Oral Medications for Type II Diabetes

Since their introduction in the late 1950s, oral hypoglycemic agents have helped millions of people with Type II diabetes maintain control of their blood glucose levels. There are now several different kinds of oral medications for diabetes that act in very different ways. Follow the hyperlinks for more detailed information.

1. Pills that help put more insulin in the bloodstream: the Sulfonylurea (sulfa containing) Type Pills o First-generation (original) oral hypoglycemics include Diabinase, Orinase, and Tolinase. These are being used less and less.

o Glucotrol, DiaBeta, Micronase, and Amaryl are second-generation (that is, newer) oral hypoglycemics. Advantages of second-generation agents include reduced side effects, 100-200 times greater potency, and a wider range of treatment options. They are also longer acting than most of the first generation pills and can be taken just once or twice a day.

You can only take a sulfa-containing pill for your diabetes if your liver and kidney function are good.

2. A new pill that helps put more insulin in the bloodstream:

Prandin

The newest pill for persons with Type 2 diabetes, released in the spring of 1998, is called Prandin. It is meant to be used either alone or in combination with the Glucophage pill (see below).

It is taken just before a meal and helps put more insulin in the bloodstream.

It's not yet clear who would get the most benefit from it, but it may be useful if you are taking Glucophage but still do not have good diabetes control. Possible side effects from long-term use are not yet known. The generic or chemical name for Prandin is repaglinide.

3. Pills that help insulin work better

A relatively new development in pills for treating diabetes is a pill that helps insulin work better. One kind of pill lowers the amount of sugar that is made in the liver. Another kind makes the body more sensitive to insulin; it actually makes the i nsulin "work better."

When a person takes either kind of pill, less insulin is needed to reduce blood sugar.

o The Biguanide Type Pills (Glucophage)

This kind of pill has been available in the United States for several years, and there is currently only one brand available. It is called Glucophage. This is the kind of pill that works by keeping the liver from making too much sugar. (Remember that the sugar in the blood comes not just from what you eat, but also from your liver! See Chapter 1 for more information.)

You can only take a biguanide pill if your kidney and liver function are normal. Some people experience stomach upset from these pills.

o Troglitazone (Rezulin)

This is a relatively new type of pill for diabetes, released by the Food and Drug Administration at the beginning of 1997. Troglitazone will be sold under the trade name of Rezulin, and it will be available in pharmacies in the United States in March, 1997. This medicine makes the body more sensitive to its insulin. It is sometimes called an "insulin resistance reducer." It does not belong to the "biguanide" family of chemicals. This is the only available "thia zolidinedione" type pill in the United States at this time. It is currently intended for use principally by persons who are already taking insulin injections. It can greatly reduce the amount of insulin needed.

/^Recently (December 1997) reports have come to light that Rezulin can cause liver damage in some people who take it. Because of this tendency to cause liver damage that can be fatal, the National Institutes have discontinued testing Rezulin in a large trial that was hoping to show that it could actually prevent diabetes (June, 1998).

The American Food and Drug Administration (FDA) has so far decided not to withdraw it from the market, but recommends that all persons taking it have regular tests of their liver. These tests should be done regularly for at least a year.

If your doctor/diabetologist has prescribed or suggested Rezulin for your diabetes, you should discuss this possible side effect with him or her. .

Oral Medications (Pills) for Diabetes

4. Acarbose

This kind of pill is also fairly new. It interferes with the absorption of sugar from the intestines after a meal. For some patients, this can mean better overall control of diabetes. There is currently one brand available. It is called Precose.

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