My Diabetes Project – Diabetes medications
If you are managing your diabetes with lifestyle changes as recommended, often Type 2 diabetes can get worse as we get older and means we may need to use different medications to control blood glucose levels.
- Metformin is a commonly used drug to treat Type 2 diabetes. It reduces the amount of glucose released by your liver into your bloodstream and makes your body’s cells more responsive to insulin. You may be prescribed this drug if overweight, as it usually doesn’t cause weight gain in users. Some side effects associated with Metformin are nausea and diarrhea, and it is not recommended for people with kidney damage.
- Sulphonylureas (including glibenclamide, gliclazide, glimepiride, glipizide, gliquidone) — it increases the amount of insulin your pancreas produces and may be prescribed if you can’t take metformin or you are not overweight, or if metformin alone isn’t controlling your blood glucose levels. Risks include hypoglycemia (low blood sugar levels) and occasionally weight gain, nausea and diarrhea.
- Glitazones (thiazolidinediones, TZDs, pioglitazones) — these medicines makes your body’s cells more sensitive to insulin so they take more glucose from your blood. They are often used in combination with metformin, sulphonylureas, or even both. They can cause weight gain or ankle swelling (oedmea) and shouldn’t be taken if you are at risk of heart failure or bone fracture.
Gliptins (DPP-4 inhibitors; include linagliptin, saxagliptin, sitagliptin, and vildagliptin) — these prevent a breakdown of a hormone called GLP-1 that helps the body produce insulin when your blood glucose levels are really high, but usually breaks down quickly. When they prevent the breakdown, gliptins prevent high blood glucose levels but don’t cause hypoglycemia (when your blood glucose levels are too low,often called “hypos”). These can be taken in addition to sulphonylureas or glitazones or replace them They are not associated with weight gain.
- Gliptins (DPP-4 inhibitors; includes linagliptin, saxagliptin, sitagliptin, and vildagliptin)—they prevent the breakdown of a hormone calles GLP-1 that helps the body produce insulin when your blood glucose levels are really high, but usually breaks down quickly. When they prevent the breakdown, gliptins prevent high blood glucose levels but don’t cause hypoglycemia (when your blood glucose levels are too low, often called “hypos”). These can be taken in addition to sulphonylureas or glitazones or in place of them, and are not associated with weight gain.
- GLP-1 agonists (including exenatide and liraglutide) — are drugs that act similarly to the hormone above, GLP-1, assists in producing insulin. Exenatide is injected twice a day and liraglutide is once a day,. Both help to reduce blood glucose and have been shown as helping with weight loss. They are usually used in overweight people who are on both metformin and sulphonylurea.
- Acarbose—prevents blood glucose levels from getting too high after a meal as it slows down the rate at which your digestive system (including your stomach, small and large intestines, liver, pancreas, and gallbladder) breaks carbohydrates down into glucose. This medicine isn’t usually prescribed due to the common side effects of bloating and diarrhea, but it is helpful if you can’t take other medications.
- Nateglinide and repaglinide both cause your pancreas to release on insulin. While the effects don’t last very long, they may be helpful for those who eat at irregular times and take them right before a meal. They can also cause weight gain and hypoglycemia (low blood sugar).