Meal planning for weight loss, blood glucose (sugar) control and exercising is often the first line of treatment for type 2 diabetes. Sometimes these measures are not sufficient to bring the blood glucose levels down or close to the normal range. Taking a medicine that lowers blood glucose levels is the subsequent move. Type 2 diabetes medications are of two kinds: insulin injections (shots) and oral medications. Diabetes pills are not insulin. Blood glucose levels are high in people with diabetes. Since glucose remains in the blood rather than entering cells where it belongs this condition occurs. Insulin must be present and the cell must be starving for glucose in order for glucose to pass into a cell.
People whose bodies still produce some insulin (the majority of people with type 2 diabetes have this condition) oral diabetes medications or diabetes pills help control sugar levels.
To achieve favorable blood sugar control these diabetes pills are often used in combination. Two problems that are faced by people with type 2 diabetes which lead to increased sugar (glucose) in the bloodstream are:
1. They do not make adequate insulin to transfer glucose into cells where it will be used as fuel.
2. Insulin resistance; cells become resistant to insulin. This means they do not seize glucose as well as they should.
People with type 2 diabetes develop “beta cell failure” over time. The cells in pancreas make insulin. However, they are no longer able to release insulin in response to high blood sugar levels. For this reason such people often need insulin injections. Insulin is given either in combination with their diabetic pills or plain insulin is administered.
Diabetes medications are grouped in classes and each class of medicine works differently.
* Sulfonylureas. More insulin is released by pancreas when it is stimulated by these diabetes pills and the blood sugar is lowered. In hemoglobin A1c ( HbA1c) these drugs cause a decrease of up to 1%-2%.
* Biguanides. The function of these diabetes pills is to improve insulin’s aptitude to transfer sugar into cells, particularly into the muscle cells. Liver is checked from releasing stored sugar by these pills. People who have kidney damage or heart failure should not use biguanides. This is because this drug causes a rapid and acute build up of acid (called lactic acidosis) in these patients. Biguanides can decrease the HbA1c by 1%-2%.
* Thiazolidinediones. Increasing insulin’s effectiveness in muscle and in fat tissue is the function of these diabetes pills. The amount of sugar discharged by the liver is lowered. The effects of insulin are made more sensitive in fat cells. In this group of oral diabetes medications a drop of 1%-2% of HbA1c is seen. The effect of lowering of blood sugar takes a few weeks after the use of these drugs. Extra caution should be exercised by people with heart failure. Periodic liver tests are recommended.
* Alpha-glucosidase inhibitors, including Precose and Glyset. The escalation in blood sugar is slowed down when these medications block enzymes which help digest starches. Diarrhea or gas can be caused by these diabetes medications. They can lower hemoglobin A1c by 0.5%-1%.
* Meglitinides, including Prandin and Starlix. The pancreas is stimulated to release more insulin and the blood sugar is lowered. The level of glucose determines the effectiveness of these diabetes medications.
* Dipeptidyl peptidase IV (DPP-IV) inhibitors including Januvia. The insulin secretion in pancreas is increased and the blood sugar is lowered in the patients with type 2 diabetes with the use of these inhibitors (Januvia). They also reduce sugar production. When the blood sugars are high this class of drug increases insulin secretion. This medication can be taken alone or with other medications.
Studies show that some type 2 diabetes medications really help prevent diabetes and diabetes related complications.
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