Diabetes Medications

Diabetes Medication

The following oral medications are commonly used in the treatment of type 2 diabetes.

Alpha-Glucosidase Inhibitors - This group slows or blocks the breakdown of starches as well as some sugars, slowing the rise in blood glucose following meals. This group includes acarbose (Precose) and meglitol (Glyset). Alpha-glucosidase inhibitors should be taken with the first bite of a meal. Possible side effects include gas and diarrhea.

Biguanides - These drugs lower blood sugar levels primarily by decreasing the amount of glucose the liver produces. A commonly prescribed biguanide is metformin (Glucophage). Metformin also helps by making muscle tissue more sensitive to insulin and thus more capable of taking glucose into the cells. This is commonly prescribed for twice a day usage. Diarrhea is a possible side effect, but the risk can be decreased by taking this drug with food.

DDP-4 Inhibitors - This newest class of drugs works to prolong the activity of certain proteins whose function is to increase insulin release after blood sugar rises (commonly after a meal) by blocking an enzyme (dipeptidyl peptidase IV or DPP-IV) which breaks down these proteins. The first of this new class of type 2 diabaetes drugs to be approved by the FDA is sitagliptin phosphate under the brand name Januvia. Januvia was approved October 17, 2006 and is manufactured by Merck and Co., Inc.

Meglitinides - This class of drugs stimulates the beta cells to release insulin, and includes repaglinide (Prandin) and nateglinide (Starlix). They are generally prescribed to be taken before meals three times a day. One side effect to watch out for while self-testing is hypoglycemia or low blood sugar. Consult your healthcare provider if your blood sugar levels fall below your target range.

Sulfonylureas - This class of drugs has been in use since the 1950s. They work by stimulating the beta cells of the pancreas to increase the release of insulin. Sulfonylureas drugs include chlorpropamide (Diabinese), glipizide (Glucotrol and Glucotrol XL), glyburide (Micronase, Glynase, and Diabeta) and glimepiride (Amaryl). These drugs all have similar effects on glucose levels, but do differ in dosage, drug interaction, how often they are taken and side effects. Like the meglitinides described above, hypoglycemia is possible with sulfonylureas. Also note that sulfonylureas, particulary chlorpropamide, can have additional side effects when taken in combination with alcohol, including sickness, vomiting and/or flushing.

Thiazolidinediones - This group is made up of rosiglitazone (Avandia), troglitazone (Rezulin), and pioglitazone (ACTOS). They work by aiding insulin function in muscle and fat cells, as well as reducing glucose production in the liver. Thiazolidinediones are often prescribed for once or twice a day use, taken with food. There is a rare, but potentially serious side effect associated with these drugs that affects the liver, so your doctor will schedule regular blood tests to monitor liver health while on drugs in the thiazolidinediones group.

Oral Combination Therapy - Because each class of drugs works differently to lower blood glucose levels, they are sometimes prescribed in combination. This can increase the cost of treatment and risk of side effects, but can also be a more effective treatment where a single drug fails to meet the treatment goals. Combination therapy is often more effective than switching from one type of drug to another.

Ask your doctor or pharmacist for more detailed information on the specific type 2 medications you may have been prescribed.