Table of contents:
- Various choices of diabetes mellitus drugs from doctors
- 1. Metformin (biguanid)
- 2. Sulfonylureas
- 3. Meglitinide
- 4. Thiazolidinediones (glitazone)
- 5.DPP-4 (gliptin) inhibitors
- 6.GLP-1 receptor agonist (incretin mimetic)
- 7. SGLT2 inhibitors
- 8. Alpha-glucosidase inhibitors
- 9. Insulin therapy
- Combinations of drugs for diabetes mellitus
- Does the person with diabetes have to take medication forever?
Diabetes mellitus or diabetes is a chronic disease that cannot be cured. However, the symptoms of diabetes and the severity of the condition can still be controlled with a healthy lifestyle and proper medication. Although not all people with diabetes (diabetes) need it, consumption of diabetes mellitus drugs is sometimes needed when high blood sugar levels do not decrease even though they have maintained a diet.
Various choices of diabetes mellitus drugs from doctors
In contrast to type 1 diabetes, which definitely requires insulin injections, type 2 diabetes can generally be treated with changes to a healthy diabetes lifestyle, such as adjusting diet and exercise routines.
But in some cases, especially when high blood sugar levels are difficult to control just by maintaining a diet, diabetes treatment needs to be assisted by the use of drugs, including insulin therapy.
In general, diabetes drugs have different ways of working and side effects. However, its function remains the same, which is to help control blood sugar levels while reducing the risk of diabetes complications.
Some classes of drugs for diabetes that doctors usually recommend are:
1. Metformin (biguanid)
The diabetes drug that is included in the biguanid group is metformin. It is the generic diabetes medication most often prescribed by doctors for type 2 diabetes patients.
Metformin works to reduce glucose production in the liver and increase the body's sensitivity to insulin. That way, the body can use insulin more effectively and glucose is more easily absorbed by the cells in the body.
The generic drug metformin for diabetes is available in pill and syrup form. However, metfomin also has side effects such as nausea, diarrhea, and weight loss.
These side effects can disappear when the body begins to adapt to the use of this diabetes drug. Usually, doctors will start prescribing other oral or injection drugs as a combination if metformin alone is not helpful enough in controlling blood sugar levels.
2. Sulfonylureas
Apart from metformin, a class of generic drugs for diabetes mellitus that is often prescribed by doctors is sulfonylureas. The sulfonylurea class of drugs works by helping the pancreas to produce more insulin.
Diabetes can also occur due to insulin resistance, meaning that the body is no longer sensitive or sensitive to insulin, which helps regulate blood sugar levels. Well, this sulfonylurea class of drugs helps the body to be more sensitive to insulin.
Generally, sulfonylurea class drugs are only intended for type 2 diabetes patients. People with type 1 diabetes do not use this drug, because basically, their bodies do not or do not produce insulin.
Some examples of the sulfonylurea class of diabetes drugs include:
- Chlorpropamide
- Glyburide
- Glipzide
- Glimepiride
- Gliclazide
- Tolbutamide
- Tolazamide
- Glimepirid
This generic drug for diabetes mellitus can cause hypoglycemia effects or a condition that lowers blood sugar rapidly. Therefore, if you are prescribed this diabetes medication by your doctor, you must adopt a regular eating schedule.
3. Meglitinide
Meglitinide diabetes drugs work like sulfonylureas, which stimulate the pancreas to produce more insulin. The difference is, the drug for diabetes mellitus works faster. The duration of its effect on the body is also shorter than the sulfonylurea class of drugs.
Repaglinide (Prandin) and nateglinide (Starlix) are examples of the meglitinide class of drugs. One of the side effects that arise from taking the meglitinide class of drugs is low blood sugar and weight gain.
Consult with your doctor to get the best advice for your condition.
4. Thiazolidinediones (glitazone)
Thiazolidinediones or also known as glitazone class drugs are also often given to help control blood sugar levels in patients with type 2 diabetes mellitus.
This drug works by helping the body to produce more insulin. Apart from controlling blood sugar, this drug also helps lower blood pressure and improves fat metabolism by increasing the levels of HDL (good cholesterol) in the blood.
Weight gain is one of the side effects of using this diabetes mellitus drug. Quoting on the Mayo Clinic page, this diabetes medication is also associated with other more serious side effects, such as the risk of heart failure and anemia.
Diabetes drugs that are included in the glitazone (thiazolidinediones) class are:
- Rosiglitazone
- Pioglitazone
5.DPP-4 (gliptin) inhibitors
Dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors) or also known as the gliptin group are generic drugs for diabetes mellitus that work to increase the hormone incretin in the body.
Incretin is a hormone in the digestive tract that works to signal the pancreas to release insulin when blood sugar levels rise. Therefore, increased production of the hormone incretin can help increase insulin supply to control high blood sugar levels, especially after meals.
In addition, this diabetes medication can also help reduce the breakdown of glucose in the liver so that it does not flow to the blood when sugar levels are high.
Usually the doctor will prescribe this diabetes mellitus drug if the administration of metformin and sulfonylurea class drugs is not effective in controlling the blood sugar of patients with diabetes.
Quoting the American Diabetes Association page, this diabetes medication is also effective for helping you lose weight.
Some of the drugs that fall into this group are:
- Sitagliptin
- Saxagliptin
- Linagliptin
- Alogliptin
Unfortunately, some reports link this drug to the risk of pancreatitis or inflammation of the pancreas.
Therefore, inform your doctor about all the health conditions you have, especially if you have a history of diseases related to the pancreas.
