Diabetes (Mellitus, Type 1 and Type 2) (cont.)
What Medications Treat Diabetes?
Many different types of medications are available to help lower blood sugar levels in people with type 2 diabetes. Each type works in a different way. It is very common to combine two or more types to get the best effect with fewest side effects.
- Sulfonylureas: These drugs stimulate the pancreas to make more insulin.
- Biguanides: These agents decrease the amount of glucose produced by the liver.
- Alpha-glucosidase inhibitors: These agents slow absorption of the starches a person eats. This slows down the rise of glucose after meals.
- Thiazolidinediones: These agents increase sensitivity to insulin but are restricted in the U.S. market.
- Meglitinides: These agents stimulate the pancreas to make more insulin.
- D-phenylalanine derivatives: These agents stimulate the pancreas to produce more insulin more quickly.
- Sodium-glucose co-transporter 1 (SGLT2) inhibitors: Approved in 2013, cenagliflozin (Invokana) the first drug of this class blocks reabsorption of glucose by the kidney, leading to increased glucose excretion and reduction of blood sugar levels. Urinary tract infections are more common with this treatment due to higher sugar levels in the urine.
- Amylin synthetic derivatives: Amylin is a naturally occurring hormone secreted by the pancreas along with insulin. An amylin derivative, such as pramlintide (Symlin), can help control blood sugar when insulin alone does not. Pramlintide is administered as a subcutaneous injection along with insulin and helps achieve lower blood sugar levels after meals, helps reduce fluctuation of blood sugar levels throughout the day, and improves hemoglobin A1c levels.
- Incretin mimetics: Incretin mimetics promote insulin secretion by the pancreas. They mimic other natural actions that lower blood sugar level. Exenatide (Byetta) was the first incretin mimetic agent approved in the United States. It is indicated for type 2 diabetes in addition to metformin (Glucophage) or a sulfonylurea when these agents alone cannot control blood sugar level.
- Insulins: Synthetic human insulin is now the only type of insulin available in the United States. It is less likely to cause allergic reactions than animal-derived varieties of insulin used in the past. The type of insulin chosen to customize treatment for an individual is based on the goal of providing optimal blood sugar control. Different types of insulin are available and categorized according to their times of action onset and duration. Commercially prepared mixtures of insulin may also be used to provide constant (basal) control and immediate control.
- Examples of rapid-acting insulin formulations
- Examples of intermediate-acting insulin formulations
- Isophane insulin, neutral protamine Hagedorn (NPH) (Humulin N, Novolin N)
- Insulin zinc (Lente)
- Examples of long-acting insulin formulations
Medically Reviewed by a Doctor on 3/3/2016
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