Medications for Type II Diabetes

Medications for Type II Diabetes

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. 　

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.

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.

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.

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

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.

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.

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

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

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.

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.

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.

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 weigh 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.

By the time that the Glucotrol XL and Glucophage needed hel, 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.

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.

TABLE OF ORAL DIABETES MEDICATIONS:

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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