Diabetes Medications
Most of the medications used to help control diabetes come in a
pill form. There are injections, like insulin and other
medications, but for now we will focus on pill medications.
Why do I need to take diabetes pills?
Insulin acts to lower blood sugar, In type 2 diabetes, you still
have some insulin, but either not enough or it can not work well.
You are trying to control your blood sugar with diet and
exercise, and it may have worked well for a time. But now in spite
of your best efforts your blood sugar is staying too high. Diabetes
pills can help get your blood sugar back in range. Taking
pills is not a sign of failure, it is just a normal progression in
the diabetes.
What are diabetes pills?
Diabetes pills, or oral diabetes medications, are not insulin.
Insulin can only be taken by injection. The stomach acid will
dissolve insulin if taken by pill. Diabetes pills fall into
two main categories:
- Medications that help your body make more insulin,
- Medications that help your body use the insulin that is
there.
To understand how diabetes pills work to lower blood sugar, let's
review how your body uses and stores sugar (glucose).
How does my body use sugar?
Glucose is a sugar that comes from most of the food you eat. When
glucose is in the bloodstream insulin helps it move into the liver and other
cells. Your cells use glucose for energy. In some people the cells
become resistant to the insulin. When this happens, the insulin doesn't
move the glucose form the bloodstream into the cell. Then the pancreas
makes even more insulin to try to keep the blood sugar in range. After a
time the pancreas can not keep up and the insulin falls off and the blood sugar
stays high.
The liver will store sugar for use when you do not eat. The liver
releases this glucose between meals and overnight. When the liver is
resistant to insulin it will release too much glucose. This is why some
some people have a high blood sugar even before breakfast.
How do diabetes pills work?
There are several different classes of diabetes pills: sulfonylureas,
biguanides, insulin-sensitizing agents, glitinides and alpha-glucosidase
inhibitors. Sulfonylureas are perhaps the oldest class and are still very
useful. The pills can be used alone or in combination with each other or
in combination with insulin. There are some pills that have a combination
of two medications. The different classes have different primary actions.
The sulfonylureas and glitinides help the pancreas make more insulin.
Biguanides and insulin sensitizers help insulin work better. Insulin
sensitizers and sulfonylureas work to lower pre-meal blood sugar.
Glitinides and alpha-glucosidase inhibitors lower after-meal blood sugar.
Sulfonylureas help the pancreas produce more insulin. There are
several different medications in this class. They are similar but are not
interchangeable. Possible side effects of the sulfonylureas are low blood
sugar (hypoglycemia), weight gain, upset stomach, rash, itching or dizziness.
Metformin, the only biguanide, acts to keep the liver from putting out
too much sugar. The liver will store sugar and release it when your blood
sugar falls below normal, such as overnight. Biguanides can also help your
body use insulin better. They will sometimes help lower cholesterol.
They do not cause weight gain. Side effect may include diarrhea, nausea,
loss of appetite and maybe an unpleasant taste in the mouth.
Insulin sensitizers (Actos) help insulin work. They work with insulin
to move sugar into the cells.
Glitinides (Starlix, Prandin) help the pancreas make more insulin.
They have a short time of action and need to be taken with meals.
Alpha-glucosidase inhibitors (Precose, Glyset) work in your digestive
tract to block the breakdown of some carbohydrates into sugar. This
reduces the amount of sugar that gets into the bloodstream and blood sugar does
not go as high after meals. Side effects can be bloating, gas and
diarrhea.
How do I know which medication is best for me?
Because the pills work in different ways, the choice of which pill is best
for you will depend on your blood sugar levels. Some people may need only
one pill and others two or three.
When do I take my pills?
Some medications work best if taken once a day and some twice a day. It
is good to try and take them about the same time each day. These
medications work best when you take them every day, not just if you think your
blood sugar is high.
Most of the diabetes pills are best if taken with a meal, usually breakfast.
Do not use your medications after their expiration date. If the pills
are discolored, throw them away. Keep your medicine with you when you
travel. If you are ill you still should take your medication and monitor
your blood sugar.
It is important that you know
- the NAME of your medication
- how many pills you take
- when you take the medication.
What else can I do to take care of my diabetes?
Food will increase your blood sugar. The more you eat at one time, the
more insulin your body needs to lower the blood sugar. Even with the
medication, your body can only make so much insulin. Your blood sugar will
be lower if you divide your food into several small meals and snacks throughout
the day. Regular activity will help use up the blood sugar too.
Do these pills cause any problems?
A few people may have a reaction like a skin rash, upset stomach or even
loose bowel movements with some of these pills.
Other medications may cause problems when you are taking diabetes pills.
It is important to let all of your doctors know the medications you take.
What if I forget to take a pill?
Here are some hints to help you remember to take your medication (everybody
misses one every now and then).
- Put your pills by your toothbrush and take when you brush your teeth.
- Mark off a calendar each day when you take your pill.
- Take your pills about the same time of day.
- Use a weekly pill box.
If you do miss a pill take it as soon as you remember. If you realize
today that you forgot yesterdays pill, do not take it now. Do not double
up on your pills.
What are these diabetes pills going to do for me?
Diabetes medications do not cure diabetes, but they will help you control
your blood sugar. If you control your blood sugar your risk of having
serious complications from diabetes is reduced. The pills work best if
you:
- Take your pills every day.
- Eat at your planned times.
- Avoid overeating.
- Keep your regular doctor visits.
Testing your blood sugar will help you know how the medications are working.