Pharmaceutical Treatment for Diabetes in Friendship, MD
Diabetes is a dysfunction of the pancreas, a large gland found behind and below your stomach. One of its functions is producing insulin, the hormone that carries glucose to the cells where your body can turn it into energy.
When it can’t produce enough (or any) insulin, or doesn’t use insulin effectively, glucose remains trapped in your blood and is unable to reach your cells. When your pancreas produces too little insulin, or no insulin at all, you experience elevated levels of glucose in your blood and urine, and you may develop diabetes.
Glucose is your body’s prime source of energy. It fuels your muscles, tissues and brain. Blood glucose is derived from the food you eat, and is stored and produced by your liver , which breaks it down into healthy, manageable levels.
Mainly, treating diabetes requires maintaining healthy insulin levels, choosing foods carefully, exercising to maintain a healthy weight, and having follow-up appointments with your healthcare provider to monitor your blood sugar.
Some medications can help if you’re at a high risk of developing diabetes, especially if you have cardiovascular disease, fatty liver disease, or polycystic ovary syndrome. These include metformin and medications to control cholesterol (called statins), as well as blood pressure medications. Your provider may also suggest aspirin to help prevent cardiovascular disease.
Medication is one method of controlling diabetes. Typically, these medications are dispensed by a doctor or other qualified medical practitioner, including integrative, functional, and naturopathic professionals.
While medication is usually effective for controlling diabetes and helping patients maintain a good quality of life, diabetes is a lifelong condition. Patients must monitor their blood sugar, triglyceride, and cholesterol levels while attending all follow-up appointments with their medical providers. Neglecting to do so may lead to severe health complications, including death.
No medication can cure diabetes. Only by adhering to your medical provider’s recommendations can diabetes be controlled and negative health effects minimized.
Type 1 patients need insulin to stay alive. Some type 2 and gestational patients also need to take insulin. Insulin comes in many forms, including rapid-acting, long-acting, and in-between options. Some patients take a combination at different times during the day.
Insulin is a hormone produced and regulated by the pancreas and liver. In normal cases, the body is able to produce and regulate the amount of insulin released into the blood, keeping blood sugar levels stabilized. For diabetics, insulin injections take the place of insulin that is normally produced by the body.
Insulin works by helping move sugar from your blood into other body tissues where it can be used for energy. Insulin also stops your liver from producing more sugar. All of the types of insulin that are available work in this way. The types of insulin differ only in how quickly they begin to work and how long they continue to control blood sugar.
Insulin treatment may decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage, eye problems (including changes or loss of vision), and gum disease.
Insulin can’t be ingested because your stomach enzymes disrupt insulin’s performance, so it’s typically injected with a small needle or an insulin pen, which looks like a regular pen that holds a small needle.
Insulin can also be administered using a pump. This device is about the size of a cellphone and contains a supply of insulin. It’s worn outside your body and connects to a catheter inserted under your abdominal skin. When needed, insulin is supplied to the bloodstream in measured doses.
A tubeless and wireless pump is an exciting new innovation. This device can be programmed to dispense certain amounts of insulin depending on your daily food intake, exercise, and blood sugar levels.
