There is no single diabetes drug treatment that suits all patients. Your needs and problems need to be discussed with your practitioner so that the best remedy can be devised for you. Oral and injected drugs can combat diabetic symptoms in a number of ways, either by improving the body’s sensitivity to insulin, or stemming the production of glucose, causing the pancreas to release more insulin or inhibiting stomach enzymes from breaking down carbohydrates.
In the huge list of drugs available each has specific drawbacks. Below are some of the most popular current medications with brief information.
Alpha-glycosidase inhibitors (Acarbose, Precose, Miglitol, Glyset): These work by breaking down starches and some sugars, the down side is that this process can cause stomach discomfort, wind and diarrhea. They do not cause weight gain.
Biguanides (Metformin, Fortamet, Glucophage etc): These improve the body’s sensitivity to insulin and inhibit the release of glucose from the liver. This process can cause slight weight loss and decline in bad (LDL) cholesterol. Possible side effects include nausea, diarrhea and occasionally a build-up of lactic acid.
Dipeptidy peptidase-4 inhibitors (Saxagliptin, Onglyza, Sitagliptin, Januvia, Linagliptin, Tradjenta): Like Biguanides above, these inhibit the release of glucose from the liver and stimulate the release of insulin, their side effects in certain patients however can be different and include inflammation of the pancreas, headache and upper respiratory tract infection.
Meglitinides (Repaglinide, Prandin, Nateglinide, Starlix): These have the advantage of being fast working and operate solely by stimulating the body to release insulin. They can lead to low blood sugar, weight gain, headaches, back pain and nausea in some patients.
Sulfonylureas (Glipizide, Glucotrol, Glimepiride, Amaryl, Glyburide, DiaBeta, Glynase): These also work quickly in the same way as Meglitinides and have similar potential side effects minus the back pain and headaches but with the addition of skin rash.
Thiazolidinediones (Rosiglitazone, Avandia, Pioglitazone, Actos): These work in the same way as Biguanides and DDP-4. They may increase levels of “good” cholesterol slightly. Possible side effects can include heart failure, heart attack, stroke and liver damage.
Amylin mimetics (Pramlintid, Symlin): These are used with insulin injections to stimulate the release of natural insulin. They may suppress hunger which can lead to some weight loss. Possible side effects include irritation at the injection site, headache, nausea and low blood sugar.
Incretin mimetics (Exenatide, Byetta, Liraglutid, Victoza): Like Amylin mimetics these stimulate the body to release insulin but they are used with metformin and sylfonylurea. The possible side effects can include dizziness, nausea, headache and kidney damage.