There are several groups of type 2 diabetes medications and each class of medicine works in a different way to lower blood sugar. Type 2 Diabetics may need medications for a certain time if they have very high sugars to prevent acute complications. But Type 2 diabetic should your should always be direct their efforts towards diabetes reversal to ultimately stop medications and live a healthy life.
Let us look at the different groups of anti diabetic drugs:
1. Biguanides
The most commonly used Biguanides is Metformin.
Metformin lowers blood glucose levels by decreasing the glucose production from your liver. It also makes your muscle tissue more sensitive to insulin so that the muscle tissue cells absorb glucose for energy. This in turn decreases glucose levels in the blood.
Side effects may include diarrhoea, upset stomach and a metallic taste in your mouth.
2. Sulfonylureas
Sulfonylureas stimulate the pancreas to release more insulin. Because they increase insulin production, you’re more at risk for low blood sugar (hypoglycaemia). Some of the common sulphonylureas are:
· Gliclazide
· Glimepiride
· Glipizide
· Glibenclamide
3. Meglitinides (glinides)
Meglitinides also stimulate your pancreas to release insulin. And similar to sulphonylureas they also have a risk of causing hypoglycaemia. Meglitinides include:
· Nateglinide
· Repaglinide
4. SGLT2 inhibitors
SGLT2 inhibitors excrete out extra glucose through your urine to lower blood glucose levels. inhibitors block your body’s ability to reabsorb glucose in the kidney’s leading to excretion of the extra glucose.
Urinary tract infection and vaginal yeast infections are some of the side effects.
SGLT2 inhibitors include:
· Canagliflozin
· Dapagliflozin
· Empagliflozin
· Remogliflozin
5. DPP-4 inhibitors (Gliptins)
DPP-4 inhibitors (gliptins) prevent the breakdown of GLP-1, a compound produced in your body. It allows GLP -1 to remain active in your body for longer. GLP -1 helps to reduce blood glucose levels and also increases satiety.
Possible side effects of DPP-4 inhibitors include headaches and gastrointestinal issues.
DPP-4 inhibitors include:
· Alogliptin
· Linagliptin
· Saxagliptin
· Sitagliptin
· Teneligliptin
6. Alpha-glucosidase inhibitors
Alpha-glucosidase inhibitors block the breakdown of starches and some forms of sugar in your intestines thus preventing post meal rise of blood glucose. Starch is a carbohydrate usually found in foods like potatoes, bread and rice. Refined flours and rice is also rich in carbohydrates.
Side effects of alpha-glucosidase inhibitors may include gas (flatulence), bloating and diarrhea.
Commonly used Alpha-glucosidase inhibitors include:
· Acarbose
· Voglibose
7. Thiazolidinediones (TZDs)
Thiazolidinediones decrease insulin resistance by helping your muscle and fat tissues be more sensitive to insulin. They also reduce glucose production in your liver.
Side effects include weight gain, water retention and increased risk of heart failure in some people.
Thiazolidinediones include:
· Rosiglitazone
· Pioglitazone
8. GLP 1 Agonists
GLP 1 agonists are incretin mimetics .They improve glucose control and also cause weight loss. The cause satiety, Slow stomach emptying and increase food dependent insulin production.
Some patients have the gastrointestinal side effects of these drugs such as nausea, vomiting, diarrhoea, and abdominal cramps.
Some examples of GLP1 agonists are-
· Dulaglutide
· Exenatide
· Liraglutide
· Lixisenatide
· Semaglutide
All GLP 1 agonists are available as injectables to be taken subcutaneously except semaglutide which is also available as oral tablet.
9. Insulin
Insulin is a hormone made by your pancreas. Insulin allows your body to use glucose for energy by allowing glucose to enter cells. It controls the blood sugar levels.
For patients with Type 1 diabetes, insulin is a life saving medicine and shouldn’t be ever discontinues and discontinuation can cause serious complications like diabetic ketoacidosis.
Insulin is given to Type 2 patients in emergencies, critical conditions or when sugars are not controlled even after giving different combinations of oral drugs.
Insulin are of different types and your doctor decides which insulin would suit you the best .