Type 2 diabetes is a condition where the body either does not produce enough insulin or is resistant to the insulin that it does produce. People with Type 1 diabetes (the juvenile or insulin-dependent type) do not take oral medications, according to RXList.com. Without treatment, diabetics have too much sugar circulating in their blood. This can lead to heart disease, kidney problems, vision loss and eventually death. There is no cure for diabetes, but proper medical treatment will prolong life and reduce complications.
Sulfonylureas
Sulfonylureas were the first oral drugs developed to treat diabetes. Sulfonylureas cause the pancreas to release insulin. They can cause hypoglycemia, or low blood sugar, which can be dangerous. As the number of Beta cells in the pancreas decrease, sulfonylureas lose their effect.
Some drugs in this class are glyburide (Diabeta, Micronase and Glynase), glipizide (Glucotrol) and glimepiride (Amaryl).
Meglitinides
Meglitinides also stimulate the pancreas to release insulin, but they have a faster onset and shorter duration than the sulfonylureas. They are most helpful for people who experience a spike in blood sugar after meals. Prandin (repaglinide) and Starlix (nateglinide) are included in this group.
Biguanides
Metformin is the only biguanide available for sale in the United States. Metformin appears to reduce the amount of glucagon, the hormone that causes the liver to release stored glucose into the blood. Metformin also makes the body cells more sensitive to insulin and slows down the absorption of glucose from the intestinal tract.
Thiazolidinediones
Thiazolidinediones (Tzds) decrease insulin resistance by causing the cells to take in glucose circulating in the system. Pioglitazone (Actos) also lowers triglyceride levels.
Alpha-glucosidase Inhibitors
Only simple sugars, like glucose and fructose, can be absorbed from the intestines after meals. Alpha-glucosidase blocks the action of digestive enzymes that break down the more complex sugars and starches to simple sugars that the body can use. This causes some of the carbohydrates to pass through the digestive tract unabsorbed. Precose and Glyset are alpha-glucosidase inhibitors taken just before meals.
Dipeptidyl Peptidase-4 Inhibitor
Incretin is a hormone released by the intestines after a meal. Incretin stimulates the release of insulin and decreases the amount of glucose made by the liver. Dipeptidyl peptidase-4 (DPP-4) inhibitors prevent the breakdown of incretin, which keeps it active longer. Sitagliptin (brand name Januvia) is an oral DPP-4 inhibitor.
References
- Basic and Clinical Pharmacology; Bertram Katzung; 2007
- Januvia Website
