In addition to insulin, other types of injected medicines are now available.
New Mechanisms in Glucose Control
Other drugs include:
(A)Albiglutide (Tanzeum)
The Insulinotropic Gut Hormone Glucagon-Like Peptide-1 (Frontiers in Diabetes)
It’s a man-made version of a hormone called GLP-1 (glucagon-like peptide-1). Your intestines normally release this substance when you eat. It helps control your blood sugar.
Who can take it: Adults who have type 2 diabetes and haven’t had success with other treatment. If you’re planning to get pregnant, talk with your doctor, since researchers haven’t studied albiglutide in pregnant women.
What it does: After you eat, albiglutide helps your pancreas release insulin, which moves blood sugar (glucose) into your cells. It also limits how much of the hormone glucagon your body makes. This substance spurs your liver to release stored sugar. The drug also slows down digestion.
Side effects: The most common ones are upper respiratory tract infection, diarrhea, nausea, and skin reactions where you give yourself the shot. All GLP-1 drugs, including albiglutide, have a boxed warning noting that in animal studies, this type of drug has been linked to thyroid cancer in some rats and mice. Experts don’t know whether it has the same effect in people, though. Inflammation of the pancreas (pancreatitis), which may be severe, is another side effect.
(B)Exenatide (Bydureon, Byetta)
What it is: Exenatide was the first GLP-1 drug approved by the FDA. Byetta came first. You take it as a shot twice daily. Bydureon is the newer, extended-release version, which you inject once a week. You can’t take both drugs.
Who can take it: Adults with type 2 diabetes for whom other treatment hasn’t worked. If you think you might get pregnant, talk to your doctor. Researchers haven’t studied this drug in pregnant women.
What it does: Like other GLP-1 drugs, exenatide tells your pancreas to release insulin, which moves glucose out of your bloodstream and into your cells. It also limits how much glucagon your body makes. This hormone prompts your liver to release stored sugar. The drug slows digestion, too.
Side effects: The most common ones include nausea, vomiting, diarrhea, feeling jittery, dizziness, headache, acid stomach, constipation, and weakness. These usually go away after the first month of treatment. Inflammation of the pancreas (pancreatitis), which may be severe, is another side effect.
The FDA has also received reports of kidney failure in people taking this drug. All GLP-1 drugs, including both types of exenatide, have a boxed warning noting that in animal studies, this type of drug has been linked to thyroid cancer in some rats and mice. Experts don’t know whether it has the same effect in people. It’s possible you could get low blood sugar or have an allergic reaction to the drug.
(C)Liraglutide (Victoza)
What it is: This is another GLP-1 drug. You inject it once a day. It helps your body release more insulin. This helps move glucose from your bloodstream into your cells.
Who can take it: Adults who have type 2 diabetes but haven’t had results with other treatment. You take it in combination with metformin or a sulfonylurea drug. If you’re planning to get pregnant, talk with your doctor. Liraglutide hasn’t been studied in pregnant women.
What it does: Like the other GLP-1 drugs, liraglutide cues your pancreas to release insulin. This moves glucose out of your bloodstream and into your cells. It also limits how much of the hormone glucagon your body makes. This substance prompts your liver to release stored sugar. The drug also slows digestion.
Side effects: The most common ones include nausea, diarrhea, and headache. Inflammation of the pancreas (pancreatitis), which may be severe, is another side effect.
All GLP-1 drugs, including liraglutide, have a boxed warning noting that in animal studies, this type of drug has been linked to thyroid cancer in some rats and mice. Experts don’t know whether it has the same effect in people.
It’s possible to have an allergic reaction to liraglutide, or to get low blood sugar while you’re taking it. If you get dehydrated from nausea, vomiting, or diarrhea, that could lead to kidney failure.
(D)Pramlintide (Symlin)
What it is: It’s a man-made version of a hormone called amylin, which your pancreas makes along with insulin when your blood sugar levels rise.
Who can take it: It’s approved for people with type 1 diabetes who are taking insulin. It’s also OK’d for people with type 2 diabetes who are taking insulin, a sulfonylurea drug, or metformin. If you think you could get pregnant, tell your doctor, since researchers haven’t studied this drug in pregnant women.
What it does: You take pramlintide with insulin after a meal. The two drugs work together to lower your blood sugar. Pramlintide also helps you digest food more slowly. This puts less sugar into your bloodstream. In addition to controlling your A1C levels, pramlintide helps lessen your appetite, so you eat less.
Side effects: Nausea is the most common one. Starting this drug at a low dose and increasing it slowly can help fight the nausea. Other side effects include less appetite, vomiting, stomach pain, tiredness, dizziness, or indigestion. The drug can also cause low blood sugar if you don’t adjust the amount of insulin you’re taking.
(E)Dulaglutide (Trulicity)
Oral Antidiabetic Drugs and GLP-1 Analogues in the Treatment of Type 2 Diabetes
What it is: This is another GLP-1 drug. Unlike the others, you inject it only once a week. It helps your body release more insulin and move glucose from your bloodstream into your cells.
Who can take it: Adults with type 2 diabetes who have not had success with other diabetes treatment. You can take it alone, or in combination with metformin, pioglitazone, or a sulfonylurea drug. If you’re planning to get pregnant, tell your doctor, since researchers haven’t studied this drug in pregnant women.
What it does: Like other GLP-1 drugs, dulaglutide prompts your pancreas to release insulin, which moves glucose out of your bloodstream and into your cells. It also limits how much of the hormone glucagon your body makes, since glucagon normally spurs your liver to release stored sugar. The drug slows digestion, too.
Side effects: The most common ones include nausea, vomiting, diarrhea, belly pain, and less appetite. All GLP-1 drugs, including dulaglutide, have a boxed warning noting that in animal studies, this type of drug has been linked to thyroid cancer in some rats and mice. Experts don’t know whether it has the same effect in people.
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