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Jamaica Scientific Research Institute
Healing the world, one disorder at a time

Conventional Treatments for Diabetes

Eating healthy, being physically active, and taking insulin are the basic therapies for Type 1 diabetes. The amount of insulin must be balanced with food intake and daily activities. An overdose of insulin may result in insulin shock.


Type 2 diabetes may be treated with oral drugs such as sulphonylureas , biguanides, thiazolidine diones , meglitinides and others (see table). In addition to combination medications such as glyburide/metformin or rosiglitazone/metformin, insulin may also be administered.


Healthy eating, physical activity, and blood glucose testing are the basic management tools for type 2 diabetes. If overweight, it is imperative the the excess weight be lost as obesity is one of the predominant contributors to Type 2 diabetes. In addition, many people with type 2 diabetes require one or more diabetes medicines—pills, insulin, and other injectable medicine—to control their blood glucose levels.

Persons with diabetes are at high risk for cardiovascular disease (CVD). In fact, at least 65 percent of those with diabetes die from heart disease or stroke. Managing diabetes is more than keeping blood glucose levels under control—it is also important to manage other risk factors such as blood pressure and cholesterol levels through healthy eating, physical activity, and the use of medications, if needed.

 Drug Type
Action Common Side Effects 
Sulphonylureas

including

Tolbutamide,Chlorpropamide , Gliclazide, Glimepiride

  • Effective in rapidly lowering blood sugar
  • Act by increasing insulin release from the beta cells in the pancreas.
  • Hypoglycemia
  • Weight gain
  • Abdominal upset
  • Headache
  • Hypersensitivity reactions
Biguanides

including

Metformin

  • Do not affect insulin output from pancreas
  • Primary acts by suppressing glucose release from and gluconeogenesis in the liver
  • Full mechanism of action is not known, but these drugs are usually referred to a disease modifying agents
  • Biguanides also tend to make the cells of the body more willing to absorb glucose already present in the blood
  • Diarrhea
  • Dyspepsia
  • Lacticacidosis- most important and serious side effect
Thiazolidine diones

including

Troglitazone, Pioglitazone, Rosiglitazone

  • Troglitazone was withdrawn from certain markets due to side effects
  • Found to reduce the risk of transition from prediabetes to diabetes mellitus Type 2
  • Act by modulating the transcription of the insulin-sensitive genes that control glucose and lipid metabolism in the muscle, adipose tissue, and the liver
  • Pioglitazone reduces insulin resistance in the liver and peripheral tissues; increases the expense of insulin-dependent glucose; decreases withdrawal of glucose from the liver;reduces quantity of glucose, insulin and glycated hemoglobin in the bloodstream.
  • Thiazolidine diones lower blood glucose by improving target cell response to insulin (that is, increasing the sensitivity of the cells to insulin).
  • Increased incidence of drug-induced hepatitis
  • Risk of bladder cancer
  • Risk of cardiovascular events
  • Fluid retention and peripheral edema

Meglitinides

including

Repaglinide,Nateglinide

  • Lowers blood glucose by stimulating the release of insulin from the pancreas. It achieves this by closing ATP-dependent potassium channels in the membrane of the beta cells. This depolarizes the beta cells, opening the cells' calcium channels, and the resulting calcium influx induces insulin secretion.
  • Weight gain
  • Hypoglycemia
  • Headaches
  • Muscle and joint aches
  • Sinus infections

Alphaglucosidase inhibitors

including

Precose

  • Inhibition of alpha glucosidase enzyme, results in carbohydrates not being broken down efficiently and thus glucose absorption is reduced.
  • Precose is not as effective as the other medications for diabetes. Since Precose works in the intestine, its effects are additive to diabetic medications that work at other sites, such as sulfonylureas.
  • Abdominal pain
  • Diarrhea
  • Gas
Pramlintide
  • A synthetic analog (structure-like molecule) of the natural human hormone amylin. Amylin is a synthesized by pancreatic beta cells and helps control glucose control after meals. The synthetic analog takes over or boosts this function once ingested.
  • When used with insulin, this compound can improve glycemic control and has additional benefits that cannot be realized with insulin alone.
  • Hypoglycemia
  • Nausea
  • Weight loss

Glucagon-likepeptide-1 (GLP-1) receptor agonists - incretin mimetics including

Exenatide,Lyraglutide


  • Causes stomach to empty slowly and therefore causes a person to feel fuller longer. The cascade effect is that nutrients are delivered to and absorbed by the intestines lazily. This is effected by a gut hormone found in humans known asGLP-1 that acts centrally in the brain to regulate hunger.
  • GLP-1 is broken down in the body by an enzyme called DPP-IV. These drugs are synthetic analogs of GLP-1 and are not easily broken down and so have many of the same effects on sugar regulation as GLP-1.
  • Hypoglycemia
  • Nausea
  • Weight loss


DPP-IV inhibitors

including

sitagliptin, linagliptin


  • Inhibit the enzyme, DPP-IV,  from breaking down GLP-1. This allows GLP-1already in the blood to circulate longer.
  • Hypoglycemia
  • Nausea

For a full profile on a drug you may be taking, visit Drugs.com or Rxlist.com and simply enter the name.

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