Medications for Type II Diabetes

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Medications for Type II Diabetes

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Suppose that you are diagnosed by your doctor as having Type II diabetes. That simply means that your pancreas is not producing enough insulin to take care of your body’s needs. This will result in elevated blood sugar (glucose) levels, which if left untreated can do severe damage to your eyesight, your circulation and your kidneys etc. You essentially will have three options:

1. Reduce your body’s insulin requirements (lose weight).

2. Introduce additional insulin into your body through daily injections.

3.Take medications, which help your body to produce more insulin or to use what you produce more efficiently.  

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Most likely your doctor will encourage you to lose weight and he will prescribe one or more medications for you to take. If he wants to put you on insulin immediately, find another doctor. Injectable insulin is difficult to control, potentially dangerous and should be the last resort for Type II diabetics.

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I was on oral medications for over 30 years and I can recall only a few mild incidents of low blood sugar. Finally, I had to supplement the medications with low levels of insulin and I had four, scary episodes of low blood sugar levels the first week and it took me nearly two months to properly balance my insulin levels with my eating patterns. Even now, I have to be much more careful about what I eat and when I eat and I carry glucose tablets with me wherever I go just in case.

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The remainder of this article is dedicated to providing a detailed description of the types of medications that are currently available, how they work, and what are their potential side effects.

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That way, when your doctor prescribes medications for you, you can ask him why he chose those particular ones and what are the potential side effects. If he cannot answer your questions satisfactorily, consider switching to a doctor who specializes in diabetes, because many family doctors do not treat enough diabetics and are not up to date

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First, let me list the categories of diabetic medications that are available with a brief description of how they work. Then I will provide a brief history of my personal experiences over the past 32 years. Finally, I will attach a table, which lists the classes, drug names, how they work, advantages and side effects for each one.

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1. Oral Diabetes Medications: Sulfonylureas – These were the earliest medications (Orinase and Diabanese) and later Glucotrol, Amaryl, DiaBeta and Glynase. They were designed to trigger insulin release by inhibiting potassium channels of the pancreatic beta cells, which make and release insulin.

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2. Meglitinides(Prandin and Starlix) Act on the same potassium channels as the sulfonylureas, but at a different binding site.

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3. Biguanides(Glucophage, Fortamet, etc.) Reduce liver glucose output and increase uptake of glucose by the muscles.

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4. Thiazolidinediones – (Avandia and Actos) Promote the better use of glucose by the cells. Recently, this class of drugs has been linked to increased risk of heart attack, stroke and liver disease. Unfortunately, they actually work quite well to control glucose levels. I was on Avandia several years before these studies were published.

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5. Dipeptidy peptidase-4 (DPP-4) inhibitors(Onglyza, Januvia and Tradjenta) Improve sensitivity to insulin and inhibit the release of glucose from the liver. I was on Januvia for a few weeks and didn’t seem to help me but maybe I wasn’t on it long enough. Some medications take awhile to work.

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6. Alpha-glucosidase inhibitors (Precose and Glyset) Slow the breakdown of starches in the small intestine so that they enter the bloodstream as glucose more slowly. These are generally not prescribed in the United States because they cause severe bloating and flatulence.

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My Personal Experience:


When I was diagnosed with Type II diabetes in 1979, there was only Orinase, Diabanese and insulin available. I was placed on Diabanese and with diet and weight loss I was able to control my diabetes for a number of years. When Glucotrol came along, I was switched to Glucotrol XL (extended release) which was more efficient. This worked for a long period of time and by the time that it no longer was enough, Glucophage had come along and was added to the Glucotrol XL.

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By the time that the Glucotrol XL and Glucophage needed help, Avandia was added and it worked amazingly well. The only side effects that I experienced was a tendency to gain weight and swelling in my ankles. When the warnings came out about Avandia I switched to Actos but it didn’t work as well as Avandia and it had all of the same side effects and warnings. My doctor then suggested Januvia, which I took for three weeks while my blood sugar continuously ran high.

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At that point I decided to bite the bullet and add insulin to the Glucotrol XL and the Glucophage (I dropped the others). My doctor then sent me to a diabetes specialist, but that is another story for another hub.

