomes including increased rates of infection, longer hospital length of stay, and even death.[1, 2] Acute illness results in a number of physiological changes, such as increases in circulating concentrations of stress hormones, or therapeutic choices, such as glucocorticoid use that can exacerbate hyperglycemia. Hyperglycemia, in turn, causes physiological changes, such as decreased immune function and increased oxidative stress, which can exacerbate acute illness. This results in a vicious cycle of uncontrolled blood sugar and worsening of the disease.[3] Randomized clinical trials in no critically and critically ill patients with type 2 diabetes mellitus (T2DM) proved that by improving glycemic control, we could reduce all of them. Consequently, the hospital objectives for T2DM patients must include improved glycemic control (preventing hypo- and hyperglycemia) so that they can reduce hospital complications, systemic infections, hospital stay, and hospitalization cost and provide an effective transition out of hospital so as to prevent readmission. Here, we review the management of T2DM patients who are admitted to the general medical wards of the hospital for a procedure of intercurrent illness. The treatment of hyperglycemia in patients with artificial nutrition and with corticosteroid therapies, and the perioperative management of T2DM are also discussed. Continue reading >>
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 >>
Oral Anti Diabetic Drugs
Mainly act by causing increased secretion of insulin from beta cells of pancreas by binding receptors on surface of beta cells. Also cause increased sensitivity of tissues to insulin Also cause decrease in release of glucagon. Ineffective in type I diabetes mellitus, requiring up to 30% of beta cells to be intact for action. Cause a decrease in conductance of ATP sensitive potassium channels decreased conductance leads to increase in positivity inside cells leading to depolarization resulting in increased entry of calcium through calcium channels increased release of insulin from beta cells. Extensively bound to plasma proteins, maximum is for Glibenclamide, while Chlorpropamide has the least. Half life varies. 1st generation drugs have short half life (4-7 hours) and short duration of action. Chlorpropamide has long half life of 36 hours (longest in 1st generation). Acetohexamide has active metabolite having same half life (4-7 hours) Second generation compounds have shorter half life of 1.5-5 hours, but have longer duration of action than 1st generation compounds, which may be due to active metabolites formed. Since more potent, usually given once daily. Most drugs are metabolized in liver and excreted in urine. Chlorpropamide is 20% excreted unchanged in urine. Glipizide and Tolbutamide are mainly excreted through bile and less through urine. More with drugs with longer half life including Chlorpropamide and Glibenclamide, in renal insufficiency, especially in elderly. Treatment is same: Have same mechanism of action and effects as sulfonyl ureas, but differ from others in: Are metabolized in liver, excreted in bile, thus can be given in renal insufficiency Cause less incidence of hypoglycemia as compared with sulfonyl ureas (shorter duration of action). Nateglinide Continue reading >>
Must Read Articles Related To Insulin Reaction
A A A Insulin Reaction An insulin reaction occurs when a person with diabetes becomes confused or even unconscious because of hypoglycemia (hypo=low + glycol = sugar + emia = in the blood) caused by insulin or oral diabetic medications. (Please note that for this article blood sugar and blood glucose mean the same thing and the terms may be used interchangeably.) The terms insulin reaction, insulin shock, and hypoglycemia (when associated with a person with diabetes) are often used interchangeably. In normal physiology, the body is able to balance the glucose (sugar levels) in the bloodstream. When a person eats, and glucose levels start to rise, the body signals the pancreas to secrete insulin. Insulin "unlocks the door" to cells in the body so that the glucose can be used for energy. When blood sugar levels drop, insulin production decreases and the liver begins producing glucose. In people with diabetes, the pancreas is unable to produce enough insulin to meet the body's demand. Treatment may include medications taken by mouth (oral hypoglycemics), insulin, or both. The balance of food intake and medication is not automatic, and a person with diabetes needs to be aware that too much medication or too little food may cause blood sugar levels to drop. Interestingly, brain cells do not need insulin to access the glucose in the blood stream. Brain cells also cannot store excess glucose, so when blood sugar levels drop, brain function is one of the first parts of the body to become affected. In an insulin reaction, the blood sugar levels are usually below 50 mg/dL (or 2.78 mmol/L in SI units). Continue Reading A A A Insulin Reaction (cont.) Insulin reactions occur when there is an imbalance of food intake and the amount of insulin in the body. The oral hypoglycemic mediat Continue reading >>
