If an effective diabetic diet, weight loss, and exercise are not enough to bring your blood sugar down near the normal range, then the next step is to take medicine. There are insulin shots and diabetes medication (pills or tablets). On this Web site, we will be covering only oral drugs.
Many patients with type 2 diabetes don’t absorb glucose as well as they should and they don’t make quite enough insulin. Sometimes they have plenty of insulin but they have insulin resistance, which means that insulin is not used effectively by the body. Because of this situation, they must take some kind of diabetes medication.
There are 3 classes of diabetes medication for type 2 diabetes based on how these drugs operate in your body. They work in the following ways to regulate blood sugar:
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The first class of diabetes medication makes the body more sensitive to the insulin that is already present. This class of products includes the thiazolidinediones, Avandia (rosiglitazone) and Actose (pioglitazone). It also includes the Biguanides, which consists of Glucophage (metformin) and Glucovance (metformin + glyburide, a sulfonylurea).
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The next class of diabetes medication stimulates the beta cells to release more insulin. This class includes the Sulfonylureas (acetohexamide, Amaryl, Glucotrol, Diabeta, Micronase, Glynase, Tolinase, Orinase) and meglitinides (repaglinide and nateglinide).
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In the final class, the breakdown of starches and certain sugars is blocked or slowed down. This class of diabetes medication includes the alpha-glucosidase inhibitors, Precose (acarbose) and Glyset (meglitol).
Each of these diabetes medications may be used in combination because they act in different ways to lower blood sugar. Many different combinations can be used but note that there is a risk of additional side effects and the more drugs you take the more it costs.*
Diabetes medication for people with type 2 diabetes works most effectively when combined with exercise and good meal planning.
Sometimes after several months or a few years, the diabetes medication might stop working; the cause is not known. It’s better to add another type of diabetes medicine than to switch to another pill. Working closely with your physician, you can experiment by trying more than one type of pill, several combinations of pills, or a combination of insulin and an oral agent.*
** Type 2 diabetes medication should be taken with care. These products interact with other drugs so you need to let your physician know about any other medicines or nutritional supplements you are taking.* You should also understand which Type 2 diabetes medications could cause hypoglycemia (low blood sugar) either by themselves, in combination with each other, or in combination with insulin injections.
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