Generally, the first question a person asks after being diagnosed with type 2 diabetes is “do I have to take medicines lifelong?” The fact of the matter remains that one has to take diabetes medications lifelong. There is no escaping from this fact – diabetes drugs are now your friends along with a diabetes diet plan and of course, the walking shoes.
Managing Diabetes
In order to stay healthy, and stay away from diabetes complications, it is important for a person to follow certain treatment guidelines. Here is a list of things you need to do in order to manage and control diabetes.
- Self-monitor blood glucose levels with a glucometer
- Take diabetes medications daily (as prescribed your diabetes doctor or endocrinologist)
- Opt for an ideal diabetes diet plan with appropriate carbohydrate, fat, and protein content
- Get regular physical exercise (ideally 150 minutes per week)
- Get regular diagnostic tests for diabetes and related complications
Type 2 Diabetes Medications
Type 2 diabetes medications have evolved over the years. Now, we have diabetes drugs that provide much better glycemic control when compared to those that existed a decade ago. This of course is possible only with proper adherence to the treatment guidelines. Diabetes medications are classified in the following groups:
- Biguanides
- Sulfonylureas
- Meglitinide derivatives
- Alpha-glucosidase inhibitors
- Thiazolidinediones
- GLP-1 agonists
- DPP-4 inhibitors
- SGLT-2 inhibitors
- Bile acid sequestrants
Apart from these diabetes drugs, other medications like insulin, dopamine agonists, and amylinomimetics are also prescribed for people with type 2 diabetes.
How do diabetes drugs work?
While oral medications are commonly prescribed in the form of diabetes tablets, some people with type 2 diabetes are also prescribed insulin. In this case, target sugar levels are achieved by infusing insulin into the body so that the sugars are absorbed by the tissues of the body from the bloodstream. However, other diabetes drugs work in different methods. Diabetes doctors and endocrinologists might prescribe a single class of medicines or a combination of two or three classes in order to make the patient achieve blood sugar control.
Biguanides
These diabetes tablets reduce blood sugar levels by reducing the production of glucose in the liver. Commonly known as metformin, they are also called Glucophage, or Fortamet. These diabetes medications do not cause weight gain and hypoglycemia (very rare). Biguanides are prescribed by diabetes doctors in mono-therapy or in combination with Thiazolidinediones or sulfonylureas.
Sulfonylureas
These diabetes tablets are prescribed by diabetes doctors and endocrinologists in order to bring blood sugar levels to normalcy. These diabetes medications work by releasing insulin from the pancreas. Sulfonylureas come in many forms including Glyburide, Glipizide, and Glimepiride. These diabetes medications are known to cause low sugar levels in certain cases. Along with that other side effects include:
- Weight gain
- Hypoglycemia
- Skin complications
- Gastric issues
- Dark-colored urine
This class of diabetes medications are not advised for people with diabetic ketoacidosis, or those with pregnancy.
Meglitinide Derivatives
These diabetes tablets also work by releasing insulin from the pancreas. These are prescribed by diabetes doctors to be taken after meals in order to reduce blood sugar levels by stimulating the release of insulin. Meglitinide derivatives come in the forms of Repaglinide, and Nateglinide. Side effects of these diabetes drugs include:
- Low sugar levels
- Diarrhea
- Nausea
- Backache
- Pain in joints
- Runny nose
- Headaches
People with cardiac complications are generally not prescribed meglitinide derivatives.
Alpha-glucosidase inhibitors
These diabetes drugs work by delaying the absorption of carbohydrates during digestion and thereby reduce postprandial blood glucose levels. Though alpha-glucosidase inhibitors do not reduce blood sugar levels as much as other diabetes medications, they are prescribed in order to reduce postprandial blood glucose levels. Alpha-glucosidase inhibitors come in the forms of Acarbose, and Miglitol. Side effects of these diabetes tablets include:
- Stomach pain
- Diarrhea
- Flatulence
Thiazolidinediones
These diabetes drugs work by sensitizing the muscles and tissues of the body to insulin. This leads to better absorption of glucose in the body thereby reducing blood sugar levels. Thiazolidinediones come in the form of Pioglitazone, and Rosiglitazone. Side effects of these diabetes medications include:
- Weight gain
- Increased risk of fractures
- Edema
- Macular edema
- Increase in LDL cholesterol
- Heart failure
- Low sugar levels
GLP-1 agonists
GLP-1 agonists stands for Glucagon-like peptide-1 agonists. They work by mimicking the effects of naturally occurring Incretin glucagon-like peptide1. This leads to stimulation of insulin release from the pancreas. GLP-1 agonists come in the form of injectable solution in the name of exenatide and in the form of Liraglutide among others. GLP-1 agonists enhance glucose-dependent insulin release, and delay gastric emptying. So, they are used in order to reduce postprandial blood sugar levels. Side effects of these diabetes medications include:
- Loss of appetite
- Indigestion
- Constipation
- Nausea
- Vomiting
- Diarrhea
- Dizziness
- Sweating
- Headaches
DPP-4 Inhibitors
DPP-4 inhibitors are a class of diabetes medications that work in multiple modes. They work by delaying gastric emptying, increasing glucose-dependent insulin secretion, and so are prescribed by diabetes doctors and endocrinologists in order to reduce postprandial blood sugar levels. These diabetes tablets are prescribed to people who are intolerant to other diabetes medications like metformin or others. Side effects of these medications include:
- Gastric issues like stomach pain, nausea, and diarrhea.
- Runny nose and other flu symptoms
- Skin rashes.
SGLT-2 Inhibitors
SGLT-2 inhibitors stands for sodium glucose transporter 2. This diabetes medication works by reducing the reabsorption of glucose from the kidneys. This results in releasing more glucose through urine and thus reducing blood sugar levels. This diabetes drug comes in the form of Canagliflozin, Dapagliflozin, Ertugliflozin, and Empagliflozin. These medications reduce HbA1c, reduce blood pressure, and cause moderate weight loss. Added to that, these diabetes drugs carry very little risk of low sugar levels. Side effects of these include:
- Genital infections
- Urinary tract infections
- Hypotension
- Excessive urination
Increased risk of cardiovascular diseases
Bile acid sequestrants
Bile acid sequestrants are prescribed to people with diabetes as part of an adjunctive therapy. Bile acid sequestrants are actually lipid lowering medications that are also used in order to reduce blood sugar levels and improve glycemic control. A common form of bile acid sequestrants is Colesevelam.