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TABLE OF ORAL DIABETES MEDICATIONS:

TYPE II DIABETES MEDICATIONS

CLASS
GENERIC NAME
BRAND NAME
ACTION
ADVANTAGES
SIDE EFFECTS
Sulfonylureas
Glipizide
Glucotrol
Stimulates the pancreas to release insulin
Fast Acting
Low blood sugar, weight gain, nausea, skin rash
 
Glimepiride
Amaryl
Stimulates the pancreas to release insulin
Fast Acting
Low blood sugar, weight gain, nausea, skin rash
 
Glyburide
DiaBeta, Glynase
Stimulates the pancreas to release insulin
Fast Acting
Low blood sugar, weight gain, nausea, skin rash
Meglitinides
Repaglinide
Prandin
Stimulates the pancreas to release insulin
Fast Acting
Severe low blood sugar, weight gain, nausea, headache, back pain
 
Nateglinide
Starlix
Stimulates the pancreas to release insulin
Fast Acting
Severe low blood sugar, weight gain, nausea, headache, back pain
Biguanides
Metformin
Glucophage, Fortamet
Stimulates the pancreas to release insulin
Fast Acting
Nausea, diarrhea, and rarely lactic acidosis
Thiazolidinediones
Rosiglitazone
Avandia
Increase sensitivity to insulin and inhibit glucose release from the liver
Slightly increases HDL (good cholesterol)
Increased risk of heart attack, stroke and liver disease
 
Pioglitazone
Actos
Increase sensitivity to insulin and inhibit glucose release from the liver
Slightly increases HDL (good cholesterol)
Increased risk of heart attack, stroke and liver disease
Alpha-glucosidase Inhibitors
Arabose
Precose
Slows the breakdown of starches and sugars in the small intestine
Doesn't cause weight gain
Stomach pain , bloating and flatulence
 
Miglitol
Glyset
Slows the breakdown of starches and sugars in the small intestine
Doesn't cause weight gain
Stomach pain , bloating and flatulence
(DDP-4) Inhibitors
Saxagliptin
Onglyza
Stimulates the release of insulin and inhibits the release of glucose from the liver
Does't dause weight gain
Upper respiratory infections, sore throat, headache
 
Sitagliptin
Januvia
Stimulates the release of insulin and inhibits the release of glucose from the liver
Does't dause weight gain
Upper respiratory infections, sore throat, headache and pancreas inflammation
 
Linagliptim
Tradjenta
Stimulates the release of insulin and inhibits the release of glucose from the liver
Does't dause weight gain
Upper respiratory infections, sore throat, headache

Type II Diabetes Medications

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Many doctors today will provide you with a free glucose testing meter to monitor your blood glucose levels. They get them from the manufacturers to distribute because most of their profit comes from selling test strips and not from the meters. If they don't give you one at least get perscriptions for testing supplies. Most insurance companies and Medicare will pay for them (I don't know about the meters). In my next hub I will dicuss in detail when and how often to test your blood sugar levels and what I consider the best way to track the results

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How to Check your Blood Glucose Level

Normal Blood Sugar levels explained

More by this Author


Comments 4 comments

Cresentmoon2007 profile image

Cresentmoon2007 5 years ago from Caledonia, MI

A well informative hub for those who may need to know this information. Voted up.


Sueswan 5 years ago

A very useful and informative hub for those who have Type 11 Diabetes.

When it comes to our health, we need to be proactive. Many doctors are just drug pushers for the drug companies in my opinion.

Voted up and interesting.


rjsadowski profile image

rjsadowski 5 years ago Author

Ultimately, we are responsible for our own health. Most doctors are well-intentioned, some have too many patients and make rash decisions and a few are incompetent. If you don't like what your doctor is doing or he won't answer your questions get another doctor.


6hotfingers3 profile image

6hotfingers3 5 years ago

A very informative hub. Thank you for the integrity of this hub. There are people learning everyday they have Type II diabetes. Your article helps them find their way through the maze. Keep up the good work!

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