Diabetes mellitus is a disease that represents a spectrum of disorders, all revolving around disruption in insulin metabolism, which results in increased blood sugar levels. The increase in blood sugar levels is the driving force behind the many systemic effects of diabetes. Diabetes is classified into types 1 and 2, and each has its own unique medications for management and treatment. However, like all medical interventions, they carry their own risk of side effects.
Hypoglycemia
This is the medical term for having low levels of sugar in the blood. Symptoms of this state include anxiety, palpitations, trembling and sweating. With increasingly low levels of blood sugar, the brain can be affected with problems such as confusion, headaches, seizures and even coma. This is one of the main drawbacks of insulin, which is used to treat mainly type 1 and advanced type 2 diabetes. Other medications that augment insulin, such as meglitinides (repaglinide, for example) or sulfonylureas (which can include glipizide or glimepiride) classes of medications.
Weight Gain
Patients on medications for diabetes can also suffer from unwanted weight gain. Like low blood sugar, this can be an effect of insulin or medications that augment insulin. Insulin increases the amount of sugar absorbed by the body that is normally wasted in diabetes. This results in the typical weight gain seen by users.
Acidosis
This is one of the feared complications of metformin therapy, which is a very common medication used to treat type 2 diabetes. Patients with decreased kidney function are at higher risk of this side effect. Since metformin is normally excreted by the kidneys, decreased kidney function results in buildup of acidic metformin byproducts in the blood stream. Although a patient can suffer from very general and vague symptoms, such as malaise, fatigue, nausea and weakness, acidosis is very dangerous and can even be life-threatening. If any of these symptoms occur suddenly in a metformin user, they should be taken very seriously and medical consultation should be sought.
Gastrointestinal Disturbances
Many of the medications used to treat diabetes can cause symptoms within the digestive system. These include upset stomach, nausea, diarrhea, constipation and possibly increased flatulence. Medications that can cause these include acarbose, sulfonylureas, metformin or thiazolidinediones.
Effects During Pregnancy
This describes diabetic medications having negative effects on a developing fetus or the pregnant mother. The safest medication that is used for diabetes in a pregnant woman is insulin. Oral medications are typically discontinued due to concerns over their safety. For example, metformin has been linked to increased risk of preeclampsia and mortality in pregnant mothers. In addition, many of the drugs have not been studied during pregnancy. Until more information is known, it is considered safer to utilize insulin.
References
- "Primary Care: Clinics in Office Practice;" Management of Type 1 Diabetes; J. Unger; December 2007
- "Primary Care: Clinics in Office Practice;" Diagnosis and Management of Type 2 Diabetes and Prediabetes; J. Unger; December 2007
- "The American Journal of Medicine;" Initiating and Intensifying Insulin Therapy in Type 2 Diabetes Mellitus; J. Tibaldi; June 2008
