Type 2 Diabetes Medications

There are three overall types of medications for diabetes mellitus: insulin sensitizers, those that increase insulin production, and others.

The medications that are commonly used to treat diabetes mellitus can be generally categorized into categories based on their mechanism of action, if known. Understanding the way diabetes mellitus develops can help patients understand how these medications work. The drugs that improve insulin resistance will improve the body's sensitivity to the insulin it produces or the the insulin a patient is injecting. These medications tend to take longer to start working, on average 2-3 months before their full effect is seen. On the other hand, the medications that increase the amount of insulin in the body work rather quickly. Finally there are medications that work by unclear mechanisms to reduce serum blood sugars. There are numerous advantages and disadvantages to each type of medication. Let the endocrinologists at Houston Thyroid and Endocrine will help a patient decide which medication regimen will work best for their lifestyle and blood sugar control.

Drugs that improve insulin sensitizers and reduce insulin resistance

Biguanides: (Metformin):These pills improve the body's ability to use insulin at the level of the muscle and liver. They also reduce sugar production from the liver.

Thiazolidinediones (Pioglitazone, Rosiglitazone): These pills reduce insulin resistance at the level of the muscle, liver, fat, and pancreas.

GLP-1 analogs (Liraglutide, Exenatide, Bydureon, Trulicity) : these medications dramatically increase the activity at the GLP-1 receptor

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Drugs that increase insulin levels

Meglitinides and sulonylureas: These medications help the beta cells in the pancrease release insulin, resulting in lower blood sugar.

And of course, there is taking insulin itself which directly increases circulating insulin levels

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Drugs that work by other mechanisms

Alpha-glucosidase inhibitors. Acarbose (Precose®):

These medications prevent absorption of sugars from the gut by inhibiting the enzymes that allow absorption of carbohydrates called glycoside hydrolases.

Colesevelam (Welchol®):

This is a cholesterol lowering medication that also reduces blood sugar through an unknown mechanism

Bromocriptine (Cycloset®):

This drug reduces blood sugars via a neural mechanism.

SGLT 2 inhibitors

The first drug in this class is Canagliflozin (Invokana®). Others are Farixga and Jardiance. These medications cause more sugar to be urinated out of the body without a significant loss of water.