Pharmaceuticals like metformin, prescribed for type 2 diabetes, can stimulate your pancreas to produce and release more insulin, while others lower insulin production and release of glucose into your liver, so you need less insulin to move sugar into your blood cells. Recent studies also suggest that metformin may be instrumental in preventing or slowing the progress of dementia and Parkinson’s disease in older patients.1
Other possible side effects of these medications include:
- memory problems
- heart problems
- kidney problems
- liver problems from lactic acid
- muscle pain and weakness
- abdominal pain, nausea and vomiting
- chills and dizziness
- upper respiratory tract infection
- low blood sugar
Other biguanides include:
- dopamine agonists (bromocriptine): it’s unknown exactly how these drugs treat type 2 diabetes; may affect body rhythms and prevent insulin resistance; side effects may include headache, dizziness, drowsiness, diarrhea, constipation, nausea, chest pain, back pain, or rapid breathing
- DPP-4 inhibitors: include alogliptin, linagliptin, saxagliptin, sitagliptin; work by blocking the action of DPP-4, an enzyme which destroys incretins—gastrointestinal hormones that help stimulate the production of insulin when it is needed and reduce the production of glucagon by the liver when it is not needed; also slows down digestion and decreases appetite; reduces blood sugar without causing hypoglycemia; may cause nausea, diarrhea, abdominal cramps, headache, sinus pain, and (rarely) skin rashes; may increase your risk of pancreatitis
- meglitinides: includes nateglinide, repaglinide, repaglinide-metformin help your pancreas release insulin by stimulating insulin-producing beta cells; may cause hypoglycemia; may cause dizziness, shakiness, fainting, sweating, cough, sinus congestion, lightheadedness, rapid weight gain, hand or foot swelling, back pain, diarrhea, or skin rash
- sodium glucose transporter 2 inhibitors: includes dapagliflozin, dapagliflozin-metformin, canagliflozin, canagliflozin-metformin, empagliflozin, empagliflozin-linagliptin, empagliflozin-metformin; prevents kidneys from retaining glucose by helping your body release it through urine; may cause complications in patients with bladder cancer, diabetic ketoacidosis, severe kidney disease, or patients using dialysis; may cause serious penis or vaginal infections, reduced urine output, dizziness, weakness, stomach pain, confusion, bladder infection, yeast infection, or flulike symptoms; may interact with insulin or diuretics
- sulfonylureas: stimulates the pancreas to make insulin with the help of beta cells; includes glimepiride, glimepiride-pioglitazone, glimepiride-rosiglitazone, gliclazide, glipizide, glyburide, glyburide-metformin, chlorpropamide, tolazamide, tolbutamide; may cause sweating, dizziness, confusion, nervousness, weight gain, abdominal pain, or dark-colored urine; may be unsafe for pregnant women; typically prescribed for 3-6 months for younger patients in order to prevent insulin use while necessary lifestyle adjustments are made; if these drugs don’t lead to adequate blood sugar control, insulin use is then indicated2
- thiazolidinediones: includes rosiglitazone, rosiglitazone-glimepiride, rosiglitazone-metformin, pioglitazone, alogliptin-pioglitazone, pioglitazone-glimepiride, pioglitazone-metformin make your body produce new fat cells that are more sensitive to insulin, lowering your blood glucose by helping your body use insulin and glucose more efficiently; may cause weight gain and fluid retention; female patients may become more susceptible to bone fracture; may cause or worsen heart failure
- other drugs: type 1 and type 2 patients usually need to take other medications to treat conditions concomitant with diabetes; these include aspirin for heart health, cholesterol medications , and blood pressure medications
Long-term complications and risk factors of pharmaceuticals
Diabetes is a complex medical condition that can cause a number of other health concerns. Taking certain diabetes medications long-term can have health effects, including:
- metformin: has a boxed warning – the most severe warning from the FDA – about lactic acidosis, a rare but serious side effect that can occur when too much acid builds up in your blood, leading to breathing problems, nausea, or circulatory shock – a medical emergency
- statin drugs: reduce cholesterol and triglycerides; deplete the body’s Coenzyme Q10 (CoQ10)—a vital nutrient for producing energy in the cells – required for proper heart function; may cause liver inflammation and muscle damage, leading to nausea, vomiting, pain on right side of abdomen, decreased appetite, dark-colored urine, muscle soreness, and muscle weakness
- niacin: may cause liver inflammation, causing nausea, vomiting, pain on right side of abdomen, and decreased appetite
- incretin mimetics: includes liraglutide, dulaglutide, lixisenatide, exenatide and albiglutide, hormone-like drugs that can supplement or replace insulin use by stimulating your pancreas to make more insulin; its long-term side effects are currently unknown3
- aspirin: typically prescribed for patients with high risk factors for cardiovascular disease; long-term use may cause gastrointestinal bleeding, stomach ulcers, and high blood pressure
Gestational diabetes mellitus (GDM) refers to diabetes that occurs during pregnancy. Like other diabetes types, gestational diabetes requires controlling your blood sugar levels so your baby stays healthy and you avoid pregnancy complications. Treatment includes monitoring your blood sugar and, in some cases, using insulin or oral medications. Proper diet and exercise are also essential.
