Medications That Treat Diabetes
Drugs For Hyperglycemia, Hypoglycemia, Insulin Resistance
Oct 28, 2009
Individuals with diabetes must treat their disease with a combination of insulin, medications, food therapy, diet and exercise programs.
Insulin is required to stimulate tissues of the body such as skeletal muscle and adipose tissue or fat to take up glucose from food. A reduced sensitivity to insulin or abnormal production of insulin can result in diabetes mellitus. Symptoms of diabetes include hyperglycemia (too much glucose in the blood), polydipsia (increase in thirst), glycosuria (excess glucose in the urine). Excess glucose in the plasma can eventually lead to renal (kidney) disease, peripheral nerve dysfunction, atherosclerosis (stiffening of the blood vessels) and peripheral vascular disease.
Insulin Is Needed To Treat Type I Diabetes
Insulin is used to treat type I diabetes. There are different types of insulin that have varying rates of acting times. Regular insulin is injected 30 minutes before a meal, resulting in peak plasma levels of insulin within two to three hours which lasts for six hours. Too much injected insulin can cause hypoglycemia, which in extreme cases can result in coma and brain damage. Hypoglycemia can be avoided by keeping a sweet snack or drink on hand at all times.
Oral Drugs To Control Blood Glucose Levels
Insulin secretion by the pancreatic beta cells is controlled by potassium channels. Tolbutamide, gibenclamide, glipizide and glicazide are medications which work by blocking these channels by binding to a sulphonylurea-binding site causing membrane depolarization, calcium entry and the secretion of insulin. For this reason these medications are called Sulphonylureas and stimulate insulin secretion. Sulphonulurea drugs are not effective in individuals with severe pancreatic beta cell dysfunction or with diabetes caused by pancreatic malfunction.
Side effects include hypoglycemia and weight gain as appetite may be increased in some individuals.
Non-sulphonylurea drugs also stimulate the secretion of insulin from the pancreatic cells but bind at different sites. These include the medication glinide, which cause less stronger stimulation of insulin secretion.
Biguanide drugs include metformin, which works by stopping glucose production and release by the liver and improves insulin resistance. It is used to alleviate hyperglycemia in individuals in type II diabetes and is often the drug of first choice, either on its own or along with sulphonylurea medications. Side effects include the risk of metabolic acidosis, abdominal bloating and diarrhea. Individuals with kidney problems and congestive heart failure should not take biguanide drugs.
Thiazolidinediones are drugs which reduce blood glucose and fatty acid levels by promoting the muscles to take up glucose, the liver to produce less glucose and the fat cells to take up fatty acids. Side effects include weight gain and fluid retention.
Alpha-glucosidase inhibitors such as the medications acarbose and miglitol target the cells in the gastrointestinal tract to delay the absorption of carbohydrates and reduce blood glucose levels after eating.
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