Living with Diabetes

Diabetes Treatment

Type 2 Diabetes (Oral Treatments)

There are five groups of oral medications used to control Type 2 Diabetes.  Each group has a different mechanism to decrease blood sugar levels.

 

 

 

 

 

 

 

1. Biguanides (Metformin)

How do they work?
  • Decrease the amount of sugar produced by the liver
  • Increase muscle tissue sensitivity to insulin, hence enhance glucose absorption
How can I take it?
  • It is better to be taken after meals
  • You can take it as little as once/day and up to three times/day
Most common side effects
  • Diarrhea and stomach upset are the most common side effects.  If you take it with food, you can minimize that side effect

 

2. Sulfonylurea (Gliclazide, Glibenclamide, Glipizide)

How do they work?
  • They  decrease the sugar levels by stimulating insulin secretion from the pancreas
How can I take it?
  • Take is as prescribed to you by your doctor. There might be some prescribing differences between sulfonylurea group medications
  • Can be prescribed once- twice/ day
Most common side effects
  • Hypoglycemia or low blood sugar levels is the most common side effect of this group
  • Weight gain
  • Allergy warning: if you are allergic to Sulfa, this group of medication is NOT suitable for you
     

 

3. Meglitinides (Repaglinide)

How do they work?
  • They  decrease the sugar levels by stimulating insulin secretion from the pancreas
How can I take it?
  • It should be taken 15 minutes before the main meal
  • To avoid hypoglycemia,  Do not take it if you are not eating your meal
Most common side effects
  • Hypoglycemia is the most common side effect of this group, but to a lesser extent than sulfonylurea
  • Mild weight gain

 

4. Thiazolidinediones (Pioglitazone)

How do they work?
  • They increase insulin uptake by the muscle and fat
  • Decrease sugar production by the liver
     
How can I take it?
  • You can have it with or without food
Most common side effects
  •  Might cause headache, or edema (fluid retention)

 

5. DPP IV Inhibitors (Sitagliptin)

How do they work?
  • They inhibit the breakdown of GLP-1, a hormone in the body that is responsible increasing insulin after meals and decreasing production of extra sugar from the liver, consequently, decreasing the sugar levels in the body
  • They decrease sugar levels in the body only when they are high, usually after meals
How can I take it?
  • You can take them with or without food
Most common side effects
  •  Very mild side effects
  • Chances of hypoglycemia are very low.


Type 2 Diabetes (Injectable Treatments)

There are two injectable groups (Not insulin) which have been used to control Type 2 Diabetes.

 

1. Incretin Mimetics (Exenatide, Liraglutide)

 

How do they work?
  • Increase insulin and decrease glucagon secretions when blood sugar levels are high
How can I take it?
  • Inject Byetta 60 minutes before the main meals, twice a day with ≥6hrs between each injection
  • Inject Victoza with or without food
     
Most common side effects
  • Nausea, which is transient
  • Weight loss in some patients

2. Pramlinitide

 

How do they work?
  • It is the artificial form of the hormone Amylin.  It works together with  insulin and glucagon to keep the blood sugar within the normal levels
  • (Pramlinitide) is the new agent. It is not used in Kuwait yet
How can I take it?
  • Injected with meals
  • Note: It is the only injectabel (non insulin) formulation which was approved by the FDA for Type 1 Diabetes. They should be taken separately
     
Most common side effects
  • Nausea, which is transient
  • Weight loss in some patients

 

Type 1 Diabetes Treatments