Many Medicine Options for Diabetes
Published by Contra Costa Times
Posted on Wed, May 17, 2006
By Dr. Craig Desoer
PERHAPS YOUR neighbor or a relative with diabetes takes different pills than you. Why is that? Your doctor is probably weighing the advantages and disadvantages of the many medicines available for type 2 diabetes.
Type 2 diabetes is the diabetes that usually comes on gradually in adults, often related to family history and being overweight. By contrast, type 1 usually comes on suddenly in children or teenagers.
One reason for using this drug first is that patients on metformin generally lose weight, which is usually good for diabetics, since excess body fat can worsen diabetes.
By contrast, many other diabetes medicines, including insulin injections, cause weight gain.
In addition, metformin almost never causes the blood sugar to drop dangerously low, also in contrast to most other medicines for diabetes.
Metformin can be dangerous for patients with kidney or heart problems. A common side effect is diarrhea, but the diarrhea can be controlled by adding a drug called clonidine (Catapress), which is also used to treat high blood pressure.
The SU medicines, which have been around for decades, work mainly by increasing insulin production by the pancreas.
So, if you take too much, your blood sugar level can drop dangerously low. An advantage of some of these medicines is that they can be taken even if the kidneys are not working well.
TZD medicines can take few weeks to work, so don't be discouraged if your sugar doesn't come down right away. They can make your feet and ankles swell, and can be dangerous if you have liver disease or heart failure.
These medicines can increase intestinal gas and loose stools, which can be annoying. Some doctors prescribe them as diet pills, but this is not an approved usage.
Byetta can reduce appetite and cause patients to lose weight. It is given by injection under the skin twice a day, and comes in a reusable pen.
Insulin comes in a number of injectable forms, depending on how quickly it acts and how long it lasts. Some insulins act within a few minutes after injection and last about four hours. Others take over an hour to start, and release small amounts of insulin gradually over a whole day.
If you are having side effects, or if your diabetes is not well controlled, ask your doctor or pharmacist about your alternatives.
Desoer practices family medicine at the Pittsburg Health Center. Healthy Outlook is written by the professional staff of Contra Costa Health Services, the county health department. Send questions to series coordinator Dr. David Pepper at firstname.lastname@example.org. For more health information, go to www.cchealth.org.