Managing diabetes begins with modifications in lifestyle. Changes in diet and exercise routines reduce blood glucose levels and improve glucose metabolism. Oral antihyperglycemics or antidiabetic medications are used when lifestyle modifications alone are not enough. Different classifications of drugs have been introduced to help in Type 2 diabetes management. The individual needs of the patient determine which specific drugs should be used in treatment.. There are several oral antidiabetic drugs on the market. A few of the most common drugs are discussed here.
Biguanides
While sulfonylureas are the oldest diabetic drugs, metformin, a biguanide is the most effective overall. Metformin is a multi-mechanism drug. It acts to improve glucose tolerance by decreasing liver production of glucose, increase sensitivity of peripheral tissues to insulin and decrease glucose absorption in the gut. Fortamet and Glucophage are two. Their appeal is that they are oral drugs that do not cause weight gain and may decrease bad cholesterol (LDL) and triglycerides, according to the Mayo Clinic. In addition, they have the advantage of not producing hypoglycemia. One rare but serious side effect is the harmful buildup of lactic acid (lactic acidosis).
Sulfonylureas
Historically, sulfonylureas are among the earliest oral medications used in the treatment of diabetes, according to Diabetes.org. Glipizide (Glucotrol), Glimepiride (Amaryl) and Glyburide (DiaBeta, Glynase) are examples of the newest sulfonylureas presented by the Mayo Clinic. Increasing insulin release from the pancreas is the way that these drugs modulate glucose level in the blood. As with all drugs, side effects range from mild to severe depending on the drug. Choosing the right drug depends on the current status of the patient combined with its side-effect profile. Sulfonylureas are one of the most effective drugs on the market for lowering glucose over time, however, they are not recommended for all patients. Patients with sulf who do not regularly monitor their glucose should avoid this class of drugs because of their known ability to cause severe hypoglycemia.
Thiazolidinediones
Increasing HDL or good cholesterol is a positive side effect of Rosiglitazone (Avandia) and Pioglitazone (Actos). They are part of a class of drugs called thiazolidinediones and decrease blood glucose by increasing the sensitivity of cells to insulin. This encourages glucose to leave the blood stream and enter cells, where it can be used for fuel. An increase in HDL would be a major advantage for patients at risk for atherosclerosis. However, the risk and benefits must be managed carefully. Retention of fluid is a major side effect of thiazolidinediones, therefore, they are not recommended for patients with heart disease, heart failure or liver damage.
