Like any other medical monster, Type-2 Diabetes requires some medicines to fight against it. To understand how they work, one must understand which type of Diabetes affects the body in what way. Type-1 Diabetes makes the body incapable of making insulin at all; hence injection of insulin shots is the only way to deal with it. In Type-2, however, the body produces insulin, but not sufficiently; or, the cells are unable to take in glucose from the bloodstream and hence the glucose builds in the bloodstream. This is known as insulin resistivity.
There are five different groups of medication that are efficacious in different ways in helping Type-2 Diabetics. Doctors usually start with oral medication (pills) to begin with and only prescribe insulin shots if the patient is unreceptive to oral medication or if the conditions are severe.
Sulfonylureas have been in the market since the 1950s with first generation drugs like Chlorpropamide (Diabinese) still in the market today. Second generations include Glipizide (Glucotrol & Glucotrol XL), Glyburide (Micronase, Glynase, & Diabeta), and Glimepiride (Amaryl). These act as stimulants on the pancreatic beta-cells to increase insulin production and have similar effects of blood-glucose levels. Their usage is however different according to other drug interactions, side effects and dosage.
Meglitinides are the next drug group, but their nature of action and dosage is similar to Sulfonylureas. Meglitinides include Repaglinide (Prandin) and Nateglinide (Starlix). Sometimes, both these can cause hypoglycemia due to their action in reduction of blood-glucose. They are also known to cause adverse reactions to alcohol like nausea and vomiting.
Biguanides act in reduction of blood-glucose by reducing glucose formation in the liver. Metformin (Glucophage) is a biguanide that also helps in making muscle cells more receptive to insulin, hence glucose absorption. One noted side-effect is diarrhea, but the same can be stopped with food intake during medication.
Thiazolidinediones act on muscle tissue and fat to help insulin work better; they also work on the liver’s functions of glucose production. This requires regular monitoring as the liver’s health may be affected, hence blood tests are a must. Rosiglitazone (Avandia), Troglitazone (Rezulin), and Pioglitazone (ACTOS) are all common Thiazolidinediones.
Alpha-glucosidase inhibitors act on the food instead of the body. They block the break-up of carbohydrates and sugar-rich foods in the digestion process. They are taken with the first bite of food and show considerable fall in blood-glucose levels after meals. However, they can have some side effects of diarrhea and gas. Acarbose (Precose) and Meglitol (Glyset) are some Alpha-glucosidase inhibitors.
** Note: The names in the brackets beside a drug are brand-names they are available under.
With all these drugs, one has to note that pills can only help you if you aren’t a severe diabetic, or a long-term patient. Pills work on milder forms of the disease in effectively working in bringing down blood-glucose levels. Insulin is often the only answer for the less fateful. Again, Diabetes pills are often used in combinations of two or more types to maximize effects. They also often stop working after prolonged used, without any effect on the status of the disease itself; again, oral combination therapy is the answer. Since insulin is the most effective and sure way of bringing down blood-glucose levels, often pills are given in combination with it to help insulin be more efficacious. On a final note, drugs and medications mentioned here are not a prescription, but for general awareness to you. A doctor’s role in Diabetes is an irreplaceable must. No medication, treatment or injections should be done without a doctor’s consultancy.