Which is the best medicine for diabetes? | Zyla Health
We all want the best medicine for diabetes to get the best results and live a healthy life. Here is a list of the world’s best medicines for diabetes.
If you are recently diagnosed with diabetes or have been dealing with it for many years, you must’ve tried to read numerous articles and consult the top doctors just to get the best medicine to manage your blood sugar levels?
As per a source, in 2014, there were more than 70 million cases of diabetes in India. It was studied to be more in urban areas than rural areas of India. Also, the number of cases increased as per the age, mostly after 50 years.
Now despite such alarming numbers, we do find many diabetics struggling to reach their target blood sugar level. And while they are struggling, they start to develop complications of diabetes like burning sensation in the hands or legs or blurred vision or effects on kidneys etc.
Possible reasons could be obesity or overweight, irregular meal timings, intake of high fat or carbohydrate, physical inactivity and high-stress levels.
One of the main reasons is poor medical management which includes delay in planning the management or delays in changing of medicines and lastly, the trouble to find out the best medication for high blood sugar levels at the earliest.
Though there is no permanent cure found till date for diabetes but it is most definitely treatable. In this blog, you will be able to know about the medicines used to treat Type 1 and Type 2 Diabetes along with their side effects.
Medicines for Type 2 Diabetes
When continuous lifestyle changes like healthy eating, regular exercise and managing weight doesn’t help to manage your blood sugar levels your doctor might put you on either medication or insulin. So let’s start off by discussing the medicines first.
Medications
Oral hypoglycemic agents (OHAs) is the term used for drugs taken by mouth in order to manage blood sugar levels. There is quite a list of OHAs that can be prescribed depending on a number of factors.
1. Biguanides
- The most commonly prescribed drug for Type 2 Diabetes and can be used to treat pre-diabetes.
- The drugs of this class work by reducing the amount of sugar produced by the liver. They make the cells of your body more sensitive to Insulin, help decrease intestinal absorption of sugar and help muscles absorb glucose.
- It is a class of drugs that contains Metformin.
- Metformin is also used as a combination medicine along with other anti-diabetic medicines.
2. Dopamine agonist
- Although the exact mechanism of action of this drug is not known it is believed to prevent Insulin resistance.
- Bromocriptine is an example.
3. Dipeptidyl peptidase-4 (DPP-4) inhibitors
- This class helps to prevent the breakdown of a useful hormone called Incretin that helps to reduce sugar levels only when they are high. Incretin remains active thus maintaining sugar levels and also preventing low sugar episodes.
- Examples include Sitagliptin, Alogliptin, Linagliptin etc.
4. Glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists)
- These drugs increase the growth of beta cells, the amount of insulin produced by your body, slowing stomach emptying and thus reducing your appetite as well.
- In case of other disease conditions along with diabetes like heart failure, chronic kidney disease, this class of drugs helps to manage sugar levels in the long run.
- Drugs Include dulaglutide, exenatide, liraglutide etc.
5. Meglitinides
- These drugs work by releasing Insulin into your body but this has chances of lowering your sugar levels.
- Examples include nateglinide, repaglinide.
6. Sodium-glucose transporter (SGLT) 2 inhibitors
- These drugs help to prevent the kidney from holding onto the drugs thus making glucose being released through urine.
- Again in case of multiple disease conditions, this class is also a preferred choice.
- Examples include dapagliflozin, empagliflozin, canagliflozin.
7. Sulfonylureas
- One of the first drugs used for diabetes. They work by stimulating the pancreas thus leading to more increase of Insulin.
- Drugs include Glimepiride, Gliclazide, glyburide, chlorpropamide, tolazamide, tolbutamide.
8. Thiazolidinediones
- These drugs help to decrease glucose in the liver. They aid the fat cells in your body to utilize Insulin better. But there is a risk of heart disease in this case. Heart functioning is monitored if this drug is in your treatment plan.
- Examples include rosiglitazone and pioglitazone
By now I am sure that you have an idea of all the classes of medicines most commonly used in case of Type 2 diabetes. Again every class works with a varied efficacy and efficiency. But the end result always is to manage sugar levels.
In every case make sure to discuss your treatment plan with your doctor in detail as diabetes is best managed when you are aware of the action of each drug and the side effects of each medicine.
Sometimes when high blood sugar levels reach a limit where medicines can’t control them, then Doctors prescribe insulin. This happens because pancreas’ insulin production is not enough and it requires insulin from an external source.
