A group of metabolic diseases typified by high blood sugar (glucose) is known as diabetes mellitus. This results from imperfection in insulin secretion or action or both.
Diabetes is a never-ending medical condition which lasts a lifetime although it can be controlled. Out of the two major types of diabetes, type 2 diabetes is more prevalent. In this patients can even generate insulin, but it is insufficient for body’s needs or in some cases the body has resistance to the insulin produced.
Taking a medicine helps to lower the blood glucose levels. There are two kinds of medicines: oral medications (pills) and insulin shots. Diabetes pills are not insulin.
Blood glucose level is high in people with diabetes. As glucose remains in the blood rather than entering cells, where it belongs, high blood glucose condition takes place. Insulin must be present and the cell must be “hungry” for glucose to enable glucose to pass into a cell. The two problems which are faced by people with type 2 diabetes are they do not make reasonably adequate insulin and cells of their bodies do not appear to capture glucose as eagerly as they should.
In the United States five classes of drugs are sold viz. Meglitinides, biguanides, sulfonylureas, alpha-glucosidase inhibitors.and thiazolidinediones. To lower blood glucose levels these five classes of drugs act in different ways.
Meglitinides are drugs that arouse the beta cells to discharge insulin. Repaglinide and nateglinide are meglitinides. They are taken before meals as hypoglycemia (low blood glucose levels) is a possibility since insulin is liberated due to sulfonylureas and meglitinides.
Alcohol and diabetes medications do not go together. Side effects like vomiting, sickness or flushing can be occasionally caused by the interaction of chlorpropamide, and sulfonylureas with alcohol.
Metformin is a biguanide. The amount of glucose generated by the liver is reduced by biguanides which primarily lowers blood glucose levels. The muscle tissue is made more responsive to insulin so glucose can be absorbed. It also helps to lower blood sugar levels. The dosage is usually two times a day. Diarrhea can be a side effect of metformin, but when the drug is taken with food this can be controlled.
Beta cells of pancreas get aroused by Sulfonylureas and release insulin. The only first-generation sulfonylurea still in practice is Chlorpropamide. Second generation sulfonylureas are used in smaller doses than first-generation drugs. The second-generation drugs are of three types: glyburide, glipizide, and glimepiride. These drugs are usually taken one to two times a day, before meals. All sulfonylurea drugs have same effect on the blood glucose levels. The side effects depend on how often they are taken and their interaction with other drugs.
Thiazolidinediones is a group of drugs formed by troglitazone, rosiglitazone, and pioglitazone (ACTOS). These drugs improve the efficiency of insulin in muscles and fat. The drug also limits the production of glucose in the liver. The dosage is usually once or twice a day with food. Thiazolidinediones are effective in lowering blood glucose levels; however they do affect the liver in rare cases. You need to monitor your liver function regularly if you are on these drugs.
Acarbose and meglitol are alpha-glucosidase inhibitors. These drugs block or slow down the breakdown of starches in the intestine thus lowering the blood glucose levels. The breakdown of some sugars like table sugar is also slowed down by these drugs. They are particularly effective in limiting the rise in blood glucose levels after meals. Diarrhea and Gas are possible side effects of these drugs.
The drugs listed above take action in different ways to lower blood glucose levels. They can be taken together and in combinations. It is relatively expensive to take more than one drug; however, oral medications definitely improve blood glucose control.
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