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I apologize for offering the following long list of medications for type 2 diabetes. I’ve lived with diabetes for many years now, not always comfortably, like when I was using Metformin (Fortamet, Glucophage and others). But I rode it out, and now I am a user of direct injections of insulin. It seemingly has no effect on my skiing or other activities (the bad back is my chief nemesis these days, but I’m in therapy for it).
I subscribe to a variety of medical publications, including the Mayo Clinic staff report, and I try to find things of interest to the senior community. The following from Mayo is detailed and lengthy, but it gives seniors some idea of what is available for type 2 diabetes treatment.
I have edited it slightly. No facts have been changed. For type 2 patients, it gives them a chance to be informed when talking to doctors. And I’ve got a long piece coming up about sleeplessness that should open some eyes (or help close them).
Healthy lifestyle choices — including diet, exercise and weight control — provide the foundation for managing type 2 diabetes. However, you may need medications to achieve target blood sugar (glucose) levels.
The list of medications for type 2 diabetes is long and potentially confusing. Learning about these drugs — how they’re taken, what they do and what side effects they may cause — will help you discuss treatment options with your doctor.
Several classes of type 2 diabetes medicines exist. Each works in different ways to lower blood sugar.
A drug may work by stimulating the pancreas to produce and release more insulin; inhibiting the production and release of glucose from the liver; blocking the action of stomach enzymes that break down carbohydrates; improving the sensitivity of cells to insulin; inhibiting the reabsorption of glucose in the kidneys.
Here’s an at-a-glance comparison of common diabetes medications. Obviously, ask your doctor about your options.
Oral medications
Meglitinides
Medications — Repaglinide (Prandin); Nateglinide (Starlix)
Advantages — Works quickly
Possible side effects — Low blood sugar (hypoglycemia); weight gain; nausea or vomiting; headache
Sulfonylureas
Medications — Glipizide (Glucotrol); Glimepiride (Amaryl); Glyburide (DiaBeta, Glynase)
Advantages — Works quickly
Possible side effects — Hypoglycemia
Dipeptidyl-peptidase 4 (DPP-4) inhibitors
Medications — Saxagliptin (Onglyza); Sitagliptin (Januvia); Linagliptin (Tradjenta)
Advantages — Does not cause weight gain
Possible side effects — Upper respiratory tract infection; sore throat; headache;
Biguanides
Medications — Metformin (Fortamet, Glucophage, others)
Advantages — May promote modest weight loss and modest decline in low-density lipoprotein (LDL), or “bad” cholesterol
Possible side effects — Nausea; diarrhea; Very rarely, the harmful buildup of lactic acid (lactic acidosis) when used in patients with kidney failure
Thiazolidinediones
Medications — Rosiglitazone (Avandia); Pioglitazone (Actos)
Advantages — May slightly increase high-density lipoprotein (HDL), or “good” cholesterol
Possible side effects — Heart failure; heart attack; fractures; increased risk of bladder cancer with pioglitazone. These medications shouldn’t be used in people with kidney disease or heart problems.
Alpha-glucosidase inhibitors
Medications — Acarbose (Precose); Miglitol (Glyset)
Advantages — Does not cause weight gain
Possible side effects — Stomach pain; gas; diarrhea
Sodium-glucose transporter 2 (SGLT2) inhibitors
Medications — Canagliflozin (Invokana); Dapagliflozin (Farxiga); Empagliflozin (Jardiance)
Advantages — May promote weight loss and lower blood pressure
Possible side effects — Urinary tract infections; yeast infections
Injectable medications
Amylin mimetics
Medications — Pramlintide (Symlin)
Advantages — May suppress hunger; may promote modest weight loss
Possible side effects — Hypoglycemia; nausea or vomiting; headache; stomach pain
Incretin mimetics
Medications — Exenatide (Byetta); Exenatide extended release (Bydureon); Liraglutide (Victoza)
Advantages — May suppress hunger; may promote modest weight loss; one injection weekly for extended release
Possible side effects — Nausea or vomiting; headache; dizziness; increased risk of inflamed pancreas (pancreatitis) and some thyroid tumors
For the full report go to: http://www.drugs.com/mca/diabetes-treatment- medications-for-type-2-diabetes
Sam Bauman writes about senior affairs, among other things, for the Nevada Appeal.
