List of Classes of Most Common Oral Type 2 Diabetes Medications
What is diabetes?
Diabetes is a chronic condition that results in high blood sugar levels in the body; it occurs when the body can’t produce insulin or utilize it as required. Insulin is a hormone that enables the body to use the glucose or sugars from the food consumed. A lot of people have glucose levels above the usual range, although not high enough to be termed as diabetes, this is known as pre-diabetes and the risk of developing full-blown diabetes is high. It’s vital for the condition to be diagnosed early enough because it worsens when medical intervention isn’t sought.
There are two types of diabetes, namely:
- Type 1 – the pancreas produces little or no insulin hormone.
- Type 2 – the body doesn’t use insulin hormone properly or the insulin produced isn’t enough to maintain normal sugar levels.
When is the best time to visit a doctor? See a physician if you encounter any of the following symptoms of diabetes:
- Frequent thirst
- Increased urination, especially at night
- Unexplained weight loss
- Cuts or wounds which take longer to heal
- Blurred vision
The medical care provider will give drugs to improve the symptoms; diabetes has no cure.
Classification of type 2 diabetes medications
Drugs used to treat type 2 diabetes (T2D) are many and most of them are taken orally, but a few through injections. Because people are different in terms of genetic makeup, height, weight, medical history and existing health conditions. A medicine effective in controlling blood sugar levels in your friend, may not necessarily work for you. Another key factor in deciding the right medication for a patient is the level of blood glucose. Therefore, the health practitioner will figure out the best medicines for T2D which will regulate the glucose levels. If need be, the doctor combines the meds from different classes to control the blood sugar in a number of different ways.
Below are classes of prescription drugs for type 2 diabetes which work in different methods to lower the blood glucose levels:
- DPP- 4 inhibitors
- Sodium-glucose transporter (SGLT) 2 inhibitors
- GLP-1 receptor agonists
- Alpha- glucosidase inhibitors
- Bile Acid Sequestrants
They are among the oldest medications for T2D still used today. The drugs stimulate the pancreas, thus the body produces more insulin. They are taken before meals one to two times ever day or as advised by the physician. Some possible unwanted side effects are low blood sugar and weight gain. However, they differ in negative effects, the number of times taken and interactions with other medicines and they include:
- Glimepiride (Amaryl)
- Chlorpropamide (Diabinese)
- Tolbutamide ( Orinase, Tol-Tab)
- Tolazamide (Tolinase)
These oral medications decrease the amount of sugar released by the liver. Additionally, these meds make the muscle tissues more sensitive to glucose; therefore, the sugars are absorbed easily and reduce the quantity of glucose absorbed by the intestines. Metformin (Glucophage, Metformin Hydrochloride ER, Glumetza, Riomet, Fortamet) is the most common type 2 diabetes medication in this category and it is taken twice per day or as per the Physician prescription. An example of unwanted side effect with Metformin is diarrhea, which is improved when the medicine is taken with food or once the body become used to the drug.
This class of meds to treat T2D works in a similar manner like Sulfonylureas by prompting the pancreas to produce more insulin, although they act faster and the time span of their effect on your body are very short. The drugs lead to lower blood sugar, but when compared with Sulfonylureas, the risk of Meglitinides is higher.
Drugs in this category include:
- Nateglinide (Starlix)
- Repaglinide (Prandin)
- Repaglinide-Metformin ( Prandimet)
The medication for diabetes type 2 in this group enable insulin to work better in the muscles and decrease glucose production by the liver. Nonetheless, the drugs are associated with weight gain and more severe undesirable effects such as heart disease, fractures, and liver problems. Because of these possible complications, the drugs are not in the first line options, but if the medical care provider prescribes any of them, he or she will closely monitor your heart function in the course of the treatment.
