Oral medications are used in type 2 diabetes in patients that are not able to achieve good glucose control with lifestyle changes such as diet and exercise. Oral medications are preferred over insulin in type 2 diabetes except in situations in which the patient is sick or has very high blood sugar levels. There are many different choices of oral medications for type 2 diabetes. They fall into different classes that help achieve blood glucose control through different mechanisms.
Metformin, also known as Glucophage, is probably the most commonly used oral medication for type 2 diabetes. It has a long record of being safe and effective. It is in the biguanide class of medication. Metformin works primarily by decreasing glucose production in the liver. Metformin also helps insulin function better and by increasing insulin sensitivity. These mechanisms lead to decrease blood glucose levels. The most common side effects are problems with the gastrointestinal system such as nausea and diarrhea. These symptoms can be reduced by starting the metformin at a low dose and gradually increasing the dose.
Another common class of medication for the treatment of type 2 diabetes is the sulfonylureas. Glypizide and glyburide are commonly used examples of this class of medication. There are many brand names of these medications they include Diabeta, Micronase, Glynase, and Glocotrol. The sulfonureals work by helping the pancreas produce more insulin and by helping the body use the insulin more efficiently. This leads to lower glucose levels as insulin is responsible for helping the body remove glucose form the blood stream. The most common side effect of this class of medication is hypoglycemia or low blood sugar.
The glitazones is another class of medication for the treatment of type 2 diabetes. Actos and Avandia are common brands of this type of medication. The glitazones such as Actos and Avandia work by sensitizing the body to insulin. This allows the body to use insulin more effectively and this lowers the blood glucose levels. An important side effect of the glitazones is water retention. Water retention, also called edema, occurs in about 5% of patients and can have important consequences in patients who have certain medical conditions such as heart disease.
The development of oral medication for type 2 diabetes is an active area of research and new medications are being studied and released. This is a partial list of the most commonly used medications but does not cover all of the available choices.