Metabolic Health

Type 2 diabetes: Which medications are best?

Reviewed by

Shifa Fathima

Best Medications for Type 2 Diabetes?

Diabetes is a chronic disease that leads to high levels of sugar in an individual’s bloodstream. The condition happens because the cells of the subject are resistant to insulin, and the pancreas releases unhealthy doses of sugar into the blood. Persons with insulin resistance have been classified as having Type 1 and Type 2 diabetes depending on the severity of their condition and the amount of blood sugar detected in their system. The third classification of ‘prediabetes’ that has become the focus of the medical fraternity identifies people who are borderline cases and can manage their lifestyle for a possible reversal of their condition. 

People with Type 2 diabetes are the worst affected by this chronic condition and usually need medication to regulate the blood glucose levels in their bodies. Type 2 diabetes has been conventionally associated with individuals in the age group of 45 and above. Lifestyle choices have resulted in children and young adults being diagnosed with this ailment, initiating them into medication early. It is, therefore, essential to understand what is the best medicine for Type 2 diabetes. The medication for Type 2 diabetes is exhaustive, and new-age drugs have brought better results and new side effects. It is always better to know what medicine suits your condition. 

What is Type 2 Diabetes?

Type 2 diabetes, more common than Type 1 diabetes, is a lifestyle disease. It affects the body’s ability to utilise glucose or sugar, its primary fuel sources derived from food. Type 2 diabetes affects insulin production and impairs its ability to help sugar from the carbohydrates reach and energise the body’s cells. 

After a person consumes food, it is further broken down during the digestive process. Carbohydrates become simple sugars, mainly glucose that fuels up the body’s cells. It is insulin’s job to help glucose move from the bloodstream to the cells. When insulin functioning is hampered and cannot get the fuel to reach the cells (insulin resistance), there is more sugar in a person’s blood. This happens simply because the cells are unable to use it. Over some time, high blood glucose levels cause damage to vital organs.

Management of Type 2 diabetes involves bringing blood sugar levels within the normal range. This can be done with diet, exercise, medication, or a combination of these. Diet and exercise might work in some individuals, while others may need medication and even insulin.

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Diabetes Medications Effectively Lower Blood Sugar

There are several medicines for Type 2 diabetes available in the market. Different medicines tackle the problem of high blood sugar in different ways. Most medications are designed to lower A1C (3-month average of blood sugar) and decrease it to under 7%. The most commonly used drugs as first-line medication regulate blood sugar levels by slowing down the sugar release in the bloodstream and its absorption. Medicines for Type 2 diabetes, such as Metformin are designed around this approach and are prescribed to individuals who have been freshly diagnosed with diabetes. The other approach by drugs designed to regulate blood glucose levels have been listed below: 

  • Some drugs stimulate the pancreas to increase the production of insulin. They are prescribed when your pancreas can’t synthesise enough insulin or the autoimmune system destroys the insulin-producing cells, such as in Type 1 diabetes. 
  • Some drugs prevent the production and release of glucose from the liver. This lowers the overall blood glucose offering relief to patients. 
  • Some drugs help block stomach enzymes that break down the carbohydrates into sugar for absorption into the bloodstream. 
  • Since persons with Type 2 Diabetes are insulin resistant, there are drugs in the market that can help improve the sensitivity of cells to insulin. This allows the body to absorb blood glucose for its energy requirements. 
  • When Type 2 diabetes progresses with age, your doctor can administer insulin to you externally. 

Always ask your medical practitioner how medicine works and the pros and cons of the salt or a combination of salts that you are being administered. In case the efficacy of your medication has waned or stopped working, you must update your doctor so he can change the oral medicines or dosage.

Newer Diabetes Medications: Weighing Risks vs Benefits

With advances in science and newer research, several newer drugs are now available. These drugs work well to lower blood glucose levels and protect the heart and kidneys. If your doctor advises one of the newer medications, it can be good to weigh the benefits against conventional drugs. The latest treatment options include glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 (SGLT2) inhibitors.

With advances in science and newer research, several newer drugs are now available. These drugs work well to lower blood glucose levels and protect the heart and kidneys. If your doctor advises one of the newer medications, it can be good to weigh the benefits against conventional drugs. The latest treatment options include glucagon-like peptide-1 (GLP-1) receptor agonists and sodium-glucose cotransporter-2 (SGLT2) inhibitors.

1. Glucagon-like Peptide-1 Receptor Agonists (GLP-1 Receptor Agonists)

GLP-1 receptor agonists are insulin’s friends. They help the hormone work more efficiently to bring down blood sugar levels after eating. Barring one, all of these drugs are self-injected under the skin. These can be administered either daily or once a week. Drugs like liraglutide, semaglutide and dulaglutide have also been shown to reduce the risk of heart disease and promote weight loss. Your doctor will be better able to decide if you need the drugs since these may cause side effects like nausea, vomiting, and in rare cases, pancreatitis.

2. Sodium-Glucose Cotransporter-2 Inhibitors (SGLT-2 Inhibitors)

The newest medication on the block, this class of drugs works by blocking the reabsorption of sugar back into the body by the kidneys. SGLT-2 inhibitors help the body get rid of glucose via urine. Medicines in this category include dapagliflozin, ertugliflozin, canagliflozin and empagliflozin. These drugs protect your cardiovascular health. There is evidence that this category of drugs benefits kidneys as it decreases the progression of chronic kidney disease. These have also been shown to aid weight loss and reduce blood pressure. A common side-effect is genital yeast infections, particularly in women.

Bottomline

Type 2 diabetes occurs when the body cannot use up glucose or sugar, its primary fuel sources after these are broken down from carbohydrates present in food. Type 2 diabetes impairs insulin production. While Metformin is traditionally used to treat Type 2 diabetes, newer drugs available in the market help manage blood sugar levels and protect the heart and kidneys. Please inform your doctor about your medical history and other conditions to help them choose the best drug for you.

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