I Have Type 2 Diabetes. What Types of Medications and Insulin Should I Take?

Q: I have type 2 diabetes. What types of medications and insulin should I take?

 

A:

Some people with type 2 diabetes can maintain their target blood sugar levels by regular dieting and exercising alone, but the other still need diabetes medications or insulin therapy. Your blood sugar level, any other health problems you have and other factors jointly decide what medications and insulin you should take. Different medications may be combined to treat your diabetes.

Here is a list of common oral diabetes medications and types of  insulin for type 2 diabetes.

  1. Metformin (Glucophage, Glumetza, others). This is the first medication prescribed for type 2 diabetes. It help your body uses insulin in a more effective way by improving your body tissues’ sensitivity to insulin.

Possible side effects of metformin include nausea and diarrhea are. With your body getting used to the medicine, these side effects usually disappear. If you fail to control your blood sugar level by taking metformin and living a healthy lifestyle, other oral or injected medications can be added.

  1. Sulfonylureas. These medications help your body produce more insulin. Medications in this category consist mainly of glipizide(Glucotrol), glyburide (DiaBeta, Glynase) and glimepiride(Amaryl). Possible side effects of sulfonylureas include gaining weight and low blood sugar.
  2. Meglitinides. Like sulfonylureas, these medications work by stimulating the pancreas to secrete more insulin. On one hand, these medications are acting faster than sulfonylureas, on the other hand, the duration of their effect in the body is shorter. Examples of these medication include nateglinide (Starlix) and repaglinide (Prandin). Possible side effects of meglitinides also include weight gain and low blood sugar but the risk of the latter is lower than with sulfonylureas.
  3. Thiazolidinediones. These medications, like metformin, improve your body tissues’ sensitivity to insulin. Examples of these medication include pioglitazone (Actos) and rosiglitazone (Avandia). Possible side effects of this class of medications include weight gain and other more serious side effects, such as increasing the risk of fractures and heart failure.
  4. DPP-4 inhibitors. These medications work by reducing blood sugar levels, and they usually have a modest effect. Linagliptin (Tradjenta), sitagliptin (Januvia) and saxagliptin (Onglyza) are examples of these medications.
  5. GLP-1 receptor agonists. These medications help lower blood sugar levels and slow digestion. Examples of these medications include liraglutide (Victoza) and Exenatide (Byetta). Possible side effects of glp-1 receptor agonists include nausea and increasing the risk of pancreatitis.
  6. SGLT2 inhibitors. These medications help prevent the kidneys from reabsorbing sugar into the blood. Consequently, the sugar is excreted through the urine.

Canagliflozin (Invokana) and dapagliflozin (Farxiga) are examples of sglt2 inhibitors. Side effects of these medications include increased urination and hypotension, yeast infections and urinary tract infections.

  1. Insulin therapy. Some people with type 2 diabetes may need insulin therapy except for the medications mentioned above.

Doctors may prescribe, according to a patient’s condition, a combination of insulin types to take throughout the day and night. Generally, people who have type 2 diabetes take long-acting insulin every night.

The following commonly seen types of insulin work in different ways. You need to decide which one to use by consulting your doctor.

1)      Insulin lispro (Humalog)

2)      Insulin aspart (Novolog)

3)      Insulin detemir (Levemir)

4)      Insulin glargine (Lantus)

5)      Insulin glulisine (Apidra)

6)      Insulin isophane (Humulin N, Novolin N)

Except for the medications mentioned above, your doctor may prescribe blood pressure and cholesterol-lowering medications and low-dose aspirin which can help prevent blood vessel and heart disease.

 

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* The Content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition.