Are Medications for the Treatment of Diabetes Safe?

In February of 2008 the NHLBI announced that the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study would be stopped because of an increased risk of death in patients on intensive glucose lowering treatment regimens. 10,251 patients with Type 2 diabetes were being treated with a range of medications for glucose control and were divided into intensive versus standard glucose lowering groups.



There were 257 deaths in the group receiving intensive treatment to lower HbA1C (a marker of elevated blood glucose levels) to below 6% compared to 203 deaths in the standard treatment group (HbA1C 7-7.9%). Deaths included sudden death and cardiovascular causes. Reactions from medical experts included "surprise" and "shock", and yet this should not have come as any surprise since the fact that glitazone medications used for diabetes, including Avandia (rosiglitazone) and Actos (pioglitazone) carry a cardiovascular risk was previously known. For example, last year an article in the New England Journal of Medicine showed that Avandia (rosiglitazone) increased heart attack risk by 43%. These drugs also cause fluid retention which increases the risk of heart failure. For instance, in the A Diabetes Outcome Progression Trial (ADOPT) 4360 patients with poorly controlled Type-2 diabetes were randomly assigned to four years of treatment with rosiglitazone, metformin, or glyburide. Rosiglitazone caused more heart failure than glyburide, and was associated with more weight gain (+4.8 kg-convert to pounds, v -2.9 kg for metformin) and fluid build up or edema (probable cause of the heart failure). 22 rosiglitazone patients developed heart failure, compared to 19 with metformin and 9 with glyburide.



In the PROspective pioglitAzone Clinical Trial in macroVascular Events (PROactive) Study, 5238 patients with Type-2 diabetes and evidence of vascular disease were randomly assigned to treatment with pioglitazone or placebo to be taken with their typical treatment regimen. There was no signficant difference in the primary outcome of any vascular event; 281 patients on pioglitazone developed heart failure compared to 198 on placebo, a 42% increase which was highly statistically significant. Most people don't know that glitazones cause weight gain and actually create new fat cells, making you more "fatty'. So in other words, they are promoting the thing that causes Type 2 diabetes in most people (i.e. weight gain), and causing the thing that we are trying to prevent by treating diabetes (i.e. heart attacks and heart failure). Not a very good deal.



Overall the older drugs for diabetes like glyburide are probably safer than the new drugs and cost much less. Diet and exercise are always the best way to prevent the development of Type 2 diabetes.

Diabetes Medications

Oral diabetic medications are most effective for patients with Type 2 diabetes with less than ten years of high blood pressure and who are of normal weight or obese. Though oral diabetic medications may be effective for years, eventually the patient may have to take insulin.



Sulfonylureas are diabetic medications that stimulate insulin production in the pancreas. Patients with allergies to sulfa drugs, or who do not have a functioning pancreas should avoid this diabetic medication. Side effects of this diabetic medication include low blood sugar, upset stomach, skin rashes, and weight gain. This diabetic medication is taken either once or twice a day.



Biguanides are diabetic medications that inhibit sugar production in the liver. This type of diabetic medication may also cause weight loss, which can improve blood sugar levels as well. Side effects of this diabetic medication include complications from alcohol use (more than 2-4 drinks a week), exacerbation of existing kidney problems, vomiting, diarrhea, dizziness, and shortness of breath. Patients who are having surgery or dye tests should inform their doctors that they are taking this diabetic medication. This diabetic medication is taken three times a day.



Alpha-glycosidase inhibitors are diabetic medications that inhibit starch digestion, preventing blood sugar spikes after meals. Side effects for this diabetic medication include gas, bloating, and diarrhea, though these problems generally subside. This diabetic medication is taken three times a day.



Thiazolidinediones are diabetic medications that increase the sensitivity of cells to insulin, thus pulling glucose out of the bloodstream and into cells. Side effects for this diabetic medication include liver complications, low blood sugar when used in conjunction with other diabetic medications, diminishing effectiveness of oral contraceptives, weight gain, anemia, and swelling of the legs. This diabetic medication is taken either once or twice a day.



Meglitinides are diabetic medications that stimulate the pancreas to produce more insulin immediately after meals. These diabetic medications work more quickly than other diabetic medications, allowing meals to be varied more than with other diabetic medications. Side effects of this diabetic medication include weight gain and low blood sugar. This diabetic medication is taken before each meal.

