Selection of drugs for the treatment of diabetes is the most important task that confronts the doctor. After all, a well-designed therapeutic scheme will help optimize blood sugar levels and prevent the development of dangerous complications of the disease.
Taking medication makes it possible to stimulate insulin production, and also prevents the immediate absorption of glucose into the blood.
Taking medications for type 2 diabetes is aimed at achieving the following goals:
- Reduce tissue insulin resistance;
- Stimulate the process of insulin synthesis;
- Resist the rapid absorption of glucose into the blood;
- Bounce back lipid balance in the body.
Therapy should start with a single drug. Further introduction of other drugs is possible. If the desired effect cannot be achieved, the doctor recommends insulin therapy to the patient.
The main groups of drugs
Taking drugs for type 2 diabetes mellitus is a prerequisite for maintaining health. However, we must not forget about maintaining a healthy lifestyle and about proper nutrition. However, not all people are able to gather their strength and force themselves to live in a new way. Therefore, drug correction is required very often.
Depending on the therapeutic effect, patients with diabetes may be prescribed drugs from the following groups:
- Drugs that eliminate insulin resistance are thiazolidinediones and biguanides;
- Drugs that stimulate insulin production in the body are glinides and sulfonylurea-based drugs;
- Preparations that have a combined composition are incretin mimetics.
Drugs that are prescribed to patients with diabetes mellitus:
- Alpha-glucosidase inhibitors;
- Prandial regulators;
Biguanides are drugs based on metformin (Glucophage, Siofor). Therapeutic effects are achieved by solving the following tasks:
- During the processing of glycogen, as well as proteins and carbohydrates, glucose synthesis is reduced;
- Tissues become more susceptible to insulin;
- Glucose deposits in the form of glycogen increase in the liver;
- Sugar enters the blood in small quantities.
Glucose enters the cells and tissues of the internal organs in larger quantities.
At the beginning of treatment with biguanides, patients develop side effects from the digestive system. However, after 14 days it will be stopped, therefore it is necessary to take it for granted. If this does not happen, then you should contact a specialist who will modify the therapeutic scheme. These side effects include nausea and vomiting, diarrhea, bloating, metal taste in the mouth.
Sulfonylurea derivatives have the ability to bind to the beta receptors of cells and activate insulin production. These drugs include Gliquidonum, Glurenorm, Glibenclamidum.
For the first use, drugs prescribed in the minimum dosage. Then, for 7 days, the dosage gradually increases.
Side effects from taking sulfonylurea derivatives include a sharp drop in blood glucose levels, a rash on the body, the defeat of the digestive system, pruritus, liver damage.
Glinides include Nateglinidum and Repaglinidum preparations. Their effect is reduced to an increase in insulin production in the pancreas. As a result, it is possible to keep the blood glucose level after the meal under control.
The drugs of this group include Pioglitazonum and Rosiglitazonum. They activate receptors in muscles and in fat cells, thereby increasing their insulin sensitivity. As a result, glucose is normally absorbed by fat cells, liver and muscles.
Thiazolidinediones are effective drugs for the treatment of type 2 diabetes, but they should not be taken during pregnancy and during breastfeeding, in patients with chronic heart failure and liver pathologies.
Incretin mimetic drugs
Exenatide is a popular incretin mimetic drug. Its action Exenatide is aimed at increasing the production of insulin, which becomes possible due to the ingestion of glucose in the blood. At the same time, the production of glucagon and fatty acids is reduced in the body, the process of digestion of food slows down, so the patient remains full longer. Incretin mimetic drugs have a combined action. The main undesirable effect of taking them is nausea. As a rule, nausea disappears within 7-14 days.
Acarbose is a drug from the group of b-glucosidase inhibitors. Acarbose is not prescribed as the main drug for treating diabetes, but this does not reduce its effectiveness. The drug does not penetrate into the bloodstream and has no effect on the process of insulin. The drug enters into competition with carbohydrates from food. Its active substance binds to enzymes that the body produces to break down carbohydrates. This helps to reduce the rate of their absorption, which prevents significant jumps in blood sugar levels.
Drugs for the treatment of diabetes – Amaryl, Janumet, Glibomet – have a complex effect. They reduce insulin resistance and increase the synthesis of this substance in the body.
Amaryl helps to increase insulin production by the pancreas, and also increases the body’s susceptibility to it.
If diet and hypoglycemic drugs do not allow to achieve the desired success, then patients are prescribed Glibomet.
Janumet does not allow glucose to fall sharply in the blood, which prevents sugar level jumps. Its use allows to increase the therapeutic effect of diet and exercise.
New generation drugs
DPP-4 inhibitors are a new generation of drugs for the treatment of diabetes. They do not affect the production of insulin by beta cells, but they protect a particular glucan polypeptide from its destruction by the enzyme DPP-4. This glucan polypeptide is essential for normal pancreatic function, as it activates insulin production. In addition, DPP-4 inhibitors support normal glucose-lowering hormone performance by reacting with glucagon.
