The American Diabetes Association estimates that 23 million Americans have diabetes, and type 2 diabetes accounts for 90 to 95 percent of these cases. Individuals with type 2 diabetes do not produce enough insulin or the cells of their bodies are insulin-resistant. Excess fat--especially abdominal fat--and lack of exercise contribute to the development of type 2 diabetes. Without insulin, blood sugar levels rise too high. High blood sugar can cause life-threatening complications. Different classes of medications are available for individuals with type 2 diabetes. Taking medications along with eating a healthy diet and exercising can help control blood sugar and manage type 2 diabetes.
Meglinitides
Beta cells in the pancreas produce insulin. Insulin helps lower blood glucose levels. Meglitinides stimulate the pancreas to increase the production of beta cells, which produces more insulin and allows the body to process glucose better, which stabilizes blood sugar levels. Meglitinides work quickly and are usually taken three times a day. Meglitinides can cause low blood sugar and weight gain.
Sulfonylureas
Sulfonylureas also stimulate the beta cells to produce more insulin. First-generation sulfonylureas, including chlorpropamide and tolbutimide, can also bind to proteins in the blood and can be dislodged by other medications that bind to the same proteins, causing a rapid decrease in blood sugar. Glipizide is a second-generation sulfonylurea that does not bind to proteins and does not cause drug interactions that can lead to dangerously low blood sugars. Glimperide is a third-generation sulfonylurea with the same advantages of the second-generation sulfonuyreas. Sulfonylureas can cause weight gain and low blood sugar.
DPP-4 Inhibitors
DPP-4 inhibitors block the action of the enzyme DPP-4 in the body, inhibiting DDP-4 from breaking down GLP-1 in the body. GLP-1 stimulates the release of insulin from the pancreas. GLP-1 also slows gastric emptying, enhances the survival of beta cells and inhibits glucagon release. The actions of GLP-1 cause a decrease in blood sugar. DPP-4 inhibitors are usually taken once a day and side effects include upper-respiratory infections, sore throat and headache. DPP-4 inhibitors can also cause severe pancreatic inflammation.
Thiazolidinediones
Thiazolidinediones do not cause the pancreas to produce insulin but enhance the body's response to insulin by lowering insulin resistance in the cells. This class of medication should only be used when other medications have failed to manage blood sugar levels. Even with the newer generation of thiazolidinediones, including rosiglitazone and pioglitizone, liver damage may be a risk. The U.S. Food and Drug Administration issued a warning that rosiglitazone may increase an individuals's risk of having a heart attack. Common side effects include low blood sugar, upper-respiratory tract infection, headaches, weight gain, anemia and muscle aches.
Biguanides
Biguanides helps regulate the amount of glucose in the body by decreasing the amount of glucose absorbed from food, decreasing the amount of glucose produced by the liver and enhancing the body's response to insulin. Metformin is a biguanide taken with meals two to three times a day. Metformin is also available as an extended-release tab that is taken once a day with an evening meal. Side effects include nausea, vomiting and diarrhea. The Mayo Clinic states that Metformin can cause a dangerous buildup of lactic acid in the body. This is called lactic acidosis and is a medical emergency.
Alpha-Glucosidase Inhibitors
Alpha-glucosidase inhibitors decrease the absorption of carbohydrates in the intestine by inhibiting the enzyme alpha glucosidase. Without alpha-glucosidase, carbohydrates are broken down slowly, keeping blood sugars stable throughout the day. Alpha-glcosidase inhibitors are often used in individuals who have been unsuccessful in managing their condition with diet, exercise and other medications. The Mayo Clinic states that alpha-glucosidase should be taken three times a day, and common side effects include nausea and diarrhea. Acarbose and miglitol are alpha-glucosides inhibitors.