It happens in both, Type 1 and Type 2 Diabetes but is mostly seen in the cases of Type 1 Diabetes. Why? Here is the reason…
Medications for Type 1 Diabetes.
Type 1 Diabetes is an autoimmune condition where the pancreas is unable to produce enough insulin to control your sugar levels naturally. So, the first and most preferred choice of medicine in Type 1 Diabetes is insulin.
Insulin
Insulin is one of the most common and widely suggested medicines by endocrinologists. It works by lowering the blood glucose levels. Used in both type 1 and type 2 diabetes, insulin is available in various types.
The type is selected based on how much insulin is needed by the body and according to the trend of your sugar level. It is all about the right amount of insulin at the right time and also the best method of getting insulin into your system.
These include:
1. Rapid-acting insulin
It begins its action in 15 minutes, reaches peak in 30–60 minutes, lasts for 3 to 4 hours and is usually taken just before a meal.
Example: insulin aspart (NovoLog, NovoRapid, FlexPen, Fiasp), insulin glulisine (Apidra) and insulin lispro (Humalog)
2. Short-acting insulin
It begins its action in about 30 to 60 minutes after it has been injected, reaches peak in 2–3 hours, lasts between 5 to 8 hours and taken before meals.
Example: regular insulin (Humulin and Novolin)
3. Intermediate-acting insulin
It begins its action in about 1 to 2 hours after injecting it , reaches peak at 4–10 hours and it lasts for 14 to 16 hours.
Example: Insulin Isophane (humulin N, Novolin N)
4. Long acting-insulin
Starts its action 2 hours after injecting and works upto 24 hours or more. It is a peakless insulin.
Example: insulin degludec (Tresiba), insulin detemir (Levemir), insulin glargine (Lantus and Toujeo)
5. Combination insulin
Also known as premixed insulin combines two different kinds of insulin. The first kind is long acting insulin that helps the body control blood sugar levels all through the day. The second kind is rapid acting or short acting insulin that controls post meal blood sugar levels.
Examples: Novolog mix 70/30, Humalog Mix 75/25 and 50/50, Humulin 70/30, Novolin 70/30, Ryzodeg
For the insulin to work properly, it is important that you’re storing and injecting it in a proper manner. Read our blog on “Are you injecting insulin the right way? Read on to know!“ for more information.
Sometimes with insulin, some other injectable drug is given to type 1 and type 2 patients which is called Amylinomimetic drug. Continue reading to know about it…
Amylinomimetic drug
Amylinomimetic drugs are injectable and Pramlintide (Symlin, Symlin Pen) is an example of this class.
When insulin is produced by the pancreas, the amylin hormone is also produced along with it. Amylin helps in managing blood sugar levels. Research has shown that when insulin is not made, even the amylin hormone is also not produced. This drug helps to manage that gap.
Benefits:
- It works by delaying the time the stomach contents are emptied.
- Its main action is to manage the post-meal sugar levels.
- It helps in managing weight by reducing appetite.
Though used separately and not mixed with insulin, it can be used along with insulin and is currently available as an injectable pen.
It can be taken with all meals and snacks but there is a method of taking it as one might not be able to take 5 injections in a single day with each meal and snack time.
Blood sugar levels on a higher side for a long time tends to harm other body organs when they’re not managed well. So, we need to take care of the other organs as well which requires lifestyle modification and medications. Here is something that can be planned…
Other medicines for diabetes
People with diabetes are at an increased risk of developing heart conditions, medicines for high blood pressure, high cholesterol and also aspirin is used to prevent the occurrence of conditions and at the same time to manage the overall health of the diabetics.
- Certain cholesterol medicines like bile acid sequestrants help to maintain steady sugar levels.
- Anti-hypertensive medications like ACE inhibitors or angiotensin II receptor blockers help to stop or manage kidney complications of diabetes.
- In the case of obesity along with diabetes, lifestyle modifications are the most prefered choice. But in some cases even when that along with changes in the diet does not seem to work, doctors suggest the following medicines as well:
- Lorcaserin increases the feeling of being full after a meal and helps to manage obesity.
- Orlistat reduces the fat absorption from the diet and also helps in weight loss.
- Phentermine and topiramate is a combination medicine that helps to reduce appetite and in turn lose weight.
Things to take care of while taking medicines for diabetes
While taking drugs for diabetes sometimes things might seem to go out of control. It is always advised to take medicines or insulin as prescribed by your Doctor to manage blood sugar levels under normal limits. Take care of the following events:
1. Hypoglycemia
One of the most common side effects of diabetic medicines. This happens when the blood sugar level drops below the target range.
