Type 2 Diabetes: Treatment for diabetes aims to maintain blood glucose levels as normal as possible and control symptoms to prevent health problems occurring later in life. People with type 2 diabetes are often given medications including insulin to better control their blood glucose levels.
Maximum of these medications are in the form of tablets, but some are given by injection.
All people with diabetes require checking their glucose levels on a regular basis. While taking medication, you may require checking your blood glucose levels more frequently to keep you safe and to secure the medication is becoming the desired effect.
In type 2 diabetes, insulin resistance leads to the condition, injections of insulin are not the first option. Preferably, other drugs are utilized to help boost insulin production. Insulin resistance occurs in the body’s cells don’t respond properly to insulin, that’s responsible for ferrying glucose to cells for energy.
When cells are resistant to insulin, they don’t utilize the insulin efficiently to take the glucose from the bloodstream into the cell. The pancreas requires producing more insulin to succeed this resistance in an effort to normalize blood sugar levels. Researchers continue to look for new and effective drugs.The various commonly prescribed oral medication for type 2 diabetes is metformin.
Classes of medications for type 2 diabetes
- Biguanides
- Sulphonylureas
- Alpha-Glucosidase Inhibitors
- Thiazolidinediones (Glitazones)
- Dipeptidyl Peptidase 4 (DPP4) Inhibitor
- Sodium-Glucose Transporter (SGLT2) Inhibitors
- Incretin Mimetics
- Combination Oral Pills
Biguanides
Chemical name: Metformin, Metformin ER
This group of insulin tablets helps to lower blood glucose levels by reducing the amount of stored glucose released by the liver. They need to be started at a low dose and increased slowly. Metformin is often prescribed for people with type 2 diabetes who are overweight. It generally doesn’t lead to weight gain and may help to manage weight. Metformin may need to be combined with the sulphonylurea or other classes of tablets and/or insulin. Metformin by itself does not cause hypoglycemia but may contribute to hypoglycemia when used in conjunction with a sulphonylurea tablet or insulin.
Some Brand Names
- Glucophage®
- Extended-release (ER):
- Glucophage XR®
- Fortamet®
- Glumetza
- Riomet® (liquid, 500 mg/5ml)
Sulphonylureas
Chemical name: Gliclazide, Gliclazide ER, Glibenclamide, Glipizide, Glimepiride
Sulphonylureas lower blood glucose levels by stimulating the pancreas to release more insulin, can cause hypoglycemia. Other possible side effects -weight gain, gastric upsets, skin rashes, jaundice. Sulphonylureas may require being combined with metformin tablets.
Some Brand Names
Tolbutamide
- Orinase®
- various generics
Glimepiride
- Amaryl®
- various generics
Glipizide
- Glucotrol®
- Glucotrol XL®
- various generics
Glyburide
- Micronase®, DiaBeta®
- various generics
Glyburide, Micronized
- Glynase PresTab®
- various generics
Thiazolidinediones (glitazones)
Chemical name: Rosiglitazone, Pioglitazone
They help to lower blood glucose levels by increasing the efficiency of your own insulin, especially on muscle and fat cells. Their effect is slow, begin working and one to two months for their full effect. They should not be taken by people who have liver disease.
Some Brand Names
Pioglitazone (preferred over rosiglitazone)
- Actos®
Rosiglitazone
- Avandia®
Alpha-Glucosidase Inhibitors
Chemical name: Acarbose, Miglitol
They help to slow down the digestion and absorption of certain dietary carbohydrates in the stomach (intestine). Side effects include flatulence (wind), bloating and diarrhea.
Some brand names
Acarbose
- Precose
Miglitol
- Glyset
DPP-4 inhibitors
Chemical name: Alogliptin, Sitagliptin, Saxagliptin, Linagliptin
They work by inhibiting the enzyme DPP-4. This enhances the levels of active incretin hormones which act to lower blood glucose levels by increasing insulin secretion and decreasing glucagon secretion.
Some brand names
Alogliptin
- Nesina®
Sitagliptin
- Januvia®
Saxagliptin
- Onglyza®
Linagliptin
- Tradjenta®
Incretin Mimetics
Chemical name: Exenatide, Liraglutide, Albiglutide, Dulaglutide
They are given by injection under the skin. They are not a substitute for insulin.
Some brand names
Exenatide
- Byetta®
Liraglutide
- Victoza®
Albiglutide
- Tanzeum®
Dulaglutide
- Trulicity®
Sodium-Glucose Transporter (SGLT2) Inhibitors
Chemical name: Canagliflozin, Dapagliflozin, Empagliflozin
Take with or without food. Might help lower blood pressure.Might help with weight loss. Side effects can include an increase in urinary tract infections (UTIs), genital thrush and increased urination. Dosages needs to be adjusted for people over the age of 75 years
Some brand names
Canagliflozin
- Invokana®
Dapagliflozin
- Farxiga®
Empagliflozin
- Jardiance®
Combination Oral Pills
Alogliptin/Metformin
- Kazano®
Alogliptin/Pioglitazone
- Oseni®
Empagliflozin/Linagliptin
- Glyxambi®
Empagliflozin/Metformin
- Synjardy®
Canagliflozin/Metformin
- Invokamet®
Dapagliflozin/Metformin XR
- Xigduo XR®
Glyburide/Metformin
- Glucovance®
- various generics
Glipizide/Metformin
- Metaglip®
- various generics
Linagliptin/Metformin
- Jentadueto®
Rosiglitazone/Metformin
- Avandamet®
- various generics
Pioglitazone/Metformin
- ActoPlus Met®
- various generics
Pioglitazone/Glimepiride
- Duetact®
Rosiglitazone/Glimepiride
- Avandryl®
- various generics
Sitagliptin/Metformin
- Janumet®
Sitagliptin/Metformin
- Janumet XR®
Repaglinide/Metformin
- PrandiMet®
Pioglitazone/Metformin XR
- ActoPlus Met XR®
Saxagliptin/Metformin XR
- Kombiglyze XR®
Insulin therapy
Type 2 diabetes is a progressive condition with decreasing insulin production over time. As they will need insulin treatment to control their blood glucose levels, sometimes with tablets as well. This can happen about 50% of people within 10 years of being diagnosed.
There are many types of insulin, and they each work in a different way. Options include:
- Insulin lispro (Humalog)
- Insulin glulisine (Apidra)
- Insulin aspart (Novolog)
- Insulin detemir (Levemir)
- Insulin glargine (Lantus)
- Insulin isophane (Humulin N, Novolin N)
