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Long Term ComplicationsKeeping your blood glucose levels well controlled reduces the risk of developing long term complications. |
Diabetes Drugs
Drug therapy for type 1 diabetes
Diabetes is controlled by a combination of lifestyle modification and drug therapy. The lifestyle changes include dietary changes and inclusion of exercise as part of the treatment to control blood glucose levels and this is relevant to both type 1 and type 2 diabetes management. However, with regards to type 1 diabetes the only drug therapy is insulin. Insulin is a naturally occurring hormone produced by the pancreas. However, in type 1 diabetes, the body makes little or no insulin. Insulin is life-saving as it regulates the levels of glucose in the blood so that it is always within a safe limit. In type 1 diabetes, insulin needs to be replaced to allow this process of glucose control to continue and make the person safe with reduced risk of acute and chronic complications.
Insulin list and side-effects
Insulin is given by injection and each insulin belongs to one of 6 main types namely, rapid-acting analogues, short-acting, intermediate acting, pre-mixed biphasic, premixed analogues and long-acting analogues. They are included in the two main regimens which people with type 1 diabetes can have which are twice daily and four times daily insulin. Twice daily may be pre-mixed biphasic such as Humulin M3 or pre-mixed analogues such as Novomix 30. More commonly the four injections a day regimen is used as it mimics normal physiological insulin secretion. The main diabetes drugs side effects of insulin therapy are weight gain, hypoglycaemia, lipohypertrophy and hunger.
Drugs list for managing type 2 diabetes
Type 2 diabetes is a progressive disease due to the gradual decline in beta-cell function. In type 2 diabetes, the treatment often commences with tablets soon after diagnosis. The tablets are called oral hypoglycaemic agents (OHAs) and aim to lower blood glucose levels. The diabetes drugs list for type 2 diabetes include 6 main groups of OHAs which are suplhoylureas, biguanides, alpha-glucosidase inhibitors, glitazones, prandial glucose inhibitors and gliptins. There are many side-effects associated with OHAs. Hypoglycaemia and weight gain are side-effects of the sulphonylureas. All OHAs include gastro-intestinal disturbances, nausea, diarrhoea, rashes and renal impairment as possible side-effects.
New diabetes drugs and their side-effects
Newer drugs for managing type 2 diabetes are the DPP4 inhibitors (gliptins) and glucagon-like peptide (GLP -1) injections. Both groups of drugs exploit the incretin effect (gut hormones) which is diminished in type 2 diabetes. They enhance insulin secretion in a glucose-dependent manner. The common side effects of these new diabetes drugs are nausea and diarrhoea.
As beta-cells decline in type 2 diabetes, treatment options change. Treatment from a diabetes drugs list considers the clinical presentation, stage of diabetes, current diabetes medication and overall glycaemic control. Lifestyle issues such as occupation, weight, culture, social situation are also considered. Most patients with type 2 diabetes will eventually require insulin therapy. The number of agents on the diabetes drugs list aim to treat hyperglycaemia in type 2 diabetes. The newer agents have eliminated the two major side-effects namely hypoglycaemia and weight gain which are features of the older classes of drugs. The newer drugs may preclude the need for insulin therapy in type 2 diabetes.
