Diabetes Treatment
Several kinds of medicine can help you control your blood sugar level. Some medicines are pills that you take by mouth (orally). Oral medicine doesn’t work for everyone, though. Some people need to take insulin. If you need insulin, you’ll have to give yourself a shot (either with a syringe or with an insulin pen). Most people who have type 2 diabetes start with an oral medicine. Your doctor will tell you which kind of medicine you should take and why. Five kinds of diabetes medicine are available in pill form: sulfonylureas, biguanides, thiazolidinediones, glucosidase inhibitors and meglitinides. Each medicine has good points and bad points. Your doctor will decide which medicine is right for you.
Sulfonylureas
Sulfonylureas (some brand names: Amaryl, DiaBeta, Diabinese, Dymelor, Glucotrol, Glucotrol XL, Glynase, Micronase, Orinase, Tolinase) are the most commonly prescribed diabetes medicines. These medicines help your body make insulin. They are inexpensive and have few side effects. Side effects may include weight gain and low level of sodium in the blood. Sulfonylureas can be taken alone or with metformin (a glucosidase inhibitor), pioglitazone (a thiazolidinedione) or insulin. If you’re allergic to sulfa, you can’t take a sulfonylurea.
Thiazolidinediones
This class of medicines includes rosiglitazone (brand name: Avandia) and pioglitazone (brand name: Actos). An older medicine, troglitazone (brand name: Rezulin) is no longer available because of the risk of liver problems. Rosiglitazone and pioglitazone appear less likely to cause liver problems, but people taking them need periodic liver tests. Other side effects may include weight gain and fluid retention. These medicines help your body respond better to insulin. Rosiglitazone and pioglitazone can be used alone or in combination with other diabetes medicines.
Glucosidase Inhibitors
Glucosidase inhibitors (brand names: Precose, Glyset) work in your stomach and bowels to slow down the absorption of sugar. This medicine can cause stomach pain, diarrhea and bloating, so it may not be a good choice if you have a history of stomach or bowel trouble. It can be taken alone or with a sulfonylurea.
Meglitinides
Repaglinide (brand name: Prandin) is taken with meals to control your blood sugar. Your doctor can tell you how to adjust the dose according to the number of meals you eat. Repaglinide can be taken alone or with metformin. Nateglinide (brand name: Starlix) is taken with meals to keep your blood sugar level from getting too high after you eat. Side effects may include weight gain. Nateglinide can also be taken alone or with metformin.
Your doctor may prescribe a combination of 2 or even 3 types of medicine to help control your blood sugar levels. Some combinations are available together in one pill. Some of these include a combination of a thiazolidinedione and a biguanide (Avandamet and ACTOplus Met) or a sulfonylurea and a biguanide (Glucovance and Metaglip).
