Q and A on Diabetes Drug Treatment Options

Q - What's used for diabetes drug treatment?

A - The drugs commonly used to treat diabetes are in 4 categories. They are Sulfonylureas, Biguanides, Alpha-glucosidase inhibitors, and Thiazolidinediones. There are some newer drugs but they are not yet being widely used.

Q - How do these drugs work?

Q -

• Sulfonylureas
act by stimulating the pancreas to release more insulin, reduce the level of glucagon (the hormone that opposes insulin) in the blood, and enhances the action of insulin at its various action sites in the body.
• Biguanides
act primarily by reducing the rate of gluconeogenesis in the liver. Gluconeogenesis is the production of glucose from non-carbohydrates. Biguanides inhibit this process in the liver and so reduce the level of blood glucose in a diabetic.
• Alpha-Glucosidase inhibitors
are drugs that prevent a particular enzyme in the intestines from digesting carbohydrates properly. When carbohydrates are not digested into their simpler components (like glucose and maltose) it becomes difficult for the body to absorb them and this reduction in the absorption will also lower blood glucose levels.
• Thiazolidinediones
are new drugs that make the cells of the body more sensitive to the effects of insulin.

Q - Can they be combined with insulin?

A - Some people with type 2 diabetes mellitus will need a combination of diabetes pills and insulin to achieve optimal blood glucose control.

Q - What are the side effects of these drugs?

A - These drugs cause various side-effects including hypoglycaemia (low blood sugar), hyperinsulinaemia (excess insulin in blood), and weight gain. Some of them have side effects which are specific to them. Ask your physician to explain the side effects of the medications you are asked to take.

Q - Who needs them?

A - Diabetes drug treatment is used for people who have type 2 diabetes.

Q - How often should they be taken?

A - They should be taken as prescribed by your physician or health care provider. People respond in different ways to the medications. The frequency of drug administration that works in one person may not be as effective in another.

Q - How will I know if they are effective?

A - To know if your diabetes drug treatment protocol is effective, you need to monitor your blood glucose levels using a glucose meter. Your ideal blood glucose level and the frequency of monitoring will be explained to you by your diabetes care team.

Q - Why do I need more drugs than others?

A - Our bodies are different. And they respond in different ways when exposed to the same drugs. Some people may need more of a particular drug to achieve the same effect that others achieved with a lesser dose. Also, some other people may need 2 or 3 different drugs to achieve the same level of control that another person achieved with 1 drug. That's the way it is. The goal is optimal blood glucose control so don't be frightened by the number of drugs you need to take. Just be consistent and you will obtain good results with time.

Published - June, 2006