While some people with type II diabetes can achieve blood glucose control by following a prescribed meal plan and exercising regularly, others will need to add oral medication to their daily routine.
Oral medications, however, are not for everyone with type II diabetes. They are most likely to help people who have had high blood glucose levels for less than 10 years, are normal weight or above rather than very thin and are willing to follow the prescribed meal plan. They are not prescribed unless there is some insulin secretion by the pancreas.
Most oral medications for diabetes are sulfonylurea drugs. They lower blood glucose levels by encouraging the pancreas to produce and release more insulin. Commonly prescribed drugs in this category are Orinase (tolbutamide), Tolinase (tolazamide), (Dymelor (acetohexamine), Diabeta or Micronase (glyburide), Glucotrol (glipizide), Diabinese (chloropropamide) and Amaryl (glimepiride).
These medications increase the risk of hypoglycemia, especially when meals are skipped or too much alcohol is consumed, so people who take them should be alert to any necessary precautions. Sulfonylurea drugs should not be taken by people who are allergic to sulfa drugs or who are pregnant, and should be used with caution by people with significant liver or kidney disease.
A newer type of medication, belonging to a class of drugs called biguanides, was approved in 1994. This medication, metformin (brand name Glucophage) helps lower blood glucose by decreasing the liver’s release of stored glucose, hindering the absorption of glucose from food being digested in the small intestine; it may also lower insulin resistance in the muscles. Metformin is effective in about 80 percent of people who try it.
Metformin has three distinct advantages:
These two types of oral medications are not an either/or proposition. Metformin can be used along with a sulfonylurea for people whose blood glucose levels are poorly controlled on just the sulfonylurea and a meal plan.
The latest medication to join the arsenal of diabetes treatment is acarbose (brand name Precose). It helps keep after-meal blood glucose levels from going as high as they could by temporarily blocking the action of enzymes that help digest starches. This improves long-term glucose control, as shown by lowered glycosylated hemoglobin levels.
The timing and duration of action of different oral diabetes medications vary widely, so it is important to follow your prescribed medication schedule exactly and report any possible side effects to your doctor. Also, check with your doctor before taking any other medications, either prescription or nonprescription. Sometimes, other drugs you take can interact with your diabetes medication, or have a direct effect on your blood glucose levels, so you’ll need to be prepared for any such actions.
It is possible that, after a period of time, your body will stop responding to oral medications. If this happens, your doctor may recommend adding insulin to your daily routine, either with or without your oral medication. This requires some adjustment, but you will benefit from the improved blood glucose levels you will be able to achieve.
Oral medications, however, are not for everyone with type II diabetes. They are most likely to help people who have had high blood glucose levels for less than 10 years, are normal weight or above rather than very thin and are willing to follow the prescribed meal plan. They are not prescribed unless there is some insulin secretion by the pancreas.
Most oral medications for diabetes are sulfonylurea drugs. They lower blood glucose levels by encouraging the pancreas to produce and release more insulin. Commonly prescribed drugs in this category are Orinase (tolbutamide), Tolinase (tolazamide), (Dymelor (acetohexamine), Diabeta or Micronase (glyburide), Glucotrol (glipizide), Diabinese (chloropropamide) and Amaryl (glimepiride).
These medications increase the risk of hypoglycemia, especially when meals are skipped or too much alcohol is consumed, so people who take them should be alert to any necessary precautions. Sulfonylurea drugs should not be taken by people who are allergic to sulfa drugs or who are pregnant, and should be used with caution by people with significant liver or kidney disease.
A newer type of medication, belonging to a class of drugs called biguanides, was approved in 1994. This medication, metformin (brand name Glucophage) helps lower blood glucose by decreasing the liver’s release of stored glucose, hindering the absorption of glucose from food being digested in the small intestine; it may also lower insulin resistance in the muscles. Metformin is effective in about 80 percent of people who try it.
Metformin has three distinct advantages:
- Because it decreases glucose release rather than increases insulin activity, the risk of very low blood glucose levels (hypoglycemia) is reduced.
- It helps lower high blood fat levels.
- It helps promote weight loss.
These two types of oral medications are not an either/or proposition. Metformin can be used along with a sulfonylurea for people whose blood glucose levels are poorly controlled on just the sulfonylurea and a meal plan.
The latest medication to join the arsenal of diabetes treatment is acarbose (brand name Precose). It helps keep after-meal blood glucose levels from going as high as they could by temporarily blocking the action of enzymes that help digest starches. This improves long-term glucose control, as shown by lowered glycosylated hemoglobin levels.
The timing and duration of action of different oral diabetes medications vary widely, so it is important to follow your prescribed medication schedule exactly and report any possible side effects to your doctor. Also, check with your doctor before taking any other medications, either prescription or nonprescription. Sometimes, other drugs you take can interact with your diabetes medication, or have a direct effect on your blood glucose levels, so you’ll need to be prepared for any such actions.
It is possible that, after a period of time, your body will stop responding to oral medications. If this happens, your doctor may recommend adding insulin to your daily routine, either with or without your oral medication. This requires some adjustment, but you will benefit from the improved blood glucose levels you will be able to achieve.
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