A Quick Overview Of Oral Medications
For type 1 diabetes
With type 1 diabetes, you need to take insulin your whole life, since your body won’t produce any. It must be administered through injections or using a pump. If you’re wondering why no one has invented an insulin pill yet, that’s because stomach enzymes would make short work of it.
In addition to insulin therapy, managing type 1 diabetes also requires exercising, eating a proper diet and monitoring blood glucose. Some oral medicines are sometimes prescribed to complement this. These include the following:
Blood pressure medications are useful to preserve kidney health, especially if there is a risk of diabetic nephropathy. These medications are recommended for people whose blood pressure exceeds 130/80 mmHg.
Aspirin is sometimes recommended for daily use to prevent heart problems.
Cholesterol-lowering medications reduce cholesterol and are often used preventively, since diabetes increases the risk of heart disease.
Note that these medications are also used to manage other types of diabetes.
For type 2 diabetes
With type 2 diabetes, your body still produces insulin but is unable to use it properly. The basic way to manage the disease is through better lifestyle habits: eating better, exercising, quitting smoking and losing weight. That being said, oral medications may become necessary given the progressive nature of diabetes.
There are several types of oral antidiabetics, and they sometimes need to be combined to achieve the desired results. Here are the main ones:
Biguanides enhance the body’s sensitivity to insulin so it can be used more efficiently while decreasing the production of glucose by the liver. Nausea and diarrhea are common, but usually temporary, side effects.
Sulfonylureas stimulate the production of insulin by the pancreas. They can cause hypoglycemia and weight gain.
Meglitinides increase the production of insulin by the pancreas, but are short-acting. The risk of hypoglycemia is lower than with sulfonylureas, and some weight gain is common.
Thiazolidinediones, like biguanides, enhance insulin sensitivity and decrease glucose production by the liver. They aren’t used as a first-line treatment because of their potentially severe side effects (heart failure, fractures, etc.).
DPP-4 inhibitors help regulate glucose levels without causing hypoglycemia, but have a modest effect. Unlike other medications, they do not cause weight gain.
GLP-1 analogs slow down digestion by replicating the effect of intestinal hormones that play a role in controlling blood glucose levels. They are often used in combination with other medications, can cause hypoglycemia and nausea, and increase the risk of pancreatitis.
SGLT2 inhibitors are relative newcomers to the field of diabetes treatment. These medications prevent the kidneys from storing glucose so that it is instead excreted through urine. Low blood pressure, yeast/urinary infections and a more frequent need to urinate are common side effects.
Alpha-glucosidase inhibitors slow down the digestion of carbs in the intestine and help synthesize them. They have very few side effects, most of which are gastrointestinal in nature (gas, bloating, etc.) and usually vanish after some time.
Note – The material presented here is for informational purposes only and does not replace your physician’s advice. You may be prescribed other medications depending on your situation.
American Diabetes Association, “New Medications for People With Type 1?”: http://www.diabetesforecast.org/2013/sep/new-medications-for-people-with-type-1.html?referrer=https://www.google.ca/. Accessed February 1, 2017.
Canadian Diabetes Association, “2013 Clinical Practice Guidelines Quick Reference Guide”: http://guidelines.diabetes.ca/CDACPG_resources/CPG_Quick_Reference_Guide_WEB.pdf. Accessed February 1, 2017.
Diabetes Québec, “Antidiabetic Medications”: http://www.diabete.qc.ca/en/living-with-diabetes/care-and-treatment/drugs-and-insulin/antidiabetic-medications. Accessed February 1, 2017.
Mayo Clinic, “Type 1 diabetes”: https://www.mayoclinic.org/diseases-conditions/type-1-diabetes/basics/treatment/con-20019573. Accessed February 1, 2017.
Mayo Clinic, “Type 2 diabetes”: https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/treatment/txc-20169988. Accessed February 1, 2017.