Anti-diabetic Drugs
Tweet Antidiabetic drugs are medicines developed to stabilise and control blood glucose levels amongst people with diabetes. Antidiabetic drugs are commonly used to manage diabetes. There are a number of different types of antidiabetic drug including: Insulin Pramlintide (Amylin) GLP-1 receptor agonists (such as Byetta and Victoza) Oral hypoglycemics (tablets) Antidiabetic drugs for type 1 diabetes For people with type 1 diabetes, daily insulin injections are essential to maintain health. Type 1 diabetics must also eat properly, keep blood glucose levels from going too low or too high, and monitor blood sugar levels. In America, pramlintide, marketed as Amylin, is used in addition to insulin by some people with type 1 diabetes to further help control their diabetes. Amylin is not currently prescribed in the UK. Antidiabetic drugs for type 2 diabetes For people with type 2 diabetes, diet and exercise may be enough to control blood glucose levels in some. However, when diet and exercise is no longer efficient, anti-diabetic drugs may be prescribed. Medication will either be taken orally in the form of tablets (oral hypoglycemics), or be injected (insulin and GLP-1 receptor agonists). Read more about oral hypoglycemics Antidiabetic treatment considerations for type 2 diabetes Biguanides, such as Metformin, are commonly prescribed as a first antidiabetic medication. If biguanides are not effective on their own you may be given alternative medication either instead of, or in addition to, biguanides. The type of medication you are offered could depend on a variety of factors as different medication have different advantages and disadvantages. Some common factors that your doctor will consider are as follows: How effective is the medication for reducing blood sugar levels? Wil Continue reading >>
Diamicron 80mg Tablets
Non insulin dependent diabetes (type 2) in adults when dietary measures, physical exercise and weight loss alone are not sufficient to control blood glucose. Posology • Initial dose The total daily dose may vary from 40 to 320 mg taken orally. The dose should be adjusted according to the individual patient's response, commencing with 40-80 mg daily (½- 1 tablet) and increasing until adequate control is achieved. A single dose should not exceed 160 mg (2 tablets). When higher doses are required, Diamicron 80 mg Tablets should be taken twice daily and according to the main meals of the day. In obese patients or those not showing adequate response to Diamicron 80 mg Tablets alone, additional therapy may be required. • Switching from another oral antidiabetic agent to Diamicron 80 mg: Diamicron 80 mg can be used to replace other oral antidiabetic agents. The dosage and the half-life of the previous antidiabetic agent should be taken into account when switching to Diamicron 80 mg. A transitional period is not generally necessary. A starting dose of 40-80 mg (½ to 1 tablet) should be used and this should be adjusted to suit the patient's blood glucose response, as described above. When switching from a hypoglycaemic sulfonylurea with a prolonged half-life, a treatment free period of a few days may be necessary to avoid an additive effect of the two products, which might cause hypoglycaemia. • Combination treatment with other antidiabetic agents: Diamicron 80 mg can be given in combination with biguanides, alpha glucosidase inhibitors or insulin. In patients not adequately controlled with Diamicron 80 mg, concomitant insulin therapy can be initiated under close medical supervision. Special Populations Elderly Diamicron 80 mg should be prescribed using the same dosing r Continue reading >>
Oral Hypoglycemic As Attractive Alternative To Insulin For The Management Of Diabetes Mellitus During Pregnancy
