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January 7, 2021
4 min. read

Diabetes Treatment: Top Medications for Type 2 Diabetes

Medly

Diabetes is a chronic health condition that affects the way your body processes blood sugar, or glucose, which is an important source of fuel for your body. In those living with diabetes, your body resists the effects of insulin, a hormone that regulates the movement of sugar into your cells, or the body doesn’t produce enough insulin to maintain normal glucose levels.

Patients experience symptoms including increased thirst, frequent urination, hunger, fatigue, and blurred vision. While there is no cure for diabetes, treatment to help manage the disease usually includes a combination of diet, exercise, insulin therapy, and medications. Below, we discuss treatment options for those living with type 1 and 2 diabetes.

Flow Chart of Diabetes Therapy as per the American Diabetes Association Guidelines:

Diet

Eating nutritious, low-fat, and high-fiber foods can help keep blood sugar levels stable and reduce the risk of complications. Remember to consult a dietician for specific recommendations as every individual’s needs vary. Foods they may ask you to focus on include fruits, vegetables, and whole grains, while avoiding animal products and refined carbohydrates like white bread and sweets.

Counting carbohydrates is one way you can manage your blood sugar levels. On average, people living with diabetes should get about 45% of their calories from carbs. A carb serving is measured as 15 grams per serving. That means most women need 3 to 4 carb servings (45–60 grams) per meal, while most men need about 4 to 5 carb servings (60–75 grams).

Exercise

It is recommended to get 150 minutes of aerobic exercise per week, which breaks down to at least 20 mins per day. Before starting any exercises you will want to keep track of your glucose levels and monitor how you feel as physical activity impacts your blood sugar levels. Always speak to your healthcare team to see which exercise and regimens would work best for you.

Diabetes medications

Along with diet, exercise and other lifestyle changes, metformin is the first line of treatment for those living with diabetes. However, you may be prescribed additional medications to manage your diabetes depending on the severity of your condition.

Metformin

Metformin works by decreasing glucose production in the liver, lowering insulin resistance, and by helping the intestines to absorb less glucose from food. It can decrease A1c levels, an average measure of your blood sugar levels over the past 3 months, by 1% to 2% and fasting glucose levels by an average of 25%.

Metformin is usually well tolerated by patients, though you may experience symptoms of abdominal cramping, diarrhea, and flatulence when first beginning the therapy.

Glipizide

Glipizide belongs to the sulfonylurea class of medications. Other drugs in this class include glimepiride and glyburide. A sulfonylurea is usually prescribed after an initial three month period of treatment with metformin, if a patient’s A1c levels are still above individualized target.

Sulfonylureas work by stimulating insulin secretion from the beta cells in the pancreas, which then promotes sugar uptake from the bloodstream and thus causing a decrease in blood glucose after eating.

A major risk for this class of medications is hypoglycemia, and therefore its use should be monitored carefully and to avoid using any other drugs that may cause hypoglycemia. Glipizide has been shown to reduce A1c levels by 1% to 2%, and usually works best if taken 30 minutes before eating.

SGLT-2 inhibitor drugs

Medicines in the SGLT2 inhibitor class include canagliflozin, dapagliflozin, and empagliflozin. These drugs work on the kidneys and work by blocking glucose from being reabsorbed back into the body. These medications have cardiovascular benefits but do have a few side effects that you can discuss with your healthcare team before initiating this therapy.

diabetes treatment

Insulin therapy

If your body can’t make enough insulin, insulin therapy can help keep your blood sugar levels within an acceptable range. Insulin therapy is categorized as fast acting insulin, intermediate acting insulin, or long acting insulin.

Fast-acting insulin is absorbed quickly from your fat tissue (under the skin) into the bloodstream and usually timed with your meals. Intermediate-acting insulin is absorbed more slowly and usually lasts a few hours, usually used to control blood sugar overnight, while fasting and in between meals.

Long acting insulin is absorbed slowly and usually lasts most of the day, it is used to control blood sugar overnight, while fasting and between meals. There are a variety of different types of insulin, and your treatment plan may require a mix of different insulin types to use throughout the day and night.

You will want to discuss with your doctor the best way to administer your insulin therapy, whether by injection or by using a pump.

Other medications

Many individuals living with diabetes are at an increased risk to develop microvascular and macrovascular complications such as coronary artery disease, stroke, nephropathy, etc.

Thus, your doctor may write additional prescriptions such as blood pressure medication, aspirin, or cholesterol-lowering drugs in order to reduce complications and manage your other symptoms. Furthermore, it is important that follow-up care with all providers are scheduled and maintained as they ensure best possible outcomes.

Of the more than 34 million Americans living with diabetes, approximately 90-95% of them have type 2 diabetes. While it most often develops in people over age 45, more and more Americans are getting diagnosed as children, teens, and young adults. Consistent medication adherence and lifestyle management are both important parts of treating for diabetes.

If you have questions about your medications or lifestyle changes, contact one of our expert pharmacists at Medly today.

Sources Mayo Clinic Pharmacy Times CDC

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