Diabetes drugs are life-savers for diabetics because they help manage levels of blood glucose, a sugar the body needs for energy. In type 1 diabetes, the pancreas is unable to produce insulin, a hormone that transports glucose from the blood to cells throughout the body. In type 2 diabetes, cells are insulin-resistant and cause blood glucose levels to swell. According to the American Diabetes Association, numerous drugs treat diabetes.
Size
The National Institute of Diabetes and Digestive and Kidney Diseases estimates that diabetes affects 23.6 million people in the United States, is a leading cause of death and disability and costs $174 billion per year. More than 90 percent of diabetics have type 2 diabetes. Epidemiology studies, such as one published in Pediatric Diabetes, indicate an epidemic of type 2 diabetes among adults, adolescents and children who are overweight or obese. According to IMS Health, human insulin drug sales in 2009 totaled $6.3 billion, an increase of more than 160 percent since 2005.
Classes
Insulin, injectable and oral medications are three classes of diabetes drugs, according to the American Diabetes Association. More than 20 types of insulin products are sold in the U.S. that deliver insulin through a syringe, pen or pump. Research in Diabetes Educator presents two examples of injectable drugs that include a synthetic form of amylin, a recently discovered hormone made in the pancreas that regulates post-meal glucose, and incretin mimetics, substances that act like natural hormones, for type 2 diabetics. Six classes of diabetes pills are available to type 2 diabetics, including sulfonureas and meglitinides that stimulate the pancreas to release insulin, biguanides that lower blood glucose levels by reducing the amount produced in the liver, thiazolidinediones that enhance the way insulin works plus reduces release of glucose from the liver, alpha-glucosidase inhibitors that lower blood glucose by blocking the breakdown of starches and a new class of drug called DPP-4 inhibitors that help glycosylated hemoglobin without causing low blood sugar levels.
Types
Two popular injectables are pramlintide and exenatide. Pramlintide is a synthetic form of amylin taken with meals. Exenatide is the first type of incretin mimetic injected with meals. Chlorpropamide is the only first-generation sulfonylurea used today, and is taken one or two times a day before meals. Nateglinide and repaglinide are meglitinides taken before each meal. Metformin is a biguanide taken two times a day. Rosiglitazone and pioglitazone are thiazolidinediones. Acarbose and meglitol are alpha-glucosidase inhibitors taken with the first bite of a meal. Two DPP-4 inhibitors are sitagliptin and saxagliptin.
Considerations
Physicians sometimes prescribe insulin with one or two other medications that act in different ways to lower blood glucose. Combining drugs is usually more effective to improve blood glucose control than switching drugs. Diet, exercise and illness can affect outcome.
Precaution
Some diabetes medicines can cause side effects such as nausea. Rosiglitazone and pioglitazone can increase the risk for heart failure. Ask your doctor about possible side effects of any medication prescribed.
References
- American Diabetes Association: Living with Diabetes
- National Diabetes Information Clearinghouse: Diabetes
- "Pediatr Diabetes"; Epidemiology of Childhood Type 2 Diabetes and Obesity; Shaw, J.; Dec 2007
- IMS Health: Top Therapeutic Classes by U.S. Sales
- "Diabetes Educator"; The Physiology of Amylin and Insulin; Martin, C.; May-Jun 2006
