Classes of Oral Diabetes Medications – And How They Work
Oral diabetes medications are not initially needed for every patient
with diabetes mellitus type 2. Many people find they can control their
type 2 diabetes by controlling their diet, getting more exercise and
maintaining a healthy weight.
"But over time, most people with type 2 diabetes will need to take a
medicine, too. Many also have heart disease, high blood pressure,
and/or elevated cholesterol, and will need to take medicines for these
conditions along with a diabetes drug. "(1)
Oral diabetes medications are useful tools that can help a person
with diabetes better manage blood sugar levels along with a good diet
and exercise plan.
One common misconception is that oral diabetes drugs
are insulin or insulin therapy. Insulin, however, cannot be taken orally
because the enzymes of your digestive track would destroy it. Oral
medications work to control blood sugar levels but are not insulin.
Classes of oral diabetes medications
There are six distinct classes of oral diabetes medications which include:
- Alpha-glucosidase inhibitors, this class uses the drug
names acarbose (Precose) and miglitol (Glyset). It works by slowing
down the digestion of certain carbohydrates in the intestines and is
taken with the first bite of food at a meal.
- Biguanides use the drug name metformin (Glucophage, Glucophage XR,
Riomet [liquid formulation]). It works by decreasing production of
glucose by the liver and improving insulin sensitivity in the liver,
muscles and fat cells. It is taken with food to lessen the side effects.
- D-Phenylalanine derivatives use the drug name nateglinide (Starlix)
and work by stimulating the pancreas to release more insulin. This class
of oral diabetes medications is taken 1 to 30 minutes before a meal.
- Meglitinides, which use the drug name repaglinide (Prandin) aids the
diabetic by stimulating the pancreas to release more insulin. This
medication is taken 15 minutes before a meal.
- Sulfonylureas, is a class that uses the drug name chlorpropamide
(Diabinese), glyburide (Diabeta, Glynase, Micronase), glipizide
(Glucotrol), glipizide extended-release (Glucotrol XL), or glimepiride
(Amaryl). It works by stimulating the pancreas to release more insulin
and is taken with food or before a meal.
- Thiazolidinediones, uses the drug name pioglitazone (Actos) or
rosiglitozone (Avandia) and works by improving insulin sensitivity and
decreasing production of glucose in the liver. It is taken with or
- Combination products, go by the names Avandamet (rosiglitazone and
metformin), Glucovance (glyburide and metformin) or Metaglip (glipizide
and metformin). They work by combining the affects of the individual
medications and can be taken as directed.
Each of the classes of oral diabetes medications has a different
mechanism of action to help the diabetic patient control their blood
glucose levels. A diabetic will usually begin by taking one oral
diabetes medication along with making healthy lifestyle changes.
The results will be monitored and future treatment will be based on those results.
(1) Consumer Reports (2009). Treating type 2 diabetes: the oral diabetes drugs. Retrieved from http://www.consumerreports.org/health/resources/pdf/best-buy-drugs/Diabetes-2pager-March2009.pdf
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