Diabetes: Medications, Treatments, and Remedies
Lifestyle can have a big impact on how your body handles blood glucose and sometimes a change in habits and activities is all that’s needed to prevent or better manage diabetes. But if changes in lifestyle aren’t enough to keep blood sugar levels normal, your doctor may prescribe medication to help lower insulin levels or insulin therapy. We’ll discuss here the most often prescribed classes of medications for diabetics.
Insulin therapy, taken by injection, is the most common medication doctors prescribe for those with type 1 diabetes whose bodies cannot make their own insulin. Insulin types vary by how quickly they begin working and by how long they are effective. Long-acting insulin may be used overnight, while short-acting insulin could be used before or after meals. Your doctor will offer advice to help you decide which type of insulin to use and when it should be taken. While there is the potential for dangerous side effects from insulin, including hypoglycemia, ketoacidosis, and high cholesterol, careful blood sugar monitoring can greatly reduce the risk and ease your mind that insulin can be safely taken.
If insulin alone does not work to keep blood sugar levels stable in type 1 diabetes patients, it may be supplemented with Amylinomimetic drugs that are injected before meals to delay the time it takes your stomach to digest food. The lag time lowers your blood glucose and also works to reduce your appetite. Some of the common side effects of these drugs are nausea, headache, loss of appetite, fatigue, and abdominal pain.
Medicine for Type 2 Diabetes
For patients with type 2 diabetes, the goal is to help the body better use insulin and rid the blood of excess sugar. While insulin is one option, more often other medications are needed to reverse the effects of insulin resistance. Each type of diabetic medication works in slightly different ways and typically each can be found under a host of brand names.
The most often medicine first prescribed for type 2 diabetes patients is metformin which lowers the amount of glucose in the liver making your body better able to respond to insulin. Other drug options are:
- DPP-4 inhibitors that help the body to make insulin while lowering blood glucose.
- Alpha-glucosidse inhibitors that break down food thereby lowering blood sugar levels.
- Biguanides that decrease the amount of sugar the liver makes or how much sugar the intestines absorb.
- SGLT 2 inhibitors prevent the kidneys from retaining sugar and instead help them to release sugars through urine.
- Sulfonylureas stimulate the pancreas to make more insulin and is also the drug that has been in use the longest to combat type 2 diabetes.
There is one type of diabetic medicine that has been medically reviewed as a way to also help patients lose weight. Glucagon-like peptide 1 or GLP-1 agonists mimic the body’s natural GLP-1 hormone that stimulates the body to secrete more insulin after a meal when blood glucose levels naturally rise. The extra insulin lowers blood sugar so it has long been used to combat diabetes. An additional finding is that this drug also suppresses the appetite which can lead to weight loss. A 2021 study published in The New England Journal of Medicine, showed that patients who received the GLP-1 drug lost 14.9% of their body weight compared to just 2.4% of those who took a placebo. As weight loss is already often a way to combat diabetes, this is welcome news.
There are some common side effects from diabetes medicines but few are life-threatening and most can be managed through the help of your medical team. The common side effects from medication include nausea, diarrhea, and vomiting, as well as weight loss or gain.
There is the potential for more serious complications from two different types of diabetes medicines. Thiazolidinediones that make the body's tissues more sensitive to insulin increase the risk of congestive heart failure, bladder cancer (pioglitazone), and bone fractures. SGLT2 inhibitors that help the kidneys to inhibit the return of glucose to the bloodstream by excreting it through urine can increase the risk of bone fractures, gangrene, and amputation. However, these drugs also have been shown to reduce the risk of heart failure and stroke in patients who are at high risk for these conditions.
While diabetes medicines can result in more serious side effects, there are side effects of diabetes itself that can be equally as risky and may require different types of medication. High blood pressure can be common in patients with diabetes as diabetes damages arteries. If left untreated, high blood pressure can increase the risk of heart failure and stroke, as well as kidney disease in diabetics. Similarly, those with diabetes often have high cholesterol as diabetes tends to lower good cholesterol while raising the bad cholesterol. This combination increases the risk of heart disease and stroke. Medications may be prescribed for either of these risks and adopting a healthier lifestyle with diet changes and increased exercise will certainly be prescribed
Seeking medical advice is critical when determining the best diabetes medicine for your needs. Only you and your doctor can determine if the potential risk outweighs the known benefit of helping your body manage diabetes. No matter what diabetes medicines you are prescribed, regular blood monitoring through frequent blood tests is part of the solution to staying healthy. While regular jabs might sound awful, Genteel offers a practically painless way to test with our lancing device that uses vacuum technology and precise depth control to reduce pain. We understand that offering a better way to monitor blood glucose, is a key, along with diet, exercise, and medication, to help you manage your diabetes and enjoy a long and healthy life.