6.GLP-1 receptor agonist (incretin mimetic)
GLP-1 receptor agonists, also known as the mimetic incretin drug class, are prescribed by doctors if diabetes mellitus drugs as mentioned above are not able to control your blood sugar levels. This diabetes medication is given by injection.
This drug contains amylin, an amino acid that is produced together with the insulin hormone in the pancreas. The way it works is by stimulating the secretion (secretion) of natural hormones produced by the body in the intestines, namely incretin.
The incretin hormone can stimulate the release of insulin after meals thereby increasing insulin production and decreasing glucagon or sugar produced by the liver.
Thus, GLP-1 receptor agonists can inhibit and reduce the release of glucose produced after eating. This diabetes drug also helps slow down digestion, thus preventing the stomach from emptying quickly and holding back your appetite.
Examples of diabetes drugs for the GLP-1 receptor agonist class are:
- Ecenatide
- Liraglutide
- Semaglutide
- Albiglutide
- Dulaglutide
Recent research has shown that liraglutide and semaglutide can help reduce the risk of heart attack and stroke in people who are at high risk for both conditions.
Side effects of this diabetes medication include nausea, vomiting, and weight gain. For some people, this diabetes medication can increase the risk of pancreatitis.
7. SGLT2 inhibitors
Sodium-glucose co-transporter-2 (SGLT2) is a new class of inhibitors that are also frequently used in the treatment of diabetes.
This class of diabetes mellitus drugs works by reducing the re-absorption of glucose in the blood. That way, glucose will be excreted through urine, so that the sugar that accumulates or circulates in the blood will decrease.
If balanced with the right diet and regular physical exercise program, this class of drugs can effectively help control high blood sugar in patients with type 2 diabetes.
Doctors usually will not give this drug for those who have type 1 diabetes and diabetes ketoacidosis.
Some examples of the SGLT2 inhibitor class of diabetes are:
- Dapagliflozin
- Canagliflozin
- Empagliflozin
8. Alpha-glucosidase inhibitors
Unlike most other diabetes drugs, the alpha-glucosidase inhibitor class of drugs does not have a direct effect on insulin secretion or sensitivity. On the other hand, these drugs slow down the breakdown of carbohydrates found in starchy foods.
Alpha-glucosidase itself is an enzyme that breaks down carbohydrates into smaller sugar particles — called glucose — which are then absorbed by the organs and used as energy.
When the absorption of carbohydrates slows down, the change in starch (starch) in carbohydrates is also slower. This allows the process of changing starch to glucose to proceed slowly. As a result, blood sugar levels become more stable.
Medicines of this class will have the best effect if taken before meals. Some diabetes drugs that fall into the alpha-glucosidase inhibitor class are:
- Acarbose
- Miglitol
Consumption of diabetes medication does not cause low blood sugar or weight gain.
However, using this drug can make you pass gas frequently and experience side effects of digestive problems. If you experience it often, consult a doctor immediately to adjust the dose that is safer.
9. Insulin therapy
Blood sugar levels in diabetics can be controlled by adopting a healthy lifestyle and taking medication regularly.
However, for people with type 1 diabetes, insulin therapy is the main way to control the disease because their pancreas can no longer produce insulin. That is why, insulin therapy is more commonly aimed at people with type 1 diabetes, rather than using diabetes mellitus drugs.
Even so, people with type 2 diabetes sometimes also need this therapy. They need insulin therapy because even though their pancreas can still produce the hormone insulin, the body cannot respond to the insulin it produces optimally.
Usually doctors prescribe insulin therapy for type 2 diabetes patients who are unable to control their blood sugar through lifestyle changes and oral medication.
There are several types of additional insulin that are used for the treatment of diabetes. Types of insulin are distinguished based on the speed of action which includes:
- Fast acting insulin (rapid-acting insulin)
- Regular insulin (short-acting insulin)
- Medium acting insulin (intermediate acting insulin)
- Slow acting insulin (long-acting insulin)
Combinations of drugs for diabetes mellitus
Before prescribing diabetes mellitus drugs, the doctor will consider various things related to the health condition of diabetics, such as:
- Age
- Medical history
- Type of diabetes experienced
- Disease severity
- Past medical or therapeutic procedures
- Side effects or tolerance to certain types of drugs
In the treatment of diabetes, there are many drugs that have different functions and ways of working in controlling blood sugar. Therefore, your doctor may be able to prescribe several types of diabetes medication at once if you think it will be more effective.
In addition, the drug combination can keep your A1C test (blood sugar level test for the last 3 months) under control for a longer time compared to single therapy or single-drug treatment.
The drug metformin, for example, is often combined with sulfonylurea class drugs or insulin therapy. The sulfonylurea class of drugs can also be combined with the glitazone diabetes drug.
You should not stop taking your medication carelessly or take it outside of the prescribed dosage, even when checking your blood sugar at home shows normal results.
Talk to your doctor about diabetes mellitus treatment plans. Later, the doctor will decide whether your treatment is successful or something needs to be changed.
Does the person with diabetes have to take medication forever?
You usually no longer need to take diabetes medications if the diabetes test results show:
- A hemoglobin A1C test result is less than 7%
- The result of fasting blood sugar in the morning is less than 130 mg / dL
- Postprandial blood sugar results or two hours after meals should be less than 180 mg / dL
However, to get rid of the use of diabetes drugs you have to adopt a healthy lifestyle, regulate your diet, and exercise regularly for diabetes. If necessary, you should consult a nutritionist to help you formulate the right diabetes diet menu rules.
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