Insulin is a hormone produced by cells in the pancreas called beta cells. Insulin helps the body use blood glucose (a type of sugar) for energy.There are several different kinds of diabetes medicines in addition to insulin. These medicines can lower blood sugar levels but they’re not the same as insulin. Most of these medicines are available in pill form. Insulin can’t be taken as a pill because acids in the stomach destroy it before it can enter the bloodstream.
People with type 2 diabetes do not make enough insulin and/or their bodies do not respond well to it, leading to elevated blood sugar levels. Oral diabetes medications bring blood sugar levels into the normal range through a variety of ways.
Oral diabetes medicines help control blood glucose levels in people whose bodies still produce some insulin, such as some people with type 2 diabetes. These medicines are prescribed along with specific dietary changes and regular exercise. Many oral diabetes medications may be used in combination to achieve optimal blood glucose control.
This webpage provides general information about the different oral medicines for diabetes. It will help you learn more about your medication. Always take your medicine exactly as prescribed by your doctor. .
For what conditions are diabetes pills used?
Oral diabetes medications are only used to treat type 2 or non-insulin-dependent diabetes. Patients with type 1 diabetes are dependent on insulin for their treatment.In type 2 diabetes, the body still makes some of its own insulin, but isn’t able to make enough to keep up with the body’s needs or use its own insulin effectively. Diabetes pills don’t replace the body’s insulin, but they can help the body make more insulin or help it more effectively use the insulin it does make.
Most people who have type 2 diabetes take diabetes pills to help them keep their blood sugar levels closer to normal. People with type 1 diabetes don’t use diabetes pills. They need to take insulin shots because their bodies can’t make any of their own insulin.
Diabetes pills can also help with weight loss and help improve cholesterol and triglyceride levels, which tend to be abnormal in people with type 2 diabetes.
There are 6 groups of oral diabetes drugs. Each group has a different active ingredient and works in a diff erent way. The chart below compares the different groups of Type 2 medications.
|MEDICATIONS FOR TYPE 2 DIABETES|
|Classification||Medication||Route||The way it works||Time and Dose|
|Sulfonylureas||Glimepiride (Amaryl) Glipizide (Glucotrol) Glipizide ER (Glucotrol XL) Glyburide||Oral||Increases insulin production||1 or 2 times a day|
|Biguanides||Glucophage (aka Metformin) Glucophage XR||Oral||Lowers glucose from digestion||2-3 times a day, XR once a day|
|Alpha-Glucosidase Inhibitors||Glyset and Precose||Oral||Slows digestion, slows glucose production||Take before each meal|
|Thiazolidinediones||Actos and Avandia||Oral||Lowers glucose production||Once daily with or without food|
|Meglitinides||Prandin and Starlix||Oral||Increases insulin production||5-30 minutes before meals|
|DPP-4 Inhibitors||Januvia||Oral||Lowers glucose by blocking an enzyme||100 mg. once a day|
|Incretin Mimetics||Byetta||Injectable||Helps the pancreas make insulin, slows digestion||10 mcg. Inject within an hour of AM and PM meals|
|Anti-hyperglycemic||Symlin||Injectable||Controls postprandial blood glucose||15 mcg. Inject before major meals|
For information on the side-effects of Type 2 medications click this link side effects of diabetes medication
Are there differences among types of oral diabetes medications?
1.Second generation sulfonylurea (Glucotrol®, Amaryl®, and DiaBeta®)
These medications lower blood glucose by stimulating Beta cells in the pancreas to release more insulin.
Sulfonylureas have been used since the 1950s to help people lower their blood sugar levels. Over the years, newer and better versions of this drug have become available. One of the best drugs currently available in this class is glimepiride (Amaryl).
Here’s how these pills work: Sulfonylureas help the pancreas make more insulin. When the insulin gets into the bloodstream, blood sugar levels go down. Like people who take insulin, people who take sulfonylureas need to be careful that their blood sugar levels don’t drop too low.
How do I know if my diabetes pill is working?
The best way to find out how well your diabetes pill is working is to test your blood sugar. Ask a member of your health care team what time of day is best for testing. You’ll want to test when your diabetes medicine is expected to be most active in your body. Keep a record of your blood sugar levels during that time to see if they’re at or near your goal.
If your levels are at or near your goal and you’re not having any problems with the medicine, then it’s probably working well. If you’re still not sure, talk to your doctor or other member of your care team.
Can I stop taking my diabetes medicine after my blood sugar is under control?
It’s reasonable to think that after a person gets good blood sugar control, it means the end of managing diabetes. But that’s not the case.
People with type 1 diabetes aren’t able to make their own insulin, so they will always need to take insulin shots every day.
For people with type 2 diabetes who are on medicine, the answer isn’t as clear. Sometimes when people are first diagnosed, they start on pills or insulin right away. If the person also works hard to control diabetes with diet and exercise, he or she can lower the need for medicine and might be able to stop taking it altogether. As long as the person is able to keep blood sugar levels normal with diet and exercise, there isn’t a need for medicine.
However, type 2 diabetes changes over time. The change can be fast or slow, but it does change. This means that even if a person was able to stop taking medicine for a while, he or she might need to start taking it again in the future. If a person is taking medicine to keep blood sugar normal, then it’s important to keep taking it to lower the chances for heart disease and other health problems.
What’s the difference between generic and brand name medicines?
The generic name is the name of the medicine’s chemical makeup. The brand name is the name that the company who makes the medicine uses to advertise and sell the drug. For example, metformin comes from a class of drugs called biguanides. The company that introduced this drug in the United States sells it under the brand name Glucophage.
What non-insulin injectable drugs are approved for diabetes?
If the oral diabetes medication you’re taking isn’t getting your HbA1c into a healthy range, your doctor may suggest a combination therapy that also includes injectable insulin or an injectable medication. Which medications you wind up using depends on your preference and medical history.
The goal for medication therapy of type 2 diabetes is generally an HbA1c of less than 7%. However, your health care provider will determine your HbA1c goal based on individual factors.
CLICK HERE for an overview of the classes of non-insulin injectable medications currently available.
Other drugs are on the horizon as well, as scientists work to improve the variety of medications to treat type 2 diabetes.
Frequently doctors will prescribe one type of oral medication and discover it isn’t really helping to control blood glucose that much.
In the past, this would have meant that the patient would likely be put on insulin. Now,doctors can try another type of medication to see if it helps correct problems.
Doctors often notice that a particular medication works well for a period of time and then begins to work less well for a diabetic.
Now they can mix and match medications that work on different aspects of the diabetes problem to see if that will improve blood glucose control.
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