Understanding the Different Medications for Diabetes
According to the American Diabetes Association, 38.4 million people in the US are living with diabetes. Additionally, nearly 2.8 million Texans have diagnosed diabetes and another 621,00 residents have it but are unaware.
Simply put, diabetes is chronically high blood sugar. Left untreated, diabetes can lead to serious and debilitating complications like heart disease, nerve damage, kidney damage, memory loss, blindness, limb amputation, and more.
To maintain normal blood sugar levels, your body needs two things: insulin and insulin sensitivity. Insulin is like a “taxi” that carries glucose (sugar) from the foods you eat to your cells, where it’s turned into energy. Your cells also need to be insulin sensitive, meaning they can open up to let glucose in instead of letting sugar build up in your bloodstream.
Medication Classifications
The first steps for treating diabetes include lifestyle changes, such as weight loss, exercise, and eating a healthy diet. There are also medications that can help to keep your blood sugar in the normal range. Here are the main classes of medications your health care provider may prescribe:
Biguanides : Better known as metformin, this drug is often one of the first medications prescribed for type 2 diabetes. Metformin reduces the amount of glucose your liver produces and improves insulin sensitivity, making it easier for your cells to absorb glucose.
Metformin can also help you lose weight. One caution, though, is that for some people, metformin can cause low blood sugar (hypoglycemia), nausea, and diarrhea.
Sulfonylureas: This class of diabetes medications works by stimulating your pancreas to make more insulin, which means more glucose gets transported to your cells where it’s used for energy, instead of building up in your bloodstream. Common examples of sulfonylureas include glipizide, glyburide, and glimepiride.
For many people, these medications work extremely well to reduce blood sugar quickly. Plus, they can be combined with other medications. However, they may cause weight gain and low blood sugar, especially if you delay or skip a meal.
DPP-4 Inhibitors: Medications like sitagliptin, saxagliptin, and linagliptin help your body control blood sugar levels after meals. They work by blocking the DPP enzyme, which breaks down incretin—hormones that help increase insulin production and reduce glucose production in the liver.
DPP-4 inhibitors typically don’t cause weight loss or gain, and they usually don’t lead to low blood sugar. However, some people might experience joint pain, and in rare cases, pancreatitis.
GLP-1 Receptor Antagonists: These injectable medications, including liraglutide, semaglutide, and dulaglutide, act like incretin hormones to help lower your blood sugar. They do that by boosting insulin production when your blood sugar is high. Plus, they reduce your appetite, which can help with weight loss.
One of the benefits of GLP-1 receptor agonists is their low risk of causing dangerously low blood sugar levels. However, some people may experience nausea and vomiting, particularly when they first start using these medications.
SGLT-2 Inhibitors: These medications, such as canagliflozin, dapagliflozin, and empagliflozin, lower blood sugar by preventing your kidneys from reabsorbing glucose back into your bloodstream. Instead, they release excess glucose through urine.
SGLT-2 inhibitors can also help with weight loss and have a positive impact on your heart health. They generally have little risk of causing low blood sugar, but some people may experience side effects like urinary tract infections and increased thirst.
Thiazolidinediones (TZDs): TZDs, like pioglitazone and rosiglitazone, help to lower your blood sugar levels by making your body's cells more sensitive to insulin. Therefore, more glucose is transported to your cells instead of building up in your bloodstream. Downsides of TZDs can include weight gain and fluid retention.
Meglitinides: Meglitinides such as repaglinide and nateglinide help to lower blood sugar by stimulating your pancreas to release more insulin, especially after meals. Since they work quickly and are short-acting, they’re useful for managing blood sugar spikes after eating.
It’s important to make sure your blood sugar doesn’t dip too low, though, especially if you miss a meal or take too much.
Choosing the Right Medication for You
The right diabetes medication comes down to a few factors, including the type of diabetes you have, how well your blood sugar is managed, and other medications you’re taking. Your lifestyle—including your diet and exercise habits—also make a difference.
At Innovista Medical Center, our health care providers will develop a personalized treatment plan that meets your unique needs and preferences. They will work with you to monitor your blood sugar and lifestyle habits, as well as making medication adjustments to find the most effective combination for you. You may also work with a patient care coordinator to ensure all your needs are met in a timely and efficient manner.
