Oral Diabetic Meds Unraveled

• Pharmacology for diabetics has come a long way. Here’s a quick primer on the oral prescription products that are available. Note that Type II diabetics are prescribed oral medications as these agents are for people who don’t make enough insulin or are in most cases insulin resistant. The categories are described in layman’s terms and this is not an inclusive list. For more indepth information including adverse drug issues see the resources.

Classifications of Oral Agents:

Alpha-glucosidase Inhibitors:This type of drug delays the absorption of carbohydrates. They are generally taken with meals.

• Miglitol (Glyset)

• Acarbose (Precose)

Biguanides:Biguanides make the cells more sensitive to insulin and reduce plasma glucose levels.

• Metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet )

Dipeptidyl peptidase IV Inhibitors: The DPP-4 inhibitors increase insulin secretion and decrease gastric emptying.

• Sitagliptin (Januvia)

Meglitinides:These drugs also increase the production of insulin in the pancreas. They are fast acting and usually given after meals

• Repaglinide (Prandin)

• Nateglinide (Starlix)

Thiazolidinediones: These drugs reverse insulin resistance.

• Pioglitazone (Actos)

• Rosiglitazone (Avandia)

Sulfonylureas: These drugs act on the pancreas to increase the production of insulin. They are not used for patients who have zero insulin production.

• Glimepiride (Amyrl)

• Glipizide (Glucotrol, Glucotrol XL)

• Glyburide (Micronase, Diabeta, Aventis)

Combination Therapies:

• ACTOplus met = Actos + Metformin

• Avandaryl= Avandia + Glimiperide

• Avandamet = rosiglitazone maleate + metformin

• Duetact= Actos + glimepiride

• Janumet= Januvia + metformin

Resources:

Other Diabetes Medications-American Diabetes Association

Diabetes Medications-Islets of Hope

Diabetes Drugs-Consumer Reports (also features price comparisons)

Diabetes treatment: Medications for type 2 diabetes-Mayo Clinic

News:

U.S. News & World Report, July 3, 2008. FDA Panel Calls for More Testing of Diabetes Drugs. Per the FDA, drugs designed to control type 2 diabetes should be subjected to more thorough safety reviews to ensure they don’t raise the risk of heart problems.

Science Daily, October 2, 2007. Clinical Trials For Diabetes Drugs Should Measure Outcomes Important To Patients, Doctors Urge. “Most clinical trials for new diabetes drugs do not consider the impact medication will have on a patient’s quality of life or other outcomes that are important to patients, such as the risk of developing complications associated with diabetes, according to a Mayo Clinic commentary in The Lancet.”

FoxNews . Com, May 22, 2007. Avandia: Getting the Facts. Fox News examines the findings of a study in the New England Journal of Medicine and the Avandia heart attack risk.