In diabetes, glucose builds up in the bloodstream instead of being metabolized by the cells, leading to hyperglycemia (high blood sugar). There are two main types of diabetes. Type 1 is insulin-dependent diabetes, in which the insulin-secreting beta cells of the pancreas do not function. In type 2 diabetes, the more common type, beta cells either produce too little insulin or the body's resistance to insulin renders the hormone less effective. Unlike type1, type 2 diabetes often is treated with oral medications.
Injectable Medications
Type 1 diabetics need insulin, since beta cells in the pancreas do not secrete the hormone. According to the American Diabetes Association, more than 20 types of insulin are manufactured in the United States. Differences in the way they work, how they are made, and the cost of each allow doctors to choose the correct combination to manage individual needs. Insulin must be maintained at constant levels in the body to prevent complications. When levels are too low the body produces high levels of ketones, creating symptoms of frequent urination, dry mouth, excessive thirst, nausea, vomiting and blurred vision. Alternatively, too much insulin can lead to confusion, loss of consciousness, seizure, coma and death.
Two other injectable drugs can help improve control of diabetes. Pramlintide, for type 1, is a synthetic form of amylin, which works with insulin to stabilize blood sugar. Amylin, like insulin, is normally manufactured by beta cells in the pancreas. Exenatide, for type 2 diabetes, is a synthetic form of a substance in the saliva of a reptile, the Gila monster, that can stimulate the body to produce more insulin.
Older Oral Medications
Metformin is a drug that helps the cells of the body use insulin. It often is used in combination with other oral medications for type 2 diabetes. Side effects can include nausea and diarrhea.
Sulfonylureas, such as glipizide and glyburidem stimulate the beta cells to produce more insulin and aid its effectiveness. While these drugs are inexpensive and have few side effects, they are contraindicated for patients allergic to sulfa.
Newer Oral Medications
Rapid insulin releasers, such as Prandin and Starlix, help the pancreas make insulin, according to The American Academy of Family Physicians. These medications work short-term and must be taken with meals. Side effects include weight gain.
Alpha-Glucosidase (AG) Inhibitors include Precose and Glyset, which work in the bowel to inhibit the digestion of starchy foods. Slowing down this process helps control blood sugars. Gas, bloating, diarrhea and stomach pain may result from the action of AG inhibiting medicines.
Two dipeptidyl peptidase-4 (DPP-4) inhibitors, sitagliptin and saxagliptin, can help the body produce more insulin after meals. Nasal congestion, sore throat, headache and upper respiratory infections are possible side effects. The brand name Janumet is a combination of a DPP-4 inhibitor and metformin.
