What is Metformin? What is insulin? And what is Glipizide? What are all these diabetes medications and why do I need them?
Living with diabetes can be overwhelming, especially when your doctor is throwing around different medication options. However, with a little education and patience, you can tackle all of your treatment options with ease.
Let's dive into the types of medications used for type 2 diabetes and what they all mean.
There are several types of diabetes medications on the market and each of them does different things. Working with your doctor, the two of you will come up with the best medicine or combination of medicines to work for you.
Oral Diabetes Medications
Many people who are considered pre-diabetic will start off trying to get their sugars under control with diet and exercise. If that doesn’t do it, the usual next step is an oral drug like Metformin to lower the blood glucose levels.
Metformin or Glucophage are used to decrease the actual glucose produced by your liver. They also help your body to be able to absorb the glucose more quickly.
Many people start out with biguanides because it is well tolerated, however, the most frequent side effect is diarrhea. Which may be prevented when the medicine is taken with food, and it also tends to reduce once your body adjusts a bit to the general effects.
Sulfonylureas medications that help your pancreas to release more insulin into your body. These are taken orally usually once or twice a day before meals.
Meglitinides work with your body to help your pancreas release more insulin into your system. These particular medications are usually taken before each meal.
Relatively new to the diabetes medication market, DPP-4 inhibitors help to improve your A1C while not causing hypoglycemia. The DPP-4 inhibitors help a compound in the body called GLP-1 stay active longer.
The GLP-1 helps reduce the blood glucose in the body. This class of drugs doesn’t tend to cause weight gain, and they appear to have no (or a positive) effect on cholesterol.
Thiazolidinediones not only help the insulin to work better but they contribute to reducing the overall production of glucose, and so they are effective at helping reduce your A1C.
Some of the original thiazolidinediones caused liver issues and they may increase the risk of heart failure for some people. So if you are taking any of these, don’t be surprised if your doctor is monitoring both your liver and your heart.
Another relatively new class of medications, SGLT2 inhibitors work to eliminate excess glucose through urine.
When the glucose passes through your kidneys, it can either be reabsorbed into your body or can be eliminated. The SGLT2 inhibitor works to keep it from being reabsorbed.
One thing to be aware of with SGLT2 inhibitors, they are known for passing glucose through your urine and may put you at risk for urinary tract and yeast infections. Be sure to talk to your doctor about this if you have any of those issues.
Remember to talk to your doctor if you frequently have urinary tract infections or yeast infections.
Alpha-glucosidase inhibitors block starches in the intestines and slow the breakdown of some sugars. This, in turn, keeps your blood glucose levels from rising after a meal.
They are mostly taken with your meal but may have intestinal side effects like gas and diarrhea.
Bile Acid Sequestrants (BAS)
Bile acid sequestrants lower cholesterol and reduce glucose levels. These drugs bind with the bile acids and that helps reduce cholesterol and, in turn, lower the glucose.
Common side effects of Bile acid sequestrants are flatulence and constipation.It's important to talk to your doctor about any new or reoccurring side effects.
Injectable Diabetes Medications
In addition to the oral medications, there are also various injectable medications that can be used to treat type 2 diabetes.
GLP-1 Receptor Agonists
This type of injectable helps your body to make insulin and at the same time, keep the liver from producing too much glucose.
One benefit to some patients is a reduction in appetite and, in turn, some weight loss. These drugs might initially give you a bit of nausea, but that usually goes away after a time. Which drug you take determines how often you will need the injection.
Another type of injectable which helps your body to produce its own insulin. In addition, it slows the path of food movement to enable the glucose to stay lower after meals.
Usually the last tried drug for type 2 diabetes. Sometimes insulin pens are used in combination with some of the above-mentioned drugs. There are various types of insulin products are based on how quickly they work in the body.
Side Effects of Diabetic Medications
As noted above, many medications will have a tendency to cause intestinal side effects. Diarrhea, nausea, and gas are the most common side effects.
You should also be aware that alcohol doesn’t always mix well with diabetes medications. Some interactions can cause vomiting and general malaise.
Be sure to ask your doctor about your particular situation to see what they recommend for you.
The Costs of Diabetes Medications
Many people are rightly concerned about being able to afford their diabetes medicines. I know this is a constantly debated topic. I have found a few things to help me personally.
Here are a few tips:
- Go to the drug websites for the medical assistance programs. Your doctor’s office or pharmacy should be able to help you with this if needed. Many medications offer things like free trial periods, discounted products or even work with your insurance to bring down your co-pays. In past years, this help has turned out to be the only way I could afford some of my prescriptions. A simple Google search will also tell you the website of the production company.
- Ask your doctor about generics. Many insurance companies will offer much lower co-pays for you to use generic medications.
- Discuss the dosage. It’s possible a slightly higher or lower dose may provide a better price. When in doubt, call your insurance company directly for their help. They are usually more than happy to help you find ways to cut costs on your care.
As you can see, there’s a lot to consider and look at regarding type 2 diabetes medications and the combinations of drugs is endless.
But, if you and your doctor can have good communication and a little bit of patience, you are sure to come up with the right plan for you. Remember, your sugar control is not just dependent on the medications.
You still need to take the proper diet and exercise precautions too. But, those are blogs for another day.