“Oh, you’re taking that medicine? My doctor said it has a lot of side-effects.”
“You have to try this home remedy that my long lost relative suggested. It worked for someone she knew.”
No matter what type of diabetes you have, and no matter what stage of it you are in, there are suggestions aplenty for its treatment. Other than in early stages of type 2 diabetes, it is not possible to simply reverse the condition with quick-fixes. In some cases, drastic lifestyle changes may also not be enough to correct the course. Effectively managing it requires the advice of an expert doctor and diligent adherence to his recommended treatment plan.
While you may be on one or more of these diabetes medications, you still might not be aware of the purpose they serve, or the way it works in the body. Keep reading to know more about the factors that affect your prescription, and the different types of medications you could be prescribed.
Factors That Decide the Diabetes Medicines You Take
As earlier mentioned, the type of diabetes you have, and the severity of it are two major factors that play into the medicines you are prescribed. For those with Type 1 Diabetes, the body is not capable of producing insulin at all and will require insulin therapy. They may also be recommended to take other medicined that delay glucagon secretion in the body, thus lowering blood sugar.
When it comes to Type 2 Diabetes, the body is capable of producing insulin but has become incapable of using it well. In such cases, the doctor would prescribe medicines that can help your body use insulin better or get rid of excess blood sugar. Several oral medications can be prescribed for these purposes but in severe cases, you may also have to take insulin.
In the case of gestational diabetes, lifestyle changes such as better nutrition and physical activity are largely preferred. But in more complicated scenarios, you may also be given insulin injections, and asked to watch your glucose levels closely.
What Are the Medicines You May Be Prescribed
If there are 77 million diabetes patients in India, there are just as many ways to prescribe medicines to them. The ultimate goal here is to regulate your insulin levels and to rid the body of excess sugar. Most medications in this regard are oral drugs, but there are also a few that are injections.
For Type 1s Diabetes patients, insulin is often the most commonly prescribed medications. They are given based on how severe your insulin depletion is, and the options include short-acting insulin, which is the most common, as well as of rapid-acting insulin, intermediate-acting insulin, and long-acting insulin. There is even combination insulin which may be prescribed in certain complicated scenarios.
Those dealing with Type 1 Diabetes may also be given Pramlintide, an injectable drug that delays the emptying of the stomach. This can help in regulating glucagon secretion in the blood, thus lowering your blood sugar.
The most common medication that patients are placed on for Type 2 Diabetes is Metformin, a type of drug that lowers the glucose levels in the liver and generally improving the body’s sensitivity to insulin. The medicine needs a few weeks to get used to the body and might cause certain side effects. Other treatments are usually explored when a combination of metformin and lifestyle changes fail to work.
One of the main types of medicine that are used in this is Sulfonylureas, which helps the body secrete more insulin. Its primary function is to help the body secrete more insulin and the most common side effect includes low blood sugar and/or weight gain.
Meglitinides are a more fast-acting version of Sulfonylureas. They also stimulate the pancreas to release more insulin, but are more fast-acting and lasts for a shorter time in the body.
Thiazolidinediones are other medications that make the body’s tissues more sensitive to insulin. But owing to the increased risk of heart failure and anaemia it is only used as a last resort.
DP-4 Inhibitors, which include sitagliptin, saxagliptin, and linagliptin, help reduce blood sugar levels. But their effect is very minor in this regard, and rather may cause joint pain and/or increase your risk of pancreatitis.
Certain injectable medicines known as GLP-1 receptor agonists are prescribed to help with slowing digestion and lowering blood sugar levels. They are often used to aid in weight loss and include medicines such as exenatide, liraglutide, and semaglutide.
Last but not the least, SGLT2 Inhibitors such as canagliflozin, dapagliflozin, and empagliflozin are prescribed to prevent the kidney from reabsorbing sugar into the blood and to ensure it is excreted through the urine. These are proven to reduce the risk of heart attack and stroke in high-risk patients but pose challenges of urinary tract infection, low BP and even a risk of diabetic ketoacidosis.
In earlier days, insulin therapy was only used as the last step in diabetes treatment. But owing to its effectiveness in treating diabetes, it is now being used widely. The reason that insulin is injected, rather than ingested is that digestion can potentially interfere with insulin processes when taken orally.
Depending on your diabetes stage, and lifestyle, your doctor may prescribe different types and dosages of insulin for you, for different times of your day. Most commonly, patients are prescribed one single dose of insulin at night, which will help keep diabetes in check throughout the next day. If the dosage is not well managed, there are also chances of experiencing hypoglycemia in the patient.
At the end of the day, the combination of medicines you may be given is unique, and your expert doctors have their reasons for prescribing them. If you do choose to try out home remedies, make sure to check with your doctor that there is no harm in using them. And when your doctor prescribes a new medication, make sure to educate yourself on its usage, dosage, and potential interactions. Factors such as the cost of the medication may also be kept in mind by the doctor to provide you with a treatment plan that works best for you.
Being aware and involved in your disease management can go a long way in keeping them at bay.