Diabetes medication classes

An important question that is asked by patients newly diagnosed with diabetes, what will be my treatment? Here we are going to give an overview of diabetes medication classes.  

Diabetes mellitus DM

The body needs insulin which is secreted from the pancreas in order to help it to consume glucose and to get energy from it.

Diabetes medication classes

The management of diabetes mellitus differs according to the type of diabetes and then to the response of the patient.

There are 2 types of diabetes mellitus: Type 1 and Type 2 DM

Types 1 DM

Insulin is the only treatment for this type, because the patient’s pancreas is not secreting insulin at all.

Type 2 DM

It is managed by oral hypoglycemic medications that are to say oral antidiabetic medications.

The patient’s pancreas is secreting insulin, but it is insufficient or not well-functioning because of insulin resistance.

Sometimes the blood glucose level is not controlled by oral antidiabetic medications alone but needs insulin in addition.

Antidiabetic medications

There are different antidiabetic medications that are classified in Diabetes medication classes. They include:

Biguanides

Such as metformin. It increases the body sensitivity to insulin and reduces the production of glucose from the liver.

The patient takes it in 2 doses with meal.

Sulfonylureas

    There are 2 generations of sulfonylureas, and the patient should take them before meals.

    They enhance the release of insulin from the pancreas, thus, they can lower the blood glucose level secondary to its mechanism of action.

Alpha-glucosidase inhibitors

They prevent the rise of the blood glucose through preventing the breaking of the dietary complex carbohydrates (for instance Pasta and) potatoes as well as simpler carbohydrates.

Bile Acid Sequestrants

For example welchol. It reduces the low-density lipoprotein-cholesterol as well as glucose.

It is safe with patients suffering from liver disease because it is not absorbed into the general circulation.

Dopamine-2 Agonists

It reduces the blood glucose level after meals.

Dipeptidyl peptidase IV (DPP-4) inhibitors

A relatively new category added to the diabetes medication classes. They reduce only the high glucose level, meanwhile, never cause hypoglycemia.

Meglitinides

They stimulate the pancreas to secrete insulin, so hypoglycemia can results secondary to its intake.

Selective sodium-glucose transporter-2 (SGLT2) inhibitors

A new group of medications that are acting on the kidneys to increase the excretion of glucose to the urine.

Thiazolidinediones (TZDs)

They reduce the production of glucose from the liver of the patient as well as helping the insulin to act on the body fat and muscles.

Glucagonlike peptide–1 (GLP-1) agonists. 

Lines of DM treatment other than diabetes medication classes include:

  • Diet modification to be healthier.
  • Controlling the bodyweight to achieve the optimum body mass index, because obesity is the main factor of insulin resistance0
  • Orlistat to reduce the body weight in some patients.
  • Treatment of diabetes complications.

The Best medicine for diabetes

First of all, the control of carbohydrates in the diet is the best step in the treatment of DM.

No single medication is a best medicine for diabetes, but there is “The best medication for this particular patient”

The response of patients to different diabetic medications classes is variable, what is suitable to one is not suitable for the other.

However, physicians recommend starting with metformin as the first line of treatment in all patients with type 2 DM.

The patient may better respond to a combination of 2 of the diabetes medications classes than to a single medication.

The patient with type 1 DM must receive insulin, whereas patients with type 2 DM may need insulin together with oral antidiabetes medications.

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