Saturday, December 15, 2018

What Type 2 Diabetes Medications Should I Take?

December 10, 2015 by  
Filed under General

A pile of type 2 diabetes medications

There are many different types of type 2 diabetes medications. Choosing the right one for you is something you and your doctor will need to discuss. As your body, diet, exercise habits, and overall health change over time, adjusting diabetes medications may become necessary. Some common type 2 diabetes medications include:

  • Metformin (also called a biguanide)
    • Metformin is an oral medication that helps control blood sugar levels in people with type 2 diabetes. It is not used to treat type 1 diabetes. Do not take metformin if you are in a state of ketoacidosis. Before you start taking the medication be sure to tell your Dr. if you have a history of heart, kidney, or liver disease. Some people may develop a life-threatening condition called lactic acidosis while on the medication. If you have any symptoms including: muscle pain or weakness, numbness or a cold feeling in the arms and/or legs, trouble breathing, stomach pain, vomiting, slow or uneven heart rate, dizziness, or feeling weak or tired seek medical treatment. You are more likely to develop lactic acidosis if you have a history of liver or kidney disease, congestive heart failure, or of you drink large amounts of alcohol. If you have to have a x-ray or CT scan using a dye injected into the vein, you will need to stop taking Metformin for a couple of days to prevent lactic acidosis.  
  • Sulfonylureas
    • Sulfonylureas are a class of medication that stimulate the pancreas to release more insulin. They are only effective if there is some pancreatic beta-cell activity present. Sulfonylureas are only used to treat people with type 2 diabetes.
  • Thiazolidinediones (TZDs)
    • TZDs express and recess certain nuclear receptors allowing the genes to store more fatty acids. This leads to a decrease in the amounts of fatty acids present in circulation. As a result, cells become more dependent on the oxidation of glucose in order to yield energy for cellular processes. This leads to lower glucose levels in the blood. Several different TZDs have been linked to a number of problems including: bladder cancer, medicine induced hepatitis, liver failure, water retention leading to edema, coronary heart disease, and heart attacks. Your Dr. should run tests frequently to monitor how the TZDs might be affecting you. TZDs are only meant to treat type 2 diabetics, and are often prescribed in conjunction with other diabetes medications.  
  • GLP-1 (glucagon-like peptide-1) receptor agonists
    • This class of medications encourages the pancreas to increase insulin synthesis and release. GLP1Rs also stimulate the part of the brain that controls appetite, and some patients have reported a loss in weight. There is a lower risk for hypoglycemia than with some other medications, however the pancreas does need to be monitored.
  • SGLT2 (sodium-glucose cotransporter 2) inhibitors
    • SGLT2 inhibitors, inhibit the reabsorption of glucose into the kidneys. The glucose is instead disposed of in urine. This can lead to lower blood glucose levels. SGLT2 inhibitors are only used to treat type 2 diabetics. There is a risk of developing ketoacidosis, urinary tract infections, yeast infections, and hypoglycemia. This medicine can be prescribed alone or in addition to other diabetes medications.
  • DPP-4 (dipeptidyl-peptidase-4) inhibitors
    • Incretin is a hormone that tells your body to release insulin after you eat. Insulin delivers glucose into the cells for energy, lowering the glucose levels in the blood. An enzyme called DPP-4 removes incretin from the body. Because some type 2 diabetics do not make enough incretin which leads to a higher blood glucose level, so it may be necessary to add a DPP-4 inhibitor. A DPP-4 inhibitor slows the removal of incretin, allowing it to remain in the body longer thus lowering blood glucose levels.
  • Insulin
    • Insulin is produced by beta cells in the pancreas. It promotes the absorption of glucose into cells and inhibits the production of glucose in the liver. Type 1 diabetics do not have the ability to produce insulin, and must inject it subcutaneously in order to control blood glucose levels. Patients with type 2 diabetes may need to take insulin in addition to other diabetes medications depending on how much insulin their pancreas is capable of making.
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