Medication
The pills used
to treat type 2 diabetes are not insulin. Instead, they work with insulin to help
control blood glucose. This is why they don't work for people who have type 1
diabetes. There
are several different groups of pills for Type 2 diabetes. Each group can control
blood glucose in a different way. Most pills have at least two names. One is the
scientific name (generic) and the other is the name given to it by the company
who makes it (known as brand name). This site has used the generic names. The
main groups are as follows: Sulphonylureas
These are
the most commonly prescribed diabetes tablets and work by helping the pancreas
produce more insulin. They also help insulin to work more effectively. Tablets
in this group include: Gliclazide, Glibenclamide, Chloropropamide, Tolbutamide,
Glimepiride. Their main side effects is hypoglycaemia (low blood glucose) and
some may encourage weight gain. Biguanides
This group
of tablets are often used as the first line of treatment, especially for people
who are overweight. This is because they do not encourage weight gain. Biguanides
work by helping to stop the liver producing new glucose and helps insulin carry
glucose into muscle and fat cells more effectively. They don't raise insulin levels
so there is little risk for lows (hypoglycaemia) when the pills are taken alone.
Their side effects include: stomach upsets and nausea which may be lessened by
taking Biguanides with food. The main tablet in this group is Metformin. Alpha-glucosidase
inhibitor This
is usually given as an add-on treatment with Biguanides or Sulphonylureas. It
works by delaying the absorption of starchy food from the intestine and so slowing
down the rise in blood glucose after meals. The only pill in this group is Acarbose.
Acarbose should always be chewed with the first mouthful of food or swallowed
whole with a little liquid immediately before food. Its side effects can include
an upset stomach and wind. Thiazolidinediones
(Glitazones) These
pills help overcome insulin resistance, allowing the body to use its own natural
insulin more effectively. As Glitazones lower the need for insulin there is little
risk of lows (hypoglycaemia) when these pills are taken alone. Pills in this group
include Rosiglitazone and Pioglitazone. Repaglinide
This is
a new type of tablet - brand name Novonorm. It works by increasing the amount
of insulin produced during a meal. It is similar to Sulphonylureas, but unlike
Sulphonylureas, it is taken with each meal and encourages the body to produce
exactly the right amount of insulin. Combination
of drugs When
a single diabetes pill is not able to lower blood glucose well enough, a combination
of drugs can be used to work on several causes of high blood glucose at the same
time. For some people even this will not be enough and they will need to take
insulin injections. Diabetes is a progressive condition and more then one type
of treatment is likely to be needed during the lifetime of a diabetic patient.
This does not always mean that the patient is doing anything wrong but that the
body needs more help over time, to keep control and complications at bay. IMPORTANT
Which choice
of medicine or combination of medicines is best for you can only be decided by
a physician. Next
>> Monitoring Your Blood Glucose <<
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