Diabetes is a condition in which your blood sugar levels are too high. This condition is due to inability of the body to make or use insulin like it is supposed to. Insulin is a hormone produced in the pancreas that regulates blood sugar level in the body, by allowing the use of sugar (glucose) from the intake of food to our body for energy. There are two types of diabetes:
Type 1 Diabetes
Type 1 diabetes is a condition in which the body does not have the capability of producing insulin. The body’s immune system destroys the cells that release insulin. Type 1 diabetes was formerly called juvenile-onset or insulin-dependent diabetes. Symptoms can start as early childhood to young adulthood. In type 1 diabetes, episodes of low blood sugar level (hypoglycemia) are also common.
Type 2 Diabetes
The more common type of diabetes among the two is type 2 diabetes. 90-95 out of 100 people with diabetes have type 2 diabetes. In type 2 diabetes, the body does not produce or use insulin well, which is also called insulin resistance. This type of diabetes was also known formerly as adult-onset or non-insulin-dependent diabetes. The chance of having pre-diabetes is high as people can have higher than normal blood sugar, but not high enough to be diagnosed with diabetes. Symptoms commonly appear during adulthood; however, type 2 diabetes occurrence is rising in children.
Diabetic patients of both types need medications to maintain their blood sugar levels normal, the types of drugs depend on the type of diabetes. Diabetes is the leading cause of blindness and kidney failure. Moreover, diabetes continues to be a critical risk factor for heart disease, stroke, and foot or leg amputations.
Medications for Type 1 Diabetes
Insulin Insulin is the most common type of medication used in type 1 diabetes treatment, but also used for treating type 2 diabetes. The type of insulin need depends on how severe the insulin depletion is.
- short-Acting Insulin (regular insulin)
- Rapid-Acting Insulin
- Insulin aspart
- Insulin glulisine
- Insulin lispro
- Intermediate-Acting Insulin
- Long-Acting Insulins
- Insulin degludec
- Insulin detemir
- Insulin glargine
- Insulin glargine
- Combination Insulin
- NovoLog Mix 70/30 (insulin aspart protamine-insulin aspart)
- Humalog Mix 75/25 (insulin lispro protamine-insulin lispro)
- Humalog Mix 50/50 (insulin lispro protamine-insulin lispro)
- Humulin 70/30 (human insulin NPH-human insulin regular)
- Novolin 70/30 (human insulin NPH-human insulin regular)
- Ryzodeg (insulin degludec-insulin aspart)
- Amylinomimetic Drug
Pramlintide is an amylinomimetic drug. Usually injected before meals, it works by delaying the time the stomach takes to empty itself which reduces glucagon secretion after meals. This helps lowers the blood sugar. However, it also reduces appetite through a central mechanism.
Medications for Type 2 Diabetes
Most medications for type 2 diabetes are oral drugs and few come as injections. Some people with type 2 diabetes may also need to take insulin depending on how severe the condition is. Different options of drugs for type 2 diabetes are:
These medications slow the breakdown of some sugars, such as table sugar. Taken before a meal, the drug help slows the rise in blood glucose levels after a meal. However, these drugs may have side effects, including gas and diarrhea. Examples of drugs in this class are Acarbose and Miglitol.Biguanides
Biguanides decrease how much sugar the liver makes and how much sugar the intestines absorb, making the body to be more sensitive to insulin, and helps muscles to absorb glucose. The most common biguanide drug is metformin. Usually taken two times a day, metformin can also be combined with other drugs for type 2 diabetes treatment.
Bromocriptine is a dopamine agonist. It’s not known exactly how this drug works to treat type 2 diabetes. It may affect rhythms in the body and prevent insulin resistance.
Inhibitors DPP-4 inhibitors help the body continue to make insulin and can also help the pancreas to produce more insulin.
Glucagon-Like Peptides (Incretin Mimetics)
These drugs are similar to the natural hormone called incretin which increases B-cell growth and how much insulin the body uses. Examples of drugs are Albiglutide, Dulaglutide, Exenatide, Liraglutide
Meglitinides are drugs that stimulate the beta cells to release insulin; however, in some cases may lower the blood sugar too much, causing hypoglycemia. Repaglinide and nateglinide are example of meglitinides.
Sodium Glucose Transporter (SGLT) 2 Inhibitors
These drugs work by preventing the kidneys from holding on to glucose and helping the body to get rid of glucose through urine excretion. Canagliflozin and dapagliflozin are SGLT2 inhibitors to treat type 2 diabetes. Side effects of these drugs can include urinary tract and yeast infections due to the increase of glucose levels in the urine.
Sulfonylurea drugs are among the oldest diabetes drugs still used today that have been in use since the 1950s. Sulfonylureas stimulate the beta cells of the pancreas to release more insulin. Chlorpropamide is the only first-generation sulfonylurea still in use today. Other drug examples of sulfonylureas are glipizide, glyburide, and glimepiride.
Examples of thiazolidinediones are rosiglitazone and pioglitazone. These medications work by decreasing glucose in the liver. They help insulin work better in the muscle and fat and also reduces glucose production in the liver. Both drugs appear to increase the risk for heart failure and increase risk of heart attacks.
Drugs in this class include sitagliptin, saxagliptin, linagliptin, and alogliptin. DPP-4 inhibitors help improve A1C without causing hypoglycemia, and works by preventing the breakdown of a naturally occurring compound in the body known as GLP-1. GLP-1 reduces blood glucose levels in the body, but broke down quickly. DPP-4 inhibitors allow GLP-1 to remain active in the body longer by interfering in the process that breaks down GLP-1.
Bile Acid Sequestrants
The bile acid sequestrant (BAS) colesevelam is a cholesterol-lowering medication that also reduces blood glucose levels in patients with diabetes. They reduce LDL cholesterol by binding with bile acids in the digestive system; the body in turn uses cholesterol to replace the bile acids which lowers cholesterol levels.
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