Magdy A Mohamed1*, Allam M Abdelmonem1, Mostafa A Abdellah1 and Adel A Elsayed2 1Obstetrics & Gynecology Department, Sohag University, Egypt 2Internal Medicine Department, Sohag University, Egypt Citation: Mohamed MA, Abdelmonem AM, Abdellah MA, Elsayed AA (2014) Oral Hypoglycemic as Attractive Alternative to Insulin for the Management of Diabetes Mellitus during Pregnancy. Gynecol Obstet (Sunnyvale) 4:193. doi: 10.4172/2161-0932.1000193 Copyright: © 2014 Mohamed MA, et al. 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 author and source are credited. Visit for more related articles at Gynecology & Obstetrics Abstract Objective: To study the efficacy and safety of glibenclamide/metformin combination as a treatment option for pregnant women with either gestational diabetes or type-2 diabetes mellitus compared to conventional insulin therapy. Methods: Eighty-four pregnant women with singleton pregnancies (65 women with gestational diabetes & 19 with type-2 diabetes mellitus) were included. They were randomly allocated to receive either glibenclamide/metformin combination or insulin. The primary end point was the achievement of the desired level of glycemic control. The presence or absence of maternal, fetal and/or neonatal complications was measured as secondary end points. Results: There were no differences between the oral hypoglycemic-treated group and insulin-treated group as regard the mean blood glucose levels. It was 125.64 ± 18.15 mg/dL in the former group where it was 124.62 ± 9.29 mg/dL in the latter one. There was no significant difference as regard the amniotic fluid volume, gestational age at delivery Continue reading >>
Pharmacology
New evidence shows that _in _ Americans born in 2000 will develop diabetes sometime during their lifetime. Flashcards Matching Hangman Crossword Type In Quiz Test StudyStack Study Table Bug Match Hungry Bug Unscramble Chopped Targets Diabetes Question Answer New evidence shows that _in _ Americans born in 2000 will develop diabetes sometime during their lifetime. 1 in 3 Type 2 prevalence by ethnicity.. which population is hit the hardest? coushatta indian tribe, %80 what was the estimated economic cost of diabetes in 2007? $174 billion ______ ______ is a group of metabolicdiseases characterized by hyperglycemia resulting from defects in insulin secretion,insulin action, or both. Diabetes mellitus Which type of diabetes involves....(ß-cell destruction, absolute insulin deficiency) Type 1 Which type of diabetes involves.... (Progressive insulin secretory defect + insulin resistance) Type 2 Impaired Fasting Glucose,Impaired Glucose Tolerance, Gestational Diabetes are all grouped into the category of _______? pre-diabetes intrinsic and extrinsic risk factors of diabetes all lead to ________ - a condition of excess blood glucose hyperglycemia normal fasting blood glucose = 70 - 100 mg/dl diagnostic lab values for diabetes; 8hr fasting plasma glucose (FPG)= > or = to 126 mg/dl diagnostic lab values for diabetes; casual plasma glucose .. done anytime = > or = to 200 mg/dl with symptoms diagnostic lab values for diabetes; 2 hour plasma glucose.. no exercise before taking = > or = to 200 mg/dl during Oral Glucose Tolerance Test (OGTT) patients with a casual plasma glucose test > 200 mg/dl may have diabetes symptoms such as... polyuria - urination, polydipsia - thirst, polyphagia - hunger, blurred vision,and unexplained weight loss Additional signs & symptoms of Type 2 Diabetes Continue reading >>
Oral Hypoglycemic Drugs
Oral hypoglycemic drugs are used only in the treatment of type 2 diabetes which is a disorder involving resistance to secreted insulin. Type 1 diabetes involves a lack of insulin and requires insulin for treatment. There are now four classes of hypoglycemic drugs: Sulfonylureas Metformin Thiazolidinediones Alpha-glucosidase inhibitors. These drugs are approved for use only in patients with type 2 diabetes and are used in patients who have not responded to diet, weight reduction, and exercise. They are not approved for the treatment of women who are pregnant with diabetes. SULFONYLUREAS – Sulfonylureas are the most widely used drugs for the treatment of type 2 diabetes and appear to function by stimulating insulin secretion. The net effect is increased responsiveness of ß-cells (insulin secreting cells located in the pancreas) to both glucose and non-glucose secretagogues, resulting in more insulin being released at all blood glucose concentrations. Sulfonylureas may also have extra-pancreatic effects, one of which is to increase tissue sensitivity to insulin, but the clinical importance of these effects is minimal. Pharmacokinetics – Sulfonylureas differ mainly in their potency & their duration of action. Glipizide, glyburide (glibenclamide), and glimepiride are so-called second-generation sulfonylureas. They have a potency that allows them to be given in much lower doses. Those drugs with longer half-lives (particularly chlorpropamide, glyburide, and glimepiride) can be given once daily. This benefit may be counterbalanced by a substantially increased risk of hypoglycemia. Side effects – Sulfonylureas are usually well tolerated. Hypoglycemia is the most common side effect and is more common with long-acting sulfonylureas. Patients recently discharged from hospit Continue reading >>
What Are Oral Hypoglycemic Agents?