The advantages of the new generation of drugs:
- The patient does not have a sharp decrease in the level of sugar in the blood since after bringing the glucose level back to normal, the medicinal substance stops its work;
- Drugs do not contribute to weight gain;
- They can be used with any drugs other than insulin and insulin receptor agonists.
The main disadvantage of DPP-4 inhibitors is that they may cause digestive disorders such as abdominal pain and nausea.
It is not recommended to take drugs in this group in case of the liver and kidney disorders.
The new-generation diabetes drugs include Sitagliptin, Saxagliptin, Vildagliptin.
GLP-1 agonists are hormones that stimulate insulin production and help restore the structure of damaged cells. These are Victoza and Byetta. Their use contributes to weight loss in people with obesity. GPP-1 agonists are released only in the form of injection solutions.
Sometimes patients with diabetes are advised to take medications based on herbal ingredients. They are designed to normalize blood sugar levels. Some patients take such dietary supplements for full-fledged medicines, but in reality, this is not the case. They will not allow recovery.
However, they should not be refused. These drugs help to improve the health of the patient, but treatment should be comprehensive. They can be taken at the stage of pre-diabetes.
Pay attention to ginseng, genugreek, psyllium, cinnamon, aloe vera, bitter melon, milk thistle. Their action is aimed at reducing the absorption of glucose in the intestine. This reduces its level in the blood. This allows you to activate the pancreas and stabilize the weight of the patient. They can be taken both for the prevention of the development of diabetes of the second type and in combination with other drugs. If you do not interrupt the therapeutic course, you will be able to achieve a stable normalization of blood sugar levels. At the same time, it is necessary to adhere to a diet and not to deviate from medical recommendations.
Features of insulin treatment
If diabetes exists in a patient for many years (from 5 to 10), then the patient requires specific drugs. For such patients, insulin injections are prescribed for a certain period or on an ongoing basis.
Sometimes insulin is prescribed even earlier than 5 years after the onset of diabetes. The doctor decides on this measure in the case when other drugs do not allow to achieve the desired effect.
In past years, people who took medications and followed a diet had a high glycemic index. By the time they were prescribed insulin, these patients already had severe diabetic complications.
The most popular hypoglycemic pills
The table below describes the most popular hypoglycemic tablets:
|Drug||Group and the main active ingredient|
|Diabeton||Group – sulfonylurea derivatives (gliclazide)|
|Maninil||Group – sulfonylurea derivatives (glibenclamide)|
|Siofor and Glucophage||Basis – Metformin (group – biguanides)|
|Januvia||Group – DPP-4 inhibitor (base – sitagliptin)|
|Galvus||Group inhibitor of DPP-4 (base – vildagliptin)|
|Victoza||Base – liraglutide (group – glucagon-like peptide-1 receptor agonists)|
|Amaryl||Group – sulfonylurea derivatives (base – glimepiride)|
|Forxiga||Group – an inhibitor of sodium-glucose contransporter type 2 (base – dapagliflozin)|
|Jardins||Group – sodium inhibitor of glucose contransporter type 2|
Medications for the treatment of type 2 diabetes can be related to the following groups:
- Biguanides (metformin);
- Sulfonylurea derivatives;
- Glinides (meglitinides);
- Thiazolidinediones (glitazones);
- Alpha-glucosidase inhibitors;
- Glucagon-like peptide-1 receptor agonists;
- Dipeptidyl peptidase-4 inhibitors (gliptins);
- Sodium-glucose contransporter type 2 inhibitors (gliflozins). These are the most modern drugs;
- Preparations of the combined type, which contain two main active ingredients;
What is the best drug for diabetes?
One of the most effective drugs is Metforminum. It rarely causes serious side effects. However, patients often develop diarrhea. To avoid this disorder, you should gradually increase the dose of the drug. However, Metforminum, despite its merits, will not allow to completely get rid of diabetes. A person must lead a healthy lifestyle.
Metforminum can be taken in most diabetic patients. It is not prescribed to people with renal insufficiency, as well as liver cirrhosis. The import analogue of Metforminum is Glucophage.
Janumet and Galvus Met combined drugs for diabetes are quite effective drugs, but their price is high.
Type 2 diabetes most often develops due to the fact that the body is not able to absorb carbohydrates from food, as well as due to physical inactivity. Therefore, with an increase in blood sugar levels, it is necessary to drastically change your lifestyle and diet. Medication is not enough.
If the patient does not give up harmful products, the reserves of the pancreas sooner or later run out. Own insulin will cease to be developed completely. In this situation, even the most effective diabetes drugs from Trusted Tablets will not help. The only way out will be insulin injections, otherwise, the person will develop a diabetic coma and he will die.
Patients with diabetes rarely survive to the time when the drugs stop working. More often, such patients experience a heart attack or stroke, rather than a complete failure of the pancreas to perform its functions.