A recent study shows that the prevalence of GDM is about 3.4% for women in their first pregnancy and 4.6% in their second pregnancy, with late-stage pregnancy, being between the ages of 36-45, and having hypertension presents a higher risk for developing GDM.4
Your medical provider will also monitor your blood sugar levels while you’re in labor. If your blood sugar suddenly spikes, your baby may release compensatory insulin—causing dangerously low blood sugar right after birth.
Gestational diabetes complications can include:
- excess growth: extra glucose can cross the placental barrier, triggering your baby’s pancreas to generate extra insulin that can make your baby grow larger than normal; typically necessitates a C-section birth
- low blood sugar: hypoglycemia can occur if your insulin production is too high; prompt feeding and administering IV glucose solution can normalize your child’s blood sugar level
- type 2 diabetes: babies whose mothers have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life
- death: untreated gestational diabetes can be fatal to your child before or after birth
In pregnant mothers, complications can include:
- preeclampsia: high blood pressure, excess protein in urine, and leg and feet swelling can cause serious or fatal complications for you or your child
- higher chance of needing C-section, typically due to pregnant women with GDM having a higher body mass index (BMI); a recent study showed that 31.6% of women with GDM studied experienced the need for emergency C-section versus 19.4% of women without GDM, and their infants’ birth weights were significantly higher5
- pre-term birth
- subsequent gestational diabetes: having gestational diabetes during one pregnancy increases your chances of having it during future pregnancies and makes you more likely to develop type 2 diabetes later in life
Speak to your healthcare provider about your personal gestational diabetes treatment plan. Treatments vary among patients due to differences in many factors, including age, weight, and medical history.
Learn more today
Diabetes can appear in many different forms and at many different stages of life, from infancy to older age. In some cases, it can be life-threatening. That’s why seeking a skilled and compassionate medical provider is key to you managing your diabetes and living a healthier, happier life without complications.
If you suspect you have diabetes or you’ve been recently diagnosed and want to learn more, explore our pages and contact a diabetes professional today.
1. Campbell, Jared M., et al. “Metformin and Alzheimer’s Disease, Dementia and Cognitive Impairment.” JBI Database of Systematic Reviews and Implementation Reports, vol. 15, no. 8, 2017, pp. 2055–2059., doi:10.11124/jbisrir-2017-003380.
2. Sola, Daniele, et al. “State of the Art Paper Sulfonylureas and Their Use in Clinical Practice.” Archives of Medical Science, vol. 4, 12 Aug. 2015, pp. 840–848., doi:10.5114/aoms.2015.53304.
3. “Medication for Type 2 Diabetes.” Current Neurology and Neuroscience Reports., U.S. National Library of Medicine, 11 Jan. 2018, www.ncbi.nlm.nih.gov/books/NBK279506/.
4. Xu, Xianglong, et al. “Prevalence and Determinants of Gestational Diabetes Mellitus: A Cross-Sectional Study in China.” International Journal of Environmental Research and Public Health, vol. 14, no. 12, 2017, p. 1532., doi:10.3390/ijerph14121532.
5. Boriboonhirunsarn, Dittakarn, and Rungnapa Waiyanikorn. “Emergency Cesarean Section Rate between Women with Gestational Diabetes and Normal Pregnant Women.” Taiwanese Journal of Obstetrics and Gynecology, vol. 55, no. 1, 2016, pp. 64–67., doi: 10.1016/j.tjog.2015.08.024.
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Annapolis, MD 21403