A new generation of diabetes treatments has hit the market. Pharmaceutical manufacturers have responded to the growing numbers of people being diagnosed with type-2 diabetes in the United States and other western nations and at least 100 new treatments are currently in development.
Learning to manage blood sugar levels is critical to the health of individuals with type-2 diabetes. Fortunately, the new diabetes medications that have been developed will help individuals keep blood glucose under control and avoid the dangerous complications that can occur with type-2 diabetes.
Here are some of the best medical treatments available for type-2 diabetes:
Sulfonylureas
Sulfonylureas are one of the oldest classes of drug used for treating high blood glucose levels in type-2 diabetes. These drugs work by stimulating the pancreas to release more insulin, but these can only be successful when pancreatic beta-cells are still active. The sulfonylurea drug metformin became available in 1955. Since that time, a number of other medications in this category have been developed. The Food and Drug Administration first approved drugs such as glyburide, glipizide and glimepiride in the 1980s.
Today, second-generation versions of these drugs are available to help patients with type-2 diabetes manage their blood glucose levels.
Thiazolidinediones
A number of drugs are covered under this category. They work by improving the how insulin is utilized in the muscles and fat cells. They also reduce glucose production in the human liver. Thiazolidinediones have been in use for type-2 diabetes since the late 1990s.
Pioglitazone, under the brand name Actos, was approved in 1999, and has experienced a number of reviews because of side effects. Additional restrictions were added to the drug label, as a result. The generic version of the drug was approved in 2012.
SGLT-2 Inhibitors
One new type of blood glucose regulating drugs for type-2 diabetes is called a sodium-glucose cotransport inhibitor. These drugs work by inhibiting certain types of proteins. These proteins increase the amount of glucose reabsorbed into the blood. The medication inhibits these proteins, the kidneys remove the glucose from the blood and it is excreted in the urine. SGLT-2 inhibitors are recommended along with diet and exercise to help normalize blood sugar levels in individuals with type-2 diabetes.
A number of SGLT-2 inhibitor medications are available, such as:
- Canagliflozin – Brand name Invokana, FDA approved in 2013
- Empagliflozin – Brand name Jardiance, approved in 2014
- Dapagliflozin – Brand name Farxiga, approved in 2014
DPP-4 Inhibitors
Other new diabetes drugs belong to a different family of medications because they function in a different manner in the human body. These drugs, called DPP-4 inhibitors, work by preventing the production of DPP-4, an abbreviation of dipeptidyl peptidase IV, which is an enzyme that blocks incretin production. Incretins are hormones that help to increase production of glucose when needed and reduce the amount produced by the liver when it is not needed. By blocking the enzyme, more incretins are available to regulate blood glucose levels to keep them in normal range.
Medications include:
- Sitagliptin phosphate – Brand name Januvia, approved October 2006
- Saxagliptin – Brand name Onglyza, approved July 2009
- Linagliptin – Brand name Tradjenta, approved May 2011
- Alogliptin – Brand name Nesina, approved January 2016.
- Vildagliptin – Brand name Galvus, not yet approved in the U.S.
GLP-1 Drugs
Glucagon-like peptide receptor agonist drugs (GLP-1) use another method of managing excess glucose. These FDA-approved diabetes drugs use several different mechanisms of action. They act upon gastrointestinal peptides to increase insulin production. They also slow down gastric emptying, reduce glucagon production after eating and decrease food intake. In combination, these actions help to improve blood sugar regulation in individuals with type-2 diabetes.
A number of different medications are available within this category:
- Dulaglutide – Brand name Trulicity, approved in 2014
- Exenatide – Brand name Bydureon, approved in 2012
- Liraglutide – Brand name Victoza, approved in 2010
- Albiglutide – Brand name Tanzeum, approved in 2014
Combination Drugs
Control of blood glucose levels can be more difficult over time, and additional measures may be needed. The option of using a combination drug that utilizes different biochemical methods for lowering blood glucose may be a good option for these patients, not only because they utilize different systems, but also because they are more cost effective.
One drug, named Glyxambil, employs both a SGLT-2 inhibitor and a DPP-4 inhibitor to block insulin from going to the kidneys and to increase glucose stored in the liver. Other drugs combine SGLT-2 inhibitors with the older diabetes drug, metformin, for improved blood glucose management. New drugs are being tested continuously to determine that combinations that do the most effective job of managing blood sugar levels.
Many of these drugs are not yet FDA-approved diabetes drugs that are available for physicians to prescribe. Future years will no doubt see a number of new drug combinations to help patients manage their type-2 diabetes.
Common Side Effects From Type-2 Diabetes Drugs
Each type of drug utilizes a different mechanism to achieve the result of reduce glucose levels in the body. This can cause side effects of various kinds that can be serious. Your doctor will monitor your condition and change your medication, if necessary.
- In some cases, the medications involved mechanisms within the liver, and this can result in problems with liver function. Your physician may require periodic liver function tests to ensure that your medications are working correctly and are not producing negative effects.
- Some studies on type-1 diabetes drugs indicate that these drugs can produce cardiovascular effects. Similarly, your physician may have you take additional blood tests or other diagnostic testing to ensure that no negative cardiovascular effects have occurred.
- Some type-2 diabetes medications are associated with an increased risk of bladder cancer. Your physician may advise you to have more frequent tests to ensure that you do not develop tumors in your urinary system.
- Type-2 diabetes drugs are also associated with stomach upset and diarrhea that can occur on an ongoing basis. If you are having these symptoms, consult with your doctor.
- Some drugs can also cause minor skin problems, such as rashes and hives. If you are troubled with these conditions, bring them to the attention of your doctor.
Type-2 diabetes can worsen over time, requiring changes in medication to ensure good control of glucose levels. The larger number of drug choices to manage blood glucose allows today’s patients an opportunity to live a longer, healthier life, free of the serious medical complications that can occur with type-2 diabetes. Talk to your doctor about the new diabetes drugs that are available for treatment of type-2 diabetes to determine which one best fits your needs.
Regardless of what medical course of action your doctor prescribes, it’s crucial that you take steps to manage your diet and live a healthy lifestyle. Often these factors play a huge role in the disease. Try to exercise – even adding modest exercise to your daily routine can help if you have been living a more sedentary life. And watch the sugar, especially the sneaky sugars that lie in even “healthy” food. Did you know, for example, that a cantaloupe has 43g of sugar?! That’s as much as 3 servings of ice cream!
