DIABETIC MEDICINES-ORAL AND INJECTABLE

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. 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. 

The first treatment for type 2 diabetes blood glucose (sugar) control is often meal planning, weight loss, and exercising. Sometimes these measures are not enough to bring blood glucose levels down near the normal range. The next step is taking a medicine that lowers blood glucose levels.

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.
The list of medications for type 2 diabetes is long and potentially confusing. Learning about these drugs and how they're taken, what they do and what side effects they may cause  will help you discuss treatment options with your doctor.

Diabetic Medications(oral)

Biguanides:

These drugs work by affecting the production of glucose that comes from digestion. They don't cause hypoglycemia and even help with weight loss and lower cholesterol numbers. They are the most commonly prescribed drugs for type 2 diabetes. Glucophage (metformin) and Glucophage XR (metformin extended release) are the most well known of these drugs.

Alpha-Glucosidase Inhibitors:

Glyset (miglitol) and Precose (acarbose) are the two most prescribed alpha-glucosidase inhibitors (aka "starch blockers") They work differently than the other medications reviewed so far. These medications need to be taken at the beginning of each meal so that they can work to slow digestion, which in turn slows the rise of glucose in the blood. They are often prescribed in conjunction with other diabetes medications. These drugs may cause diarrhea or gas.

Meglitinides:

This class of drugs is similar to the alpha-glucosidase inhibitors in that they are taken before each meal. But these drugs stimulate the pancreas to produce more insulin in relationship to how much glucose is in the blood. The brand names for these drugs are Prandin (repaglinide) and Starlix (nateglinide). They can be used in combination with some other oral medications for increased effectiveness.

Thiazolidinedione / Glitazones

Thiazolidinediones (also called glitazones) work by making the body's cells more sensitive to insulin, so less insulin is needed to move glucose from the blood into the cells. This leads to a reduction of blood glucose levels.Brand names Actos(Pioglitazone) and Avandia(Rosiglitazone)

They should be taken in combination with metformin or a sulphonylurea.

DPP-4 Inhibitors:

A new oral medication called Januvia (sitagliptin phosphate) has been approved by the FDA for management of type 2 diabetes. It's the first in a new class of drugs called DPP-4 inhibitors. Januvia lowers blood sugar levels by blocking an enzyme known as dipeptidyl peptidase IV or DPP-4.

Drug Combinations

Combination medications can be highly effective and may make it easier to stick to your diabetes treatment plan. If you experience side effects though, it can be tougher to figure out which medication is to blame.

Several drug combinations have become available to treat Type 2 diabetes. These drugs would have been given together so combining them into one tablet may help encourage patient compliance.

Actoplus Met is a combination of Actos (pioglitazone) and Glucophage (metformin) – one pill lowers the amount of glucose made by your liver. Both types help your insulin work the way it should.

Avandamet is a combination of Avandia (rosiglitazone) and Glucophage (metformin) – one pill lowers the amount of glucose made by your liver. Both types help your insulin work the way it should.

Avandaryl is a combination of Avandia (rosiglitazone) and Amaryl (glimepiride) – one pill helps your insulin work the way it should. The other pill helps your body make more insulin.

Duetact is a combination of Actos (pioglitazone) and Amaryl (glimepiride) – one pill helps your insulin work the way it should. The other pill helps your body make more insulin.

Glucovance is a combination of Glucophage (metformin) and Micronase (glyburide) – one pill helps your body make more insulin. The other pill lowers the amount of glucose made by your liver and helps your insulin work the way it should.

Janumet is a combination of Januvia (sitagliptin) and Glucophage (metformin) – one pill helps your body make more insulin when it’s needed, especially right after meals. It also helps keep your liver from putting stored glucose into your blood. The other pill lowers the amount of glucose made by your liver and helps your insulin work the way it should.

Metaglip is a combination of Glucotrol (glipizide) and Glucophage (metformin) – one pill helps your body make more insulin. The other pill lowers the amount of glucose made by your liver and helps your insulin work the way it should.

Injectable medicines

Incretin mimetics / GLP-1 analogues

Incretin mimetics, also known as GLP-1 analogues, are an injectable treatment for type 2 diabetes.
Incretin mimetics look to mimic the effect of a group of hormones called incretins which increase the production of insulin and decrease the release of glucagon in a relatively similar way DPP-4 inhibitors.

This is not a coincidence as the way DPP-4 inhibitors work is to prevent the protein dipeptidyl peptidase-4 from destroying the incretin hormones.

GLP-1 analogues have been found to be particularly effective in helping to improve blood glucose levels and helping with weight loss.

The following GLP-1 analogues are prescribed(branded names in brackets):

• Exenatide (Byetta)
• Liraglutide (Victoza)

Side effects

All medicines can have side effects.You may or may not experience any. However, if you do, speak to your doctor as there may be another medication which could be used instead.

HbA1C test:

There is a special blood test that your doctor does to determine if your diabetes is in control.  This test measures a chemical in your blood called " A1C".  The higher your sugar is, the higher your A1C will be.

Diabetologists recommends that diabetics must maintain a A1C of less than 7.0% in order to reduce the complications associated with diabetes.
The higher your A1C, the more likely it is that you will suffer complications of diabetes such as kidney disease, blindness or amputation.

Please Note-

• There is no known cure for diabetes. It is always better to prevent this disease, instead of running for medication after suffering the pain caused due to it. 
• Increased body weight is one of the major reasons for diabetes among people. Therefore it would be advisable to maintain a healthy diet and control your body fat, especially in the middle portions of the body. This will help you reduce the risk of diabetes. 
• If you know your family history, then you can take preventive measures right from the beginning. A balanced diet and regular exercise is absolutely necessary in order to stay fit and alive. This will allow free flow of blood through the veins. 
• Exercises are the only means of escape from diabetes if the cause is hereditary. Get proper monthly check up and monitor your blood pressure level.

Type 2 diabetes treatment has come a long way in the last 10 years with new drugs and devices adding up to better lives for patients.Doctors have also become much more aggressive in treating diabetes. People with type 2 diabetes are getting diagnosed and treated earlier than they once did and having better outcomes.