- Our bodies need glucose as a source of
energy for movement, growth, repair, and other functions. When we eat, our
bodies break food down into organic compounds, one of which is glucose.
But before the cells can use glucose, it must move from the bloodstream
into the individual cells. This process requires insulin.
Insulin is produced by the beta cells in the islets of Langerhans in the
pancreas. When glucose enters our blood, the pancreas should automatically
produce the right amount of insulin to move glucose into our cells. People
with type 2 diabetes either produce too little insulin, produce it too
late to match the rise in blood glucose, or do not respond correctly to
the insulin that is produced. Then glucose builds up in the blood,
overflows into the urine, and passes out of the body. This means that the
body loses its main source of energy even though the blood contains large
amounts of glucose.
Diabetes pills work in one of three ways. They either stimulate the
pancreas to release more insulin, increase the body's sensitivity to the
insulin that is already present, or slow the breakdown of foods
(especially starches) into glucose.
Categories of Diabetes Pills:
There are six categories of diabetes pills: sulfonylureas, meglitinides,
nateglinides, biguanides, thiazolidinediones, and alpha-glucose
inhibitors. These drugs can be used with or without the Insulin to control
high blood glucose in Diabetes type II (NIDDM).
o Sulfonylurea
Action: Stimulates beta cells to release more insulin
First generation:
Example: Chlorpropamide (Diabinese )
How taken :Generally taken one to two times daily, before meals; can have
interactions with other drugs. First generation sulfonylurea (older drug)
Second (new) generation:
- Examples:
Glipizide (Glucotrol )
Glyburide (DiaBeta/ Micronase/Glynase )
Glimepiride (Amaryl )
How taken : Second generation used in smaller doses than first generation
o Meglitinide
Action:Works with similar action to sulfonylureas
Examples: Repaglinide (Prandin )
How taken :Taken before each of three meals
o Nateglinide
Action:Works with similar action to sulfonylureas
Examples: Nateglinide (Starlix )
How taken :Taken before each of three meals
o Biguanide
Action:Sensitizes the body to the insulin already present
- Examples:
Metformin (Glucophage )
Metformin (long lasting) -(Glucophage XR )
Metformin with glyburide (Glucovance )
o
Thiazolidinedione (Glitazone)
Action :Helps insulin work better in muscle and fat; lowers insulin
resistance
- Examples:
Rosiglitazone (Avandia )
Pioglitazone (Actos)
How taken :Taken once or twice daily with food; very rare but serious
effect on liver
o Alpha-Glucose Inhibitor
Action :Slows or blocks the breakdown of starches and certain sugars;
action slows the rise in blood sugar levels following a meal.
- Examples:
Acarbose (Precose )
Miglitol (Glyset )
How taken :Should be taken with first bite of meal
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