Blood sugar control is essential to the prevention of the many harmful side effects of diabetes.
Options available for controlling diabetes range from nonpharmacologic therapy, diabetes pills, insulin injections, to inhalant medications.
TZDs, marketed as Avandia, Rezulin and Actos, alter fat tissues to produce an insulin-sensitizing effect. Of the three, Actos is the only less restricted TZD for use by the majority of type 2 diabetics. Avandia is strictly regulated due to its cardiovascular risks while Rezulin has been discontinued due to link to liver failure. Takeda Pharmaceutical is facing escalating Actos lawsuits due to the link between Actos and bladder cancer.
Nonpharmacologic therapy or treatment that is non-diabetes drug dependent, include regular exercise, dietary and lifestyle modifications, and weight loss. Nonpharmacologic therapy, if practiced with consistency, can reduce diabetes complications by 58 percent. For the older population (60 years and up), it can effect a 71 percent reduction in the development of type 2 diabetes. Nonpharmacologic therapy is the most cost-effective approach to diabetes control.
Injectable insulin is a hormone use to replace or supplement the insulin naturally produced by the body. At the most, type 1 diabetics utilize injectable insulin. Type 2 diabetics use this hormone when oral medications alone fail to lower blood sugar. Injectable insulin works by transporting sugar from the blood into other body parts where it should be stored for energy. It also prevents the liver from producing more sugar. The types of injectable insulin available in the U.S. market only differ in speed and length of efficacy.
Diabetes pills help lower blood glucose by either triggering the pancreas to increase insulin production or helping the body to utilize the insulin it produces properly. There are at least five leading types of diabetes pill namely alpha-glucosidase inhibitors, biguanides, meglitinides, sulfonylureas (SUs), and thiazolidinediones (TZDs).
Alpha-glucosidase inhibitors delay the body’s natural reaction of emitting glucose rapidly in the presence of high glycemic food like bread, pasta, potatoes and some sugars. Marketed as Precose and Glyset, alpha-glucosidase inhibitors should be taken at mealtime. Known side effects of the drug include diarrhea and other gas and intestinal discomfort like belching, bloating, or flatulence.
Biguanides are popularly known as metformin. It decreases glucose production in the liver while creating an insulin-sensitizing effect to fat, liver, and muscle cells. Metformin should be taken twice daily. Its most serious side effect is lactic acidosis. Metformin is also known to cause diarrhea, bloating, and heartburn. Common side effects diminish if the drug is taken consistently before a meal.
With brand names Starlix and Prandin, meglitinides stimulate the beta cells to produce more insulin with effects that can be likened to that of injectable insulin. Meglitinides should be taken three times daily before each of the three main meals. It can cause hypoglycemia due to hastened release of insulin from the pancreas. Users are advised to bring with them candies, glucose tablets, or orange juice.
The SUs available in the U.S. market today are the advanced version of the diabetes drugs introduced in the 1950s. Like meglitinides, SUs hasten the production of insulin in the pancreas and can also cause hypoglycemia. It is usually taken twice daily with meals. When taken with other diabetes drugs, careful monitoring for possible side effects is advised. SUs interact differently with different diabetes drugs.
Inhalant medications are marketed as handy, fast-acting drug for type 1 and type 2 diabetes. They aim to replace the slow-acting injectable insulin. However, the drug Exubera, the first of its kind, was discontinued in 2007 due to poor sales. As of December 2011, MannKind’s version of the drugs is already on its third phase of clinical trial.
Blood sugar control can be very well attained either through lifestyle modifications or diabetes drugs or combination of both. As with any medications, it is essential that diabetics follow prescribed doses consistently and report any observed or experienced side effects to their health care provider immediately.
