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? |
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Decrease the amount of sugar produced by the liver
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Increase muscle tissue sensitivity to insulin, hence enhance glucose absorption
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How can I take it? |
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It is better to be taken after meals
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You can take it as little as once/day and up to three times/day
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Most common side effects |
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Diarrhea and stomach upset are the most common side effects. If you take it with food, you can minimize that side effect
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2. Sulfonylurea (Gliclazide, Glibenclamide, Glipizide)
How do they work? |
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They decrease the sugar levels by stimulating insulin secretion from the pancreas
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How can I take it? |
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Take is as prescribed to you by your doctor. There might be some prescribing differences between sulfonylurea group medications
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Can be prescribed once- twice/ day
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Most common side effects |
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Hypoglycemia or low blood sugar levels is the most common side effect of this group
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Weight gain
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Allergy warning: if you are allergic to Sulfa, this group of medication is NOT suitable for you
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3. Meglitinides (Repaglinide)
How do they work? |
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They decrease the sugar levels by stimulating insulin secretion from the pancreas
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How can I take it? |
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It should be taken 15 minutes before the main meal
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To avoid hypoglycemia, Do not take it if you are not eating your meal
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Most common side effects |
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Hypoglycemia is the most common side effect of this group, but to a lesser extent than sulfonylurea
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Mild weight gain
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4. Thiazolidinediones (Pioglitazone)
How do they work? |
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They increase insulin uptake by the muscle and fat
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Decrease sugar production by the liver
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How can I take it? |
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You can have it with or without food
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Most common side effects |
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Might cause headache, or edema (fluid retention)
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5. DPP IV Inhibitors (Sitagliptin)
How do they work? |
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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
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They decrease sugar levels in the body only when they are high, usually after meals
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How can I take it? |
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You can take them with or without food
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Most common side effects |
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Very mild side effects
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Chances of hypoglycemia are very low.
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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? |
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Increase insulin and decrease glucagon secretions when blood sugar levels are high
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How can I take it? |
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Inject Byetta 60 minutes before the main meals, twice a day with ≥6hrs between each injection
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Inject Victoza with or without food
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Most common side effects |
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Nausea, which is transient
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Weight loss in some patients
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2. Pramlinitide
How do they work? |
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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
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(Pramlinitide) is the new agent. It is not used in Kuwait yet
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How can I take it? |
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Injected with meals
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Note: It is the only injectabel (non insulin) formulation which was approved by the FDA for Type 1 Diabetes. They should be taken separately
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Most common side effects |
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Nausea, which is transient
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Weight loss in some patients
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Type 1 Diabetes Treatments
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The Beta cells in the pancreas are damaged in patients with Type 1 Diabetes. Consequently, no insulin is secreted in their system. Thus, insulin is the only available medication to control their condition
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Fortunately, a new injectable drug known as Pramlintide has been approved for people with Type 1 Diabetes
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Pramlintide can be used for the type 1 individuals who are not reaching their HbA1c goal