Diabetes Medications

Diabetes medications are attempted when normal diabetic diet, weight loss and exercise fail to bring blood sugar to a normal range. They include oral drugs and hypodermal injections. Medication usually starts when the average blood glucose levels are greater than 150 mg/dl (8 mol). Diabetes medications work effectively when they are combined with exercise and diet. Oral drugs are the most common form of medication. There are many sites on the Internet that offer online diabetes medications.



There are mainly three classes of diabetes medications. The first class medication makes the body more sensitive to the insulin secreted by the body f (e.g.: thiazolidinediones and actose.) The second class stimulates the beta cells of pancreas to release more insulin (e.g.: sulfonylurea and meglitinides.) The third class blocks the breakdown of carbohydrates (e.g.: alpha-glycosidase inhibitors and meglitol.)



Diabetes medications depend on many things such as blood glucose level, blood pressure, insulin production, mode of living, genetic factors and the immune system of patients. Different medications can be taken independently or in combinations. To respond to an oral diabetes agent, you must have some insulin making ability. Diabetes medications require patient-physician partnerships also. You can experiment by trying more than one type of pill, several combinations of pills or a combination of insulin and a pill.



The most popular of all diabetes medications is insulin injection. Insulin is administrated when the average blood glucose level reaches 180 mg/dl. Forty per cent of diabetic patients require insulin injections. Insulin is injected once or twice daily. Some diabetic patients take insulin three or four times daily. Insulin is classified into different types based on the time required to absorb from under the skin to the blood stream.



Oral agents fall into three categories - short acting s, intermediate acting a and long acting s. The oral pills can have some side effects such as nausea, yellowing of skin and vomiting. Never take medication above the prescribed quantity, as it could lead to extended hypoglycemia (low blood sugar). Frequently check your blood glucose level.

Medications For Type 2 Diabetics

Diabetes type 2 is a chronic metabolic disorder that is characterized by insulin resistance. It is a disease that lacks a permanent or perfect cure. For sufferers management is the only option.
Management of this syndrome entails medication, exercise, diet and life style modification.



Applying medications is one amongst the few ways of managing diabetes type2. The medication could be in the form of oral or injectable drugs. People with diabetes type 2 need medicine (medication) because it can help their body in manufacturing more insulin which can help decrease insulin resistance or lower the rate at which their body absorbs carbohydrate.



There are 5 basic classes of medications that can be used in the management of diabetes they are



Sulfonylueas; -



This is an example of an anti diabetic drug that can be used in the effective management and treatment of diabetes. It is mostly applied in the treatment of diabetes mellitus type 2. It has some mild side effect like inducing hypoglycemia when insulin production overshoots. This could be corrected by taking sugary foods. Sulfonylueas are greatly ineffective in the treatment of diabetes type 1 or post pancreatectomy where there is absolute deficiency of insulin.



Meglitinides; -



These are drugs that are used in the treatment of diabetes. They treat diabetes by blocking the potassium channel in the beta cell, This closes the ATP dependent potassium channels and opens the cells calcium channel. The resulting calcium influx aids in stimulating the beta cells into releasing more insulin.
One of the side effects of meglitinides is hypoglycemia (low blood glucose) which occurs because meglitinides stimulate the beta into releasing insulin.



Thiazolidinediones; -



These are drugs that act as an adjunctive therapy for diabetes type 2. They help in the reduction of the level of glucose produced in the liver, and also help the insulin to function better in the muscles and fat. They are very useful and effective in lowering the level of glucose in the blood
Some of its side effects include increase risk of hepatitis, liver damages, heart failure and fluid retention resulting in edema. Some of these side effects are more pronounced if there is a withdrawal or discontinuation of usage.



Alpha-glucosidase inhibitors;-



These are oral anti-diabetic drugs that are used for the treatment of diabetics type 2. They are useful in the treatment of diabetics type 2 because they help in preventing the digestion carbohydrate by converting it into monosaccharides (simple sugar) which can easily be absorb by the intestines. They also slow the breakdown of certain sugars. After meal, their actions are capable of slowing down the rise in the level of glucose in the blood.
The side effect of this drug include diarrhea and flatulence which are dose related



Biguanides;-



These are oral hypoglycemic drugs which are useful in the treatment of diabetes they help in lowering the blood glucose level by making the tissues of the body especially the muscle tissues more sensitive to insulin It has some side effect which include diarrhea and lactic acidosis.
In applying medications to diabetes type 2, regular check is also advised. This should be done to ascertain the effect the drugs are having on our bodies.