By Beverleigh H Piepers
Beta cells of the pancreas are responsible for the secretion of insulin, the hormone that facilitates the transport of energy-producing glucose into the body's cells. In Type 2 diabetes, dysfunction of these insulin-producing cells combined with a decrease in the insulin response of individual cells, results in increased blood sugar levels. The progression of beta-cell dysfunction associated with increased insulin resistance, is the usual indication for the use of oral anti-diabetic medications. With effective oral anti-diabetic medication, hyperglycemia or high blood sugar levels can be corrected.
When are oral anti-diabetes medication indicated?
According to APC Diabetes Care Guideoral anti-diabetic medication should be initiated if:
* the fasting blood sugar level remains above 126mg/dL (7mmol/L), or
* the Hemoglobin A1c, (HbA1c), the average concentration within the red blood cells, remains above 7%
four to six weeks after appropriate lifestyle modifications, such as dietary changes and an increase in physical activity have been in effect.
What are the available oral anti-diabetic medications?
1. Insulin secretagogues a group of oral medications that stimulate the beta cells of the pancreas to secrete more insulin. They also decrease sugar production by the liver and enhance the burning of sugar into usable energy forms by individual muscle fibers. Insulin secretagogues can further be subdivided into subclasses:
* a) Sulfonylureas stimulate the secretion of insulin by the pancreas. The most common examples of this subgroup include tolbutamide, tolazamide, chloropropamide, glyburide, glypizide and glimeperide
* b) Nonsulfonylurea secretagogues are very useful in diabetics with irregular meal times because of its ability to bring about rapid stimulation of the pancreas to secrete insulin. The most common examples of this subgroup include repaglinide and nateglinide
2. Insulin sensitizers enhance the action of insulin in the body. This type of medications can further be divided into subgroups which may include:
* a) Biguanides. Metformin is the most known form of biguanides. It inhibits the production of sugar by the liver and at the same time, increases the sensitivity of the muscles and fat to insulin stimulation
* b) Thiazolidinediones (TZD) are a group of anti-diabetic medications that increase the insulin sensitivity of muscle fibers and fats.The most common examples of this group include the rosiglitazone (Avandia) and poiglitazone (Actos)
* c) Alpha-glucosidase inhibitors actively inhibits the absorption of carbohydrates in the intestines by blocking the enzyme that facilitates the absorption of carbohydrates. One of the most common problems associated with this kind of anti-diabetic medication is the development of abdominal problems such as cramps, bloatedness, flatulence and sometimes gross diarrhea. The most common examples of alpha-glucosidase inhibitor include acarbose and miglitol
* d) Dipeptidyl peptidase IV increases the secretion of insulin by inhibiting the enzymes that degrades incretin, a special hormone that trigger the secretion of insulin. The most known example of dipeptidyl peptidase IV inhibitors is sitagliptin
Although many people find they can bring their blood sugar back into the normal range by making changes to their eating plan, doctors often assume that dietary changes will not solve their Type 2 diabetic patient's blood sugar problems and prescribe one or more of the above drugs. These drugs have limited power to lower blood sugar levels back into the normal range. Dietary control is still needed to bring your blood sugar back to the normal range.
Beta cells of the pancreas are responsible for the secretion of insulin, the hormone that facilitates the transport of energy-producing glucose into the body's cells. In Type 2 diabetes, dysfunction of these insulin-producing cells combined with a decrease in the insulin response of individual cells, results in increased blood sugar levels. The progression of beta-cell dysfunction associated with increased insulin resistance, is the usual indication for the use of oral anti-diabetic medications. With effective oral anti-diabetic medication, hyperglycemia or high blood sugar levels can be corrected.
When are oral anti-diabetes medication indicated?
According to APC Diabetes Care Guideoral anti-diabetic medication should be initiated if:
* the fasting blood sugar level remains above 126mg/dL (7mmol/L), or
* the Hemoglobin A1c, (HbA1c), the average concentration within the red blood cells, remains above 7%
four to six weeks after appropriate lifestyle modifications, such as dietary changes and an increase in physical activity have been in effect.
What are the available oral anti-diabetic medications?
1. Insulin secretagogues a group of oral medications that stimulate the beta cells of the pancreas to secrete more insulin. They also decrease sugar production by the liver and enhance the burning of sugar into usable energy forms by individual muscle fibers. Insulin secretagogues can further be subdivided into subclasses:
* a) Sulfonylureas stimulate the secretion of insulin by the pancreas. The most common examples of this subgroup include tolbutamide, tolazamide, chloropropamide, glyburide, glypizide and glimeperide
* b) Nonsulfonylurea secretagogues are very useful in diabetics with irregular meal times because of its ability to bring about rapid stimulation of the pancreas to secrete insulin. The most common examples of this subgroup include repaglinide and nateglinide
2. Insulin sensitizers enhance the action of insulin in the body. This type of medications can further be divided into subgroups which may include:
* a) Biguanides. Metformin is the most known form of biguanides. It inhibits the production of sugar by the liver and at the same time, increases the sensitivity of the muscles and fat to insulin stimulation
* b) Thiazolidinediones (TZD) are a group of anti-diabetic medications that increase the insulin sensitivity of muscle fibers and fats.The most common examples of this group include the rosiglitazone (Avandia) and poiglitazone (Actos)
* c) Alpha-glucosidase inhibitors actively inhibits the absorption of carbohydrates in the intestines by blocking the enzyme that facilitates the absorption of carbohydrates. One of the most common problems associated with this kind of anti-diabetic medication is the development of abdominal problems such as cramps, bloatedness, flatulence and sometimes gross diarrhea. The most common examples of alpha-glucosidase inhibitor include acarbose and miglitol
* d) Dipeptidyl peptidase IV increases the secretion of insulin by inhibiting the enzymes that degrades incretin, a special hormone that trigger the secretion of insulin. The most known example of dipeptidyl peptidase IV inhibitors is sitagliptin
Although many people find they can bring their blood sugar back into the normal range by making changes to their eating plan, doctors often assume that dietary changes will not solve their Type 2 diabetic patient's blood sugar problems and prescribe one or more of the above drugs. These drugs have limited power to lower blood sugar levels back into the normal range. Dietary control is still needed to bring your blood sugar back to the normal range.
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