Type 2 diabetes: Which medications are best?
Metabolic Health

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.

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.

List Of Best Medicines For Type 2 Diabetes

Other than metformin, people with type 2 diabetes can take these medicines after consulting their healthcare provider and getting them approved. Here are some type 2 diabetes medications that can be used for treatment:

Sulfonylureas

Your body will produce more insulin with the aid of sulfonylureas. Examples include glyburide (DiaBeta, Glynase), glipizide (Glucotrol) and glimepiride (Amaryl). Possible adverse effects include low blood sugar levels and increased body weight. 

Glinides

The pancreas is encouraged to produce more insulin as a result of glinides. When compared to sulfonylureas, they have a more rapid onset of action and their effects last for a shorter period of time in the body. Examples include repaglinide and nateglinide. Possible adverse effects include weight gain and low blood sugar. 

Thiazolidinediones

The tissues of the body become more receptive to insulin as a result of thiazolidinediones. Examples include rosiglitazone (Avandia) and pioglitazone (Actos). It can have possible side effects like the possibility of developing congestive heart failure, risk of bladder cancer (pioglitazone), increased potential for bone fractures, poor cholesterol management (rosiglitazone) and weight gain. 

DPP-4 inhibitors

These assist in lowering blood sugar levels, however their impact is often extremely little. Examples include linagliptin, sitagliptin, and saxagliptin (Januvia, Onglyza) (Tradjenta). Possible side effects include Pancreatitis risk, aching joints.

GLP-1 receptors

Injectable drugs known as GLP-1 receptor agonists assist in reducing blood sugar levels by slowing digestion. They are often used in conjunction with weight reduction, and some of them may lower the risk of heart attack and stroke. Exenatide (Byetta, Bydureon), liraglutide (Saxenda, Victoza), and semaglutide are among examples (Rybelsus, Ozempic). Possible side effects include risk of pancreatitis, nausea and vomiting. 

SGLT2 inhibitors

These interfere with the kidneys' ability to filter blood by preventing glucose from being released back into the circulation. Consequently, glucose is eliminated via the urine. In patients with a high risk of developing certain illnesses, these medications may lower the risk of heart attack and stroke. Canagliflozin (Invokana), dapagliflozin (Farxiga), and empagliflozin are among examples (Jardiance). Possible side effects include, possible amputation, weakened bones, possible gangrene, yeast infections in the vagina, UTIs, reduced blood pressure, high triglycerides

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.

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.

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Side effects of Diabetes Medications

The most common side effect of type 2 diabetes medication is low blood sugar. You may have tremors, sweating, dizziness, and confusion as a result of low blood sugar. Extremely low blood sugar levels or hypoglycemia might pose a hazard to one's life. Make sure you follow a regular schedule for meals and don't miss meals if you want to avoid this condition. You may also have an increase in weight, urine that is darker than usual, and stomach infections or aches as a side effect of type 2 diabetes medication. In addition to this, type 2 diabetes medication have been linked to skin rashes and photosensitive responses.

What Factors Does A Doctor Consider When Recommending A Treatment For Type 2 Diabetes?

Diabetes type 2 is a complicated and chronic health problem. In order to regulate your blood sugar levels and manage your condition successfully, you need to use a number of different risk-reduction techniques at the same time. Your physician will take into account the following considerations in order to arrive at the course of treatment that will be most beneficial to you:

  • a history of heart illness, which may include heart attacks, strokes, or congestive heart failure
  • the existence or absence of heart disease;
  • whether or not there is evidence of long-term renal dysfunction (CKD)
  • your current weight as well as the possibility that the treatment will have an effect on your weight
  • the price of the medication and whether or not your insurance will cover it
  • your personal preferences, and whether or not you believe you will be able to adhere to the treatment plan are all important factors to consider.
  • The results of your A1C test, which offer information about your average blood sugar levels over the previous three months, will also be taken into consideration by your doctor.

If there aren't any special reasons not to take it, metformin is often the first medicine that doctors would prescribe for type 2 diabetes patients. If necessary, your physician may also give you additional medicines to take in conjunction with the metformin they are giving you. In general, taking one medicine after another brings the individual's A1C level down by a set amount. Certain drugs are more successful than others and may lower A1C levels by up to 1.5 percentage points. Some people may only be able to bring it down by 0.5 to 0.8 percent.

The treatment aim for the vast majority of patients is to bring down their A1C to below 7 percent and your doctor will work with you to determine the appropriate A1C goal for you. If a person's A1C is more than 9 percent, the attending physician may suggest that they begin taking two drugs at the same time. Making changes to your lifestyle is a crucial component of the comprehensive treatment approach recommended by a physician for patients diagnosed with type 2 diabetes.

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.

FAQs

What Is The Most Effective Medication For Type 2 Diabetes?

In most cases, the first drug that is provided for type 2 diabetes is metformin (also known as Fortamet, Glumetza, etc). Metformin is highly effective as it reduces the amount of glucose that is produced by the liver and increases the body's sensitivity to insulin, which results in your body making better use of insulin.

What Medication Is Better Than Metformin?

Metformin for diabetes is the most recommended medication as it is highly effective in its treatment. Other than metformin, the most effective form of medication remains insulin injections. Effective tablets other than metformin are sulfonylureas, glinides and DPP-4 inhibitors. 

What Is The New Pill For Type 2 Diabetes?

Tirzepatide is the first pharmaceutical in a brand-new class for the treatment of diabetes. It acts as an agonist for the GLP-1 receptor in addition to being a glucose-dependent insulinotropic polypeptide (GIP). Both GLP-1 and GIP are examples of a class of hormones called incretins that are secreted by the intestines when food is consumed.

What Can I Take In Place Of Metformin?

While metformin is the best medication for type 2 diabetes, there are certain alternatives that can be taken in place of it. Before changing your medication or self medicating, make sure you run it by your doctor and get it approved. Avandia, Nesina (alogliptin), Tanzeum (albiglutide), Jardiance (empagliflozin), Invokana (canagliflozin), Farxiga (dapagliflozin) are all alternatives to metformin

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