What options do I have to treat my diabetes?
Right now is an exciting time for type 2 diabetes treatment. New drug classes and medications are released with a very regularly. These medications can be used singularly or as an adjunct to Metformin therapy.
Metformin is the gold standard for type 2 diabetes treatment – it is often the first medication prescribed at diagnosis. This specific medication is so effective because it assists the body to respond to insulin that is already being produced. It also decreases the absorption of glucose in the stomach and intestines, and decreases the amount of glucose produced by the liver. This medication is not without side effects; in fact, its side effects are what deters diabetics from continuing this particular therapy, or seeking out other treatments. Diarrhea is common but can be decreased if the medication is titrated slowly. In addition, it can cause lactic acidosis, a potentially deadly condition that is often confused with common side effects associated with this medication.
Sulfonylureas are actually an entire drug class of diabetes medications. These medications are effective because they stimulate insulin release from the beta cells of the pancreas. While these medications generally work well to control blood glucose, they do have an undesirable side effect – hypoglycemia. This happens because of an excess of insulin production. This is especially undesirable to the elderly population, because they may not recognize hypoglycemia. In addition, these medications can perpetuate the beta cells to “burn out” if used for a long duration of time.
Liraglutide (Victoza) is part of the GLP-1 Receptor Agonist drug class, one of the newest drug classes for diabetes management. This medication works by bonding to a hormone (glucagon-like peptide-1); this hormone stimulates insulin production. This medication is special because it lowers blood glucose after meals as it increases insulin production if needed due to elevated blood glucose. It also delays gastric emptying. This medication is taken once per day and is administered via injection, with a pre-filled syringe. This medication has multiple side effects; weight loss is a prominent side effect and is desirable to many people. However, it can also cause pancreatitis so should be used with caution in those with a history of this condition.
Exenatide (Byetta) is also a member of the GLP-1 Receptor Agonist drug class. As such, it works similarly to Victoza. The biggest difference between Victoza and Byetta is the dosage – Victoza is injected daily, while Byetta is injected twice per day. Side effects are similar. It is important to note that Victoza and Byetta do not cause hypoglycemia, but this side effect may be noticed if taken in conjunction with insulin or sulfonylureas.
This is a short summary of diabetes treatment – these are desirable medications to the diabetic patient. There are multiple other medications that can be prescribed as well.