Blood sugar levels can drop for many reasons which include skipping or delaying a meal, eating fewer carbohydrates than usual, more physical activity than normal or injecting too much insulin.
Some signs and symptoms of diabetes include sweating, shaking, hunger, dizziness, fatigue, headaches, blurred vision. If you experience a hypoglycemic episode at night you might notice sweat-soaked clothes or even a headache.
Due to a natural rebound effect, a nighttime hypoglycemic episode sometimes leads to an unusually high fasting blood sugar reading in the morning, also known as Somogyi effect.
In case you have a hypoglycemia episode try these following steps to help bring sugar level to control:
- Measure your blood sugar level immediately.
- As low blood sugars need instant treatment, mix 1 tbsp (15 grams) glucose powder in 1 glass of water and drink. You can also have fruit if the symptoms are mild.
- Wait for 15 minutes and measure your sugars again.
- If the blood sugars are still low then repeat the 2nd and 3rd points. And if blood sugars are above 100 mg/ dL that means you are out of hypoglycemia.
In case you do not have a glucometer with you, treat the symptoms first, stabilize yourself and then go to a nearby clinic or hospital to check your sugar levels.
If this is not treated at the right time you might become unconscious and you might need an immediate injection of glucagon.
2. Hypoglycemia unawareness
Another effect of medicines relating to hypoglycemia is hypoglycemia unawareness where some people can lose the ability to sense that their blood sugar levels are low.
The body does not react to a low blood sugar level with symptoms anymore. The more you experience a low blood sugar level, the chances are more that you will develop hypoglycemia unawareness.
Increasing your blood sugar target range can help at least temporarily improve hypoglycemia awareness.
3. Hyperglycemia
Blood sugar can rise due to many reasons which include eating too much, eating the wrong types of foods, not taking enough insulin or fighting an illness.
Some symptoms are frequent urination, increased thirst, blurred vision, fatigue, hunger and difficulty in concentration.
High sugar levels do not come up as quickly as they rise up. If your sugar level is continuously high then do seek immediate medical guidance from your doctor or do go to the nearby hospital.
4. Diabetic ketoacidosis
It is a life-threatening emergency. When the cells are deprived of energy, the body begins to break down fat, producing toxic acids known as ketones.
Weight loss, nausea, vomiting, abdominal pain, fruity smell of breath etc are some symptoms.
If your ketone level is high on testing, contact your doctor right away or get immediate medical help. Read our blog on diabetic ketoacidosis to learn more.
When to consult a doctor
In the case of diabetes, a routine consultation with your treating doctor plays a vital role in managing your sugar levels.
This means that your doctor on regular consults will suggest regular testing of your overall health by suggesting blood tests. This will help to analyse the current status of the organ functioning in your body.
A consult every 2 to 3 months at least is most beneficial as your doctor might make changes in your treatment plan or your diet and even your exercise regime.
Even if you do not have any symptoms or problems or your sugar levels are in control and you are doing perfectly well do consult your doctor once as he might even reduce the dosage of medicine if all is looking good.
Again a timely consultation also helps to prevent future complications. In the case of recurrent hypoglycemic episodes or consistent high sugar levels there might be a need for the doctor to change a medicine if required or titrate the Insulin units or even make changes in your diet.
But in cases as mentioned earlier like unconsciousness, ketones observed do make sure you contact your doctor right away.
By now though I am sure you have understood the basics of diabetic medicines, their mode of action and also their side effects, this is an overwhelming amount of information. But in every disease condition it is always better to understand what suits you better as not everything might work for you as it might work for another diabetic.
Diabetes does not only need medicines but multiple factors play a role in managing this disease. Identify which part of your lifestyle affects diabetes the most, make changes accordingly and at the same time make sure you are on medicines as well.
Because diabetes is so common the research keeps going on. Always read up about the latest developments in medicine as well so that you are fully aware and also are prepared in case your doctor suggests a new medicine to manage your sugar levels better.
In case you’re searching for diabetes treatment, Zyla health is here at your service. Zyla provides care to treat your high blood sugar levels, it’s complications and its effect on other body organs.
Zyla’s Doctors, nutritionists, physiotherapists and psychologists guide you through personalised health, exercise plan and scheduled calls. You can download Zyla app and sign up for a 24*7 chat support system.
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