Common Diabetic Drugs Demystified
Dec 20th, 2008 by Giselle
Do you have diabetes? Have you been prescribed medication to help manage your blood sugar levels? Are you wondering about all the options that are available to you and their side effects? If the answer is ‘yes’ then this article is for you!
Diabetes is a chronic disease. This means it is progressive and people who have it generally have it for life. Initially, when a person is pre-diabetic, lifestyle changes involving appropriate diet and exercise are enough to keep blood glucose levels in the healthy range. But as the disease progress, medication will be prescribed to keep sugar levels down. In time, even this will fail to achieve normal blood sugar levels and insulin injections (up to 6 a day) will be prescribed.
In this article, I will discuss the 5 classes of tablets commonly prescribed for diabetics and their side effects. I hope after reading this article, you will have a better understanding of what options are available to you, how appropriate your medication is for you and the alternatives you could choose from if your current medication is inappropriate.
Essentially the 5 classes of diabetic tablets can be categorised as follow:
1. Biguanides
2. Sulphonylureas
3. Thiazolidinediones
4. Meglitinides
5. Alpha glucosidase inhibitor
Most newly diagnosed diabetics are prescribed biguanides. Biguanides are also called metformin. Metformin acts by reducing the release of sugar from your liver, slowing down absorption of sugar from you intestine and making your body more sensitive to the hormone insulin. Metformin tablets are taken with meals and may present side effects like nausea, diarrhoea and metallic taste in the mouth. You will not gain weight with this medication but may lose some weight which is a real bonus! Long term usage of metformin can cause vitamin B12 deficiency so you will need to remind your doctor to test you B12 levels regularly to make sure that you are not deficient. If you are, you will need supplements or B12 injections on a regular basis.
|
Chemical Name |
Brand Name |
|
|
Biguanides (metformin) |
Diabex |
Diaformin |
|
|
Diabex XR |
Formet |
|
|
Glucohexal |
Glucomet |
|
|
Glucophage |
Genrx metformin |
|
|
Metformin BC |
|
The second class of drugs is the sulphonylureas. Sulphonylureas are taken before meals and can cause hypoglycaemia or low blood sugar levels making you feel faint so you must have lollies or sweet drinks available for when you experience a ‘hypo’. These drugs can cause weight gain. Not such a good thing as most diabetics are also overweight. Diabetics with poorer sugar control are often prescribed sulphonylureas in combination with the biguanides (expect to take more and more drugs if you sugar control is poor).
|
Chemical Name |
Brand Name |
|
|
Glicazide |
Diamicron |
Glyade |
|
|
Diamicron MR |
Mellihexal |
|
|
Nidem |
Genrx glicazide |
|
Glibenclamide |
Daonil |
Glimel |
|
Glipzide |
Melizide |
Minidiab |
|
Glimepiride |
Amaryl |
Dimirel |
Thiazolidinediones act by lowering your blood sugar and increasing the effect of insulin on your muscles and fat cells. They increase your body’s sensitivity to insulin. These drugs can be taken any time of the day and may cause small weight gain but they seem to have the added bonus of redistributing fat from you tummy to your thighs! Good for trimming your waist!
|
Chemical Name |
Brand Name |
|
|
Thiazolidinediones (glitazones) |
Avandia |
Roziglitazone |
|
|
Actos |
Pioglitazone |
Meglitinides act by stimulating the pancreas to release more insulin. They are taken just before meals and are quick acting. Possible side effects are hypoglycaemia, gastric upset and abnormal liver function tests. Regularly stimulating the pancreas to release more insulin can place a ‘strain’ on the beta-cells cause negative health outcomes. Meglitinides are great for individuals with erratic eating patterns like shift working nurses and factory workers.
|
Chemical Name |
Brand Name |
|
|
Meglitinides |
Novonorm Prandin |
Repaglinide |
Arcabose (alpha glucosidase inhibitor) are taken before meals and act by slowing down carbohydrate digestion and absorption. The side effects like bloating, diarrhoea and flatulence are quite unpleasant. However, with all these unpleasant side effects, weight loss is natural. A good bonus!
|
Chemical Name |
Brand Name |
|
|
Alpha glucosidase inhibitor |
Glucobay Precose |
Acarbose |
I hope this article demystifies the commonly prescribed drugs for your health condition. If you are experiencing any unpleasant side effects, it might be wise to change your medication. Please do not hesitate to ask if you have any questions or wish to post a comment below.
Do you think diabetes can be reversed with a low carb diet? You mention that eventually you will have to start taking insulin uo to six times a day. There are so many studies done on actually keeping your diabetes under control with a strict carb controlled diet. Some have even reversed their complications.
Hi Tom,
Very good question. Thanks for asking. Studies on low carbohydrate diets show unequivocably overweight individuals lose weight 2-3 times faster when carbohydrate is restricted. When overweight diabetics lose enough weight to get into the healthy weight range, a reversal of diabetes is possible. The more obese these individuals are the more effective and dramatic the reversal will be. I have seem patients get off their medication when they lose 10-20% of their body weight. They could even be on a combination of metformin and sulphonylureas and still be drug free when adequate weight is lost. After much research over the last 30 years, diabetics are now advised to follow a moderately high carbohydrate diet (approximately 45 to 50g carbohydrate at each main meal and 25g carbohydrate between meals) composed largely of low glycaemic index foods. Glycaemic index is a way of ranking carbohydrate foods depending on their ‘sugar-raising potency’ in the blood. For instance, a high glycaemic index food hits the blood stream fast whereas a low glycaemic index food gets its glucose released into the bloodstream slowly. In 1981, Professors David Jenkins and Tom Wolever at the University of Toronto were the first to coin the term glycaemic index to describe the different ability of carbohydrate to raise blood glucose levels. For optimum blood sugar control, we recommend that diabetics eat a moderately high carbohydrate diet composed mainly of low glycaemic index foods so as to reduce wild fluctuations in blood sugar levels. A smoother blood sugar curve will enhance insulin sensitivity and lead to much better health outcomes. That way complications associated with diabetes are much less likely to manifest. If your sugar control is good, you can delay the progression of the disease and may never have to start injecting insulin! For a list of low glycaemic index foods, please refer to my article on Polycystic Ovarian Syndrome.
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