Medication is an important part of the treatment plan for individuals who suffer from diabetes. Physicians prescribe the most appropriate medication based on the patient’s age, gender, length of time they have suffered from diabetes, weight, symptoms, complications, blood glucose levels and affects of other underlying medical conditions from which the individual may suffer. The effectiveness of the medication is measured by the body’s response, namely the blood test A1C.
Insulin
Insulin is the hormone normally produced in the body to keep blood glucose levels within normal limits. According to the National Diabetes Information Clearinghouse, injectable insulin is used for all types of diabetes and can be administered through an insulin pump, insulin jet injector, or needle and syringe. Possible side effects include low blood glucose levels and weight gain.
Medicines That Improve Insulin Levels
According to physicians at Mayo Clinic, doctors also have the option of prescribing oral medications that will improve the effectiveness of insulin. These medications include two classes of drugs known as biguanides and thiazolidinediones. The medications are taken by mouth, do not usually cause weight gain and may have secondary side effects of decreasing bad cholesterol and slightly increasing good cholesterol. In a study published in the a 2010 article "Journal of the American Medical Association," researchers found that rosiglitazone and pioglitazone, two of the only thiazolidinedione drugs marketed in the United States, have been associated with an increased risk of serious cardiovascular events in individuals over the age of 65.
Sulfonylureas
Sulfonylureas are a class of oral medications that are used to stimulate the beta cells of the pancreas to release more insulin. According to The American Diabetes Association, these oral medications have been in use since the 1950s. There is only one first generation drug still in use today. The remainder of the drugs used in this classification are second and third generation, designed to be taken one to two times a day before meals.
Other Oral Medications
According to the American Diabetes Association, other oral medications used to treat diabetes include meglitinides, used to stimulate the beta cells to release insulin. Alpha-glucosidase inhibitors help the body lower glucose levels by blocking the breakdown of starches and slowing the breakdown of some sugars. DPP-4 inhibitors are a class of oral medication used to prevent the breakdown of a naturally occurring compound, GLP-1. This compound reduces blood glucose levels in the body, but is broken down very quickly. The oral medications act in different ways to lower blood glucose levels. In some cases, they may be combined to increase effectiveness and control.
Other Injectable Medications
Besides insulin, there are two other drugs that can be used to treat diabetes that are injectables. Pramlintide, is a synthetic form of the hormone amylin. This hormone, along with insulin and glucagon, works to maintain normal blood glucose levels. Pramlintide is taken with meals and has been shown to modestly improve A1C levels without causing hypoglycemia and weight gain. These second injectable medication is exenatide. It works to lower the glucose levels by increasing insulin secretion and also does not increase the risk of hypoglycemia on its own.
References
- National Diabetes Information Clearinghouse: What I Need to Know about Diabetes Medicines
- Mayo Clinic: Diabetes Treatment: Medications for Type 2 Diabetes
- "Journal of American Medical Association"; Type 2 Diabetes Medication Rosiglitazone Associated with Increased Cardiovascular Risks and Death”; David J. Graham; June 2010
- American Diabetes Association: Medication
