Diabetes (diabetes mellitus) is a chronic condition characterized by high blood sugar. Type 1 diabetes occurs when the body does not produce insulin. Insulin is a hormone secreted by the pancreas that regulates blood sugar levels and changes sugar to energy for the body to use. In type 2 diabetes, the body does not make enough insulin or does not properly respond to insulin. Medications can help lower blood sugar levels, which can prevent the serious health problems associated with diabetes.
Insulin
Insulin is prescribed to many individuals with type 1 or type 2 diabetes. More than 20 types of insulin are available and are differentiated by speed of onset, duration and cost. Insulin cannot be taken as a pill, as it is broken down when digested. Therefore, insulin must be injected for it to work. Insulin may be administered through an insulin pump, which delivers insulin throughout the day and replaces recurring injections.
Injectable Medications
Two injectable medications, other than insulin, are available to treat diabetes. Pramlintide (Symlin) is a synthetic form of amylin, a hormone that is produced in the pancreas and works with insulin to maintain normal blood sugar levels. Both type 1 and type 2 diabetes can be treated with pramlintide. Exanatide (Byetta) reduces blood sugar levels of type 2 diabetics by increasing insulin secretion in the pancreas. Nausea is the main side effect of both pramlintide and exanatide.
Oral Medications
Oral medications are prescribed for individuals with type 2 diabetes who are not pregnant, as the pills are not safe for the developing fetus. There are six types of oral medications for diabetes.
Sulfonylureas stimulate the pancreas to release more insulin, so there is some risk of developing hypoglycemia, or low blood sugar. Vomiting or flushing may occur if someone taking a sulfonylurea drinks alcohol. Some sulfonylureas include glipizide (Glucotrol), glimepiride (Amaryl), glyburide (Glynase, Diabeta and Micronase), and chlorpropamide (Diabinese).
Meglitinides also stimulate the pancreas to release insulin, so a person taking a melitinide may have hypoglycemia. Repaglinide (Prandin) and nateglinide (Starlix) are examples of meglitinides.
Biguanides reduce sugar production by the liver. Metformin (Glucophage) is an example of a biguanide, and it also lowers blood sugar levels by helping muscles absorb sugar. One side effect of biguanides is diarrhea.
Thiazolidinediones decrease the amount of sugar produced by the liver and help insulin work better. Rosiglitazone (Avandia) and pioglitazone (ACTOS) are thiazolidinesdiones. Some individuals taking thiazolidinesdiones are at increased risk for heart failure. Users are also monitored for possible liver difficulties.
Alpha-glucosidase inhibitors slow the break down of some sugars and prevent starches from breaking down during digestion. Examples of alpha-glucosidase inhibitors are acarbose (Precose) and meglitol (Glyset). Side effects of alpha-glucosidase inhibitors include diarrhea and gas.
DPP-4 inhibitors lower blood sugar by preventing the break down of GLIP-1, a compound in the body that reduces blood sugar. The only available DPP-4 inhibitor at the present time is sitagliptin (Januvia).
References
- "Clinical Pharmacology Made Ridiculously Simple"; James Olson; 2006.
- "The Physicians Desk Reference"; PDR Staff; 2009.
