Patients having difficulty managing type 2 diabetes through diet and exercise may experience enough trouble that their doctor will eventually prescribe medication. In time, these patients may reach the point where they require insulin injections, but oral medications typically are given a period of trial and error before that point is reached. This trial and error process can be quite lengthy because a number of medications are currently on the market to treat diabetes.
Classifications
Five main classes of oral medicine currently exist for type 2 diabetes. These are sulfonylureas, biguanides, thiazoliedinediones, alpha-glucosidase inhibitors, and meglitinides. In addition to these main classes, the are also combination drugs that combine two different classes of medication.
How Drugs Work
Diabetes drugs work in variously different manners. Sulfonylureas and meglitinides work by stimulating insulin production. Alpha-glusosidae inhibitors work by blocking digestion of carbohydrates. Biguanides work by inhibiting the production of glucose. Thiazoliedinediones increase the sensitivity to insulin. Combination drugs, as might be expected, work by combining two or more of these methods.
Biguanides
Biguanides include such brand names as Glocophage and is typically taken two to three times a day, although long lasting, once-a-day versions are also available. Many people prefer this drug because it doesn't cause hypogycemia. These drugs also are popular because they can cause weight loss and improvement in cholesterol levels. Side effects include stomach gas, diarrhea and a metallic aftertaste.
Alpha-glucosidase inhibitors
Alpha-glucosidase inhibitors are sold under brand names like Glyset and Precose. These drugs work by blocking the enzymes that are responsible for breaking down carbohydrates in the intestine. This has the effect of making blood glucose rise more slowly and steadily. Side effects include bloating, gas, diarrhea and stomach cramping.
Sulfonylureas
Sulfonylureas are actually the original class of medication for diabetes and is sold under brand names such as Orinase and Glucotrol. These drugs also go by the name of hypoglycemic agents because they work by causing the pancreas to increase higher levels of insulin. Unfortunately, these drugs can have a potentially serious side effect in the form of a hypoglycemic reaction. The older kinds of drugs are more likely to cause this side effect, but usually only if taken with another drug so check with your doctor to see if any drugs you are currently taking can cause this interference.
Thiazoliedinediones
Thiazoliedinediones are sold under brand names Actos and Avandia and are effective because they cause insulin receptors in the muscle and fat cells to increase the level of insulin sensitivity in the body while also reducing the production of glucose. Side effects include water retention in the ankles, anemia, weight gain, headaches and fatigue.
Meglitinides
Meglitinides is sold under the brand names Prandin and Starlix. They are taken at mealtime so that they can increase first phase insulin release. This is the production of insulin comes about as a result of the initial burst of blood glucose that is generated by carbohydrates directly after a meal. The side effects associated with this class of drugs can be severe, including symptoms similar to having the flu, headaches and joint and back pain.
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