Oral hypoglycemic agents are pills used to reduce blood glucose levels, but they are not insulin pills. Insulin is a hormone that can’t be taken orally, because it would be destroyed by the enzymes involved in our digestion, being reduced into simple substances or amino acids, which would not affect blood glucose levels. The most common types of oral medications for Diabetes are called Sulfonylureas and Metformin, which have been used for over 30 years. Sulfonylureas reduce blood glucose levels because they: Stimulate the pancreas to segregate more insulin. Make body cells more sensitive to the insulin produced. In order to make oral hypoglycemics work, the person has to produce some insulin. For most people with Type 2 Diabetes, oral medications are extremely effective. Occasionally, the medication can lose its effectiveness after a few years of use, in that case, it’s generally recommended to begin treatment with insulin. When are the oral hypoglycemic agents recommended? Diet and regular exercise are the mainstay treatment for Type 2 Diabetes. Because being overweight is one of the main causes of Type 2 Diabetes, a strict diet and exercise program are the first treatment alternatives a doctor will try to implement. Weight loss and exercise help the body’s cells use insulin more efficiently, which is why in many cases, people with Type 2 Diabetes can keep their blood glucose levels within normal values, without any additional treatment. If blood glucose levels remain high after making these “lifestyle” changes (diet and exercise), the next step will be to include the use of pills or oral medications into the treatment, in some cases, the person may even need insulin or other injectable drugs such as Exenatide. More about … Oral Medication Continue reading >>
Antidiabetic Drugs And Heart Failure Risk In Patients With Type 2 Diabetes In The U.k. Primary Care Setting
OBJECTIVE—To assess the effects of antidiabetic drugs on the risk of heart failure in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS—We conducted a retrospective cohort study with a newly diagnosed diabetes cohort of 25,690 patients registered in the U.K. General Practice Research Database, 1988–1999. We categorized person-time drug exposures to monotherapies in insulin, sulfonylureas (SUs), metformins, and other oral hypoglycemic agents (i.e., acarbose, guar gum) and combination therapy including insulin, combination therapy without insulin, and triple combination therapy with or without insulin. A drug-free time interval served as a reference category. Cox interval-wise (piece-wise) regression analyses were used. The main outcome was incident heart failure. RESULTS—Among 43,390 drug exposure intervals for 25,690 patients who had a mean follow-up period of 2.5 years, 1,409 patients developed heart failure. Heart failure occurred most frequently in SU monotherapy exposure. After adjusting for duration of diabetes, the timing and order of treatments received, and known risk factors for heart failure, we found no differential effects among type-specific therapies. Patients with any drug use within the first year after diabetes diagnosis had a 4.75-fold higher risk (hazard ratio) for heart failure than those with drug-free status but had no increased risk during subsequent years. CONCLUSIONS—In conclusion, the use of any pharmacological therapy for type 2 diabetes appears to be associated with an increased risk of heart failure. This risk does not persist beyond the first year after diagnosis of diabetes and does not appear to differ among the types of drug therapy examined. This observation suggests that the severity of diabetes or the preclinical du Continue reading >>
