Understand the Options for Choosing Diabetes Medications
Do you wonder how your physician chooses an appropriate medication for you? Do you feel overwhelmed from the sheer number of available medications? These guidelines will help you understand the choices that are available. In subsequent articles, there will be more information regarding each class of medication.
While there are hundreds of medications and mixtures of medications available, there are seven different classes of medication. Each class works in a different way. Your physician utilizes his knowledge about you as well as your specific type of diabetes to first decide if you need any medication, and if so , which class to use. He then chooses a medication from that class. If you require medication from more than one class he may choose to prescribe several medication or a combination pill that has two or more medications contained in it. This article will provide a brief overview of the classes of medications and how they function.
1 . ) The oldest course of medication is the sulfonylureas. Till the mid-1990s, this was the only class associated with oral medications available. Your body should be able to produce insulin in order for these types of to be beneficial, as they work by stimulating the beta cells of the pancreas to secrete insulin. Some examples of the first generation of these medications are: Tolbutamide (orinase), Tolinase (tolazamide), and Diabinese (chlorpropamide). Some of the second generation medications are: Glipizide (glucatrol), extended release Glipizide (glucatrol XL), Glyburide (Micronase, Diabeta), Glynase (micronized glyburide), and Glimepiride. These medications are distinguished by how long they last in the body, and whether they are usually cleared by the kidney or the liver organ. There are two other drugs within this class: Prandin and Starlix, which can be used before meals because they final for a very short time.
2 . ) The biguanide class has just one medication, called Metformin. Other names are Fortamet, Glucophage, Gluymetza, and Riomet. This medication works by reducing glucose production in the liver, and it also causes a small increase in glucose uptake by skeletal muscle. If there are no contraindications, the American Diabetes Association as well as the American college of clinical endocrinologists recommends using this medicine first.
3. ) In the mid-1990s, the Thiazolidinedione class of medications (also known as glitizones or TZDs) was developed. Their primary mechanism of action is to increase insulin sensitivity, which leads to more glucose getting taken up by skeletal muscle. Three medications were developed. The first, Rezulin (troglitazone), was taken off the market because it was suggested to cause liver problems. The second, Avandia (rosiglitazone), has been withdrawn from the market in European countries but was allowed under selling limitations in the US because of an increase in cardio events. The third medication, Actos (pioglitazone) had sales suspended in France and Germany because a study recommended it may increase the risk of urinary cancer.
4. ) Drugs that will affect the incretin system are separated into two subclasses:
a. The very first division is composed of injectable drugs which mimic the effect of natural incretins produced by the body. Medications in this class include Byetta (exenetide), Bydureon (long acting exenatide) Victoza (liraglutide), plus Symlin. They work by raising insulin secretion in response to glucose (sugar), decreasing the rate at which the liver puts out glucose, decreasing appetite, and by slowing the rate the stomach empties. These medications have become quite popular simply because they can help with weight loss, and have an extremely low incidence of hypoglycemia. However , these types of medications have been in the news because they have been associated with pancreatitis, and may lead to a small increase in medullary thyroid cancer.
b. The oral medications in this course work by blocking the enzyme which breaks down the incretins. While the level of natural incretins increases relatively, these drugs are not as efficient as the injectable ones. Medications with this class include Januvia (sitagliptin), Onglyza (saxagliptin), and Tradjenta. They are being observed to watch out for complications similar to the injectable medications. They very rarely trigger hypoglycemia and do not cause weight gain. All of them are being evaluated for a potential malignancy risk.
5. ) There are 3 Alpha Glucosidase Inhibitors: Acarbose (Precose), Miglitol (Glyset), and Voglibose. These work by preventing digestion associated with carbohydrates in the intestine. By avoiding carbohydrates from being converted into basic sugars and absorbed into the bloodstream from the intestine, this class associated with medications can help keep the blood sugar through rising after meals.
6. ) The newest class of medications is the SGLT2 inhibitors, which block absorption of glucose by the kidney. By increasing the amount of glucose lost through the urine, and decreasing the amount of sugar absorbed back into the blood stream, blood sugar levels may be decreased. Because none of these types of medications has been approved by the FDA, the names of the medications are disregarded from this article.
7. ) Insulin must be used for people with type I Diabetes and is often needed for those with kind 2 Diabetes. There are many types and delivery systems which will be discussed subsequently.
With a thorough understanding of your specific kind of diabetes, your physician can wade through all the options to select the best complement for you. More detailed information about each drug class will be presented in subsequent articles here, and on my website, diabeticsurvivalkit.
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