Before we discuss oral antidiabetic medications (antihyperglycemics), let’s look at the two types of diabetes.
Type 1 diabetes is caused by lack of insulin production. The so-called beta cells in the pancreas do not produce enough of this hormone.
Type 2 diabetes is caused by insensitivity to insulin. The pancreas might actually make more than the normal amount of insulin, but muscle and other cells are unable to use it to help take in sugar and convert it to energy. Type 1 diabetes generally must be treated with insulin injections. Fortunately for type 2 diabetic patients, oral antidiabetic medications are available and insulin may not be required:
- The first drug of choice for newly diagnosed type 2 diabetic patients is Glucophage (metformin). Metformin works by sensitizing cells to insulin, lowering the rate of absorption of sugar in the small intestine, and lowering the amount of sugar produced by the liver. Interestingly, this mediation does not just lower the blood sugar levels but may also significantly increase life expectancy. The important thing to know about metformin is that it may initially cause some gastrointestinal side-effects when taken, but after days to weeks the body adjusts and these fade and these side-effect should not be a reason to stop the therapy.
- Sulfonylureas work by increasing production of insulin in the pancreas and lowering breakdown of insulin in the liver.
- Glucotrol (glipizide)
- Diabeta (glyburide)
- Amaryl (glimepiride)
- Meglitinides act by stimulating release of insulin from pancreatic cells
- Prandin (repaglinide)
- Starlix (nateglinide)
- Thiazolidinediones work by improving sugar metabolism
- Avandia (rosiglitazone)
- Actos (pioglitazone)
- Alpha-Glucosidase inhibitors act by slowing absorption of carbohydrate from the small intestine
- Precose (acarbose)
- Glyset (miglitol)
- Voglib (voglibose)
- DPP-4 inhibitors work by increasing insulin release and slowing stomach emptying
- Januvia (sitagliptin)
- Onglyza (saxagliptin)
- Galvus (vildagliptin)
- Tradjenta (linagliptin)
- Vipidia (alogliptin)
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