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Medication

The pills used to treat type 2 diabetes are not insulin. Instead, they work with insulin to help control blood glucose. This is why they don't work for people who have type 1 diabetes.

There are several different groups of pills for Type 2 diabetes. Each group can control blood glucose in a different way. Most pills have at least two names. One is the scientific name (generic) and the other is the name given to it by the company who makes it (known as brand name). This site has used the generic names.

The main groups are as follows:

Sulphonylureas

These are the most commonly prescribed diabetes tablets and work by helping the pancreas produce more insulin. They also help insulin to work more effectively. Tablets in this group include: Gliclazide, Glibenclamide, Chloropropamide, Tolbutamide, Glimepiride. Their main side effects is hypoglycaemia (low blood glucose) and some may encourage weight gain.

Biguanides

This group of tablets are often used as the first line of treatment, especially for people who are overweight. This is because they do not encourage weight gain. Biguanides work by helping to stop the liver producing new glucose and helps insulin carry glucose into muscle and fat cells more effectively. They don't raise insulin levels so there is little risk for lows (hypoglycaemia) when the pills are taken alone. Their side effects include: stomach upsets and nausea which may be lessened by taking Biguanides with food. The main tablet in this group is Metformin.

Alpha-glucosidase inhibitor

This is usually given as an add-on treatment with Biguanides or Sulphonylureas. It works by delaying the absorption of starchy food from the intestine and so slowing down the rise in blood glucose after meals. The only pill in this group is Acarbose. Acarbose should always be chewed with the first mouthful of food or swallowed whole with a little liquid immediately before food. Its side effects can include an upset stomach and wind.

Thiazolidinediones (Glitazones)

These pills help overcome insulin resistance, allowing the body to use its own natural insulin more effectively. As Glitazones lower the need for insulin there is little risk of lows (hypoglycaemia) when these pills are taken alone. Pills in this group include Rosiglitazone and Pioglitazone.

Repaglinide

This is a new type of tablet - brand name Novonorm. It works by increasing the amount of insulin produced during a meal. It is similar to Sulphonylureas, but unlike Sulphonylureas, it is taken with each meal and encourages the body to produce exactly the right amount of insulin.

Combination of drugs

When a single diabetes pill is not able to lower blood glucose well enough, a combination of drugs can be used to work on several causes of high blood glucose at the same time. For some people even this will not be enough and they will need to take insulin injections. Diabetes is a progressive condition and more then one type of treatment is likely to be needed during the lifetime of a diabetic patient. This does not always mean that the patient is doing anything wrong but that the body needs more help over time, to keep control and complications at bay.

IMPORTANT

Which choice of medicine or combination of medicines is best for you can only be decided by a physician.


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