Examples of these medicines are:
- Rosiglitazone (Avandia)
- Rosiglitazone- glimepiride (Avandaryl)
- Rosiglitazone-Metformin (Amaryl M)
- Pioglitazone (Actos)
DPP- 4 inhibitors
These drugs for T2D lowers blood glucose levels without causing low blood sugar (hypoglycemia). They enable the pancreas to continue producing more insulin and such medicines are:
- Alogliptin (Nesina)
- Linagliptin (Tradjenta)
- Sitagliptin (Januvia)
- Sitagliptin-Metformin (Janumet and Janumet XR)
- Saxagliptin (Onglyza)
GLP-1 receptor agonists
This class of diabetes medications type 2 slows digestion and aid in lowering blood glucose levels. They are linked with loss of weight and they should not be used alone. Liraglutide (Victoza) and Exenatide (Byetta) falls under this category. The drugs are taken through injections.
Sodium-glucose transporter (SGLT) 2 inhibitors
They are the newest T2D medicines on the market and they prevent the kidneys fro reabsorbing glucose into the blood. Instead, the body gets rid of the sugar through the urine. The unfavorable effects can entail yeast infections, urinary tract infections, hypotension and increased urination because of elevated sugar levels in the urine.
- Dapagliflozin (Farxiga)
- Empagliflozin (Jardiance)
- Canagliflozin (Invokana)
Alpha- glucosidase inhibitors
This category of diabetes type 2 medications aids the body to slow breakdown of starchy foods and table salt, hence lowering blood sugar levels. To get the best results, take the medicines before meals. Some possible side effects are gas and diarrhea. Acarbose (Precose) and Miglitol (Glyset) belongs to this class of meds.
Bile Acid Sequestrants (BASs)
They are cholesterol lowering drugs that are also used as T2D medicines. The bile acid sequestrants aids in removing cholesterol from the body, especially LDL cholesterol which is often high in diabetic patients. The drugs bind together with bile acids in your digestive system, in turn, the body uses cholesterol to substitute the bile acid and consequently, cholesterol levels are lowered. BASs aren’t absorbed into the bloodstream; hence they are safe for individuals who can’t use other meds for diabetes type 2 because of liver problems. Colesevelam (Welchol) is an example of bile acid sequestrants.
Can insulin be used on a patient with T2D?
Most people associate taking insulin with diabetes type 1. But some individuals with type 2 diabetes may be put on insulin therapy even though they had not required it before. Some patient may need insulin for a short period of time, because of situations like pregnancy, cancer, surgery and broken bones. One can be on permanent insulin usage. Sometimes your pancreas may not release adequate insulin, especially as one age. Weight gain and chronic stress can make a patient insulin resistant. At times type 2 diabetes medications stop working and you are left with no option, but to switch to insulin therapy, therefore there are many reasons for using insulin.
What is the insulin dosage for T2D?
It depends on the level of insulin resistance, weight, eating habits and existing health conditions. Insulin is given through injections because if taken orally, the normal digestion interferes with it. The doctor will prescribe the type and the dosage of insulin which will work for you.
What to do while on medications
While on drugs to treat T2D, exercise and diet make it easier to control diabetes; the two are an important component of the treatment plan. If you stay active and eat healthy meals throughout your life, it will be possible to regulate the blood sugar levels and maintain the levels within the expected normal range. Physical activity lowers blood sugar levels in the following ways:
- The cells are able to utilize the available insulin to take up sugar during and after the exercise since insulin sensitivity is increased.
- The muscles contract during the physical activity and trigger another mechanism which enables the cells to take up sugars and utilize them for energy regardless if insulin is inadequate or one is insulin resistant.
When it comes to diet, it is equally crucial to keep the heart healthy and keep the glucose levels within the targeted range as mentioned above. Find a dietitian to come up with an individualized diet, depending on your preferences and lifestyle. As you follow the diet, remember the following few key actions:
- Eat meals and snacks on schedule
- Go for the foods high in nutrition and low in calories
- Don’t overeat
- Avoid processed foods
You should check the blood sugar levels frequently; the blood glucose number is an indication how well type 2 diabetes medications are working. The medical care provider will give the directions of the number times per day you need to check.
Disclaimer: Please note that the contents of this community article are strictly for informational purposes and should not be considered as medical advice. This article, and other community articles, are not written or reviewed for medical validity by Canadian Insulin or its staff. All views and opinions expressed by the contributing authors are not endorsed by Canadian Insulin. Always consult a medical professional for medical advice, diagnosis, and treatment.