Treatment of diabetes mellitus is based on lifestyle correction. But the introduction of drugs is not excluded, if the patient’s condition requires it. The correct selection of medicines will help alleviate symptoms, as well as bring the disease into remission. The action of the drugs is aimed more at optimizing the sugar level, which helps to prevent the progression of pathology and, as a result, the manifestation of complications. Among other things, the drugs also help to stimulate the synthesis of insulin to prevent glucose from being absorbed into the bloodstream.
Drug therapy regimen
Taking medications for diabetes mellitus is aimed at achieving a number of goals:
- Decreased tissue insulin resistance;
- Decreased absorption of glucose into the blood;
- Stimulation of insulin synthesis;
- Bringing to a normal state of lipid balance.
Treatment usually begins with one drug of some kind. Further, if the effect is low or absent altogether, then other names are introduced. If the required results were not achieved, then the patient is recommended to switch to insulin therapy.
Some antidiabetic drugs are incompatible with insulin, and therefore it is required to discuss this issue with the doctor and study the instructions for the specific name of the drug for the diabetic.
Groups of medicines
In principle, in diabetes, the use of drugs is a prerequisite to ensure that the condition of the diabetic is maintained at an optimal level. Considering that not all people are able to immediately and radically change life, nutrition, physical activity, then taking medications is absolutely necessary. Therefore, different groups of funds can be assigned:
- To eliminate insulin resistance – biguanides , thiazolidinediones ;
- To activate the synthesis of insulin – drugs based on sulfonylurea and clay ;
- Combined drugs are incretin – mimetics .
Accordingly, patients can be prescribed both one and several drugs that have a multifaceted effect. Some of them can work well, and some may require calculating the safest dosage. In any of these groups, their names are leading in terms of efficiency and popularity. Moreover, even within one section, the composition and active substances can change, and therefore analogues should be selected by a specialist.
The main representatives of this group are Metformin , Siofor , Glucophage . They are based on metmorphine . The therapeutic effect is provided by the following action:
- During the processing of carbohydrates, glycogen, proteins, the production of glucose decreases;
- Increases tissue sensitivity to insulin;
- In the liver, glycogen is deposited in increased doses;
- Sugar enters the bloodstream in smaller quantities;
- Glucose is distributed to the tissues of the organs to a greater extent.
It should be noted that at first, patients on therapy with biguanides experience side effects, especially from the gastrointestinal tract. But within about two weeks, they gradually disappear and the body gets used to this type of treatment. If the unwanted symptoms do not go away during this time, then you should contact a specialist to adjust the treatment. Side effects of biguanides include:
- Metal taste;
- Vomiting with nausea;
Otherwise, the use of the drug shows high efficiency. But it takes time to get used to therapy.
Many diabetes medications can cause side effects. But this does not mean at all that you can personally stop using medications. Such decisions are made only in consultation with a doctor.
Sulfonylurea- based drugs help bind to beta receptors. Due to this, insulin synthesis is activated. The main representatives of the group are Glibenclamide , Diabeton , Glurenorm , Glickvidon . The first use of the drug is usually started with the lowest dosages. During the week, from day to day, it is gradually increased until the drug is brought to the required value. It is important to take into account that a group of medicines of this type gives some side effects that affect the patient’s quality of life at first. In particular, the following are considered frequent:
- Falling glucose levels;
- Itchy skin;
- Liver damage;
- Rash on the body;
- Damage to the digestive system.
If undesirable effects appear, then you need to conduct a conversation with the doctor, describing to him all the negative signs, intensity, frequency of manifestations and other controversial points. It is likely that a dosage adjustment is simply required.
This group of medicines has many popular names, such as Novonorm , Repaglinid , Starlix , Nateglinid . Thanks to them, the pancreas increases the production of insulin. As a result, it turns out to keep the sugar readings under control after a meal. The effectiveness of glinides depends on the glucose level at the time of administration. The higher the blood sugar level, the more insulin the pancreas will produce. Drugs like Starlix and Novonorm are considered the latest generation drugs, and therefore are well tolerated by patients. But even they are capable of provoking quite serious side reactions of the body.
This group is represented by such drugs as Aktos , Rosiglitazone , Avandia and Pioglitazone . Due to drugs of this type, it is possible to activate the corresponding receptors in fatty, muscle tissues. Thus, it is possible to increase their insulin sensitivity. Thiazolidinediones are considered one of the most effective medications for type 2 diabetes. But it is important to take into account that in some conditions their use is contraindicated. These include, in particular, pregnancy, lactation, heart and liver diseases. These drugs have quite intense and serious side symptoms and manifestations, including edema, weight gain, eczema, negative effects on the heart, liver, and fragility of bones.
Possible contraindications should be considered. Therefore, before using the product, be sure to read the instructions for the drug. If you have questions, you need to consult a doctor.
Alpha glucosidase inhibitors
These drugs help block the production of a special enzyme in the gastrointestinal tract, under whose action complex carbohydrates are dissolved. Thus, the absorption of polysaccharides is slowed down. This group is considered to be the modern antidiabetic type of antihyperglycemic division with minimal side symptoms. In particular, these are almost the only medicines for diabetics that do not provoke gastrointestinal dysfunction. It is recommended to consume tablets together with food at the very beginning of the meal. They reduce sugar content quite easily without acting on the pancreas. Allowed to use alpha- glucosidase inhibitors with other antidiabetic drugs, including insulin. But it is important to realize that the risk of developing hypoglycemic symptoms increases in direct proportion. The main representatives of such inhibitors are Miglitol and Glucobay .
Exenatide is one of the most popular drugs in the group. The action is aimed mainly at increasing insulin synthesis. This becomes possible due to the entry of glucose into the bloodstream and a decrease in the production of fatty acids with glucagon. At the same time, a slowdown in the process of digesting food begins, due to which the diabetic remains full for much longer. The most common side effect is nausea. Moreover, it is recommended to endure this state. In practice, it became clear that this type of manifestation disappears in 1-2 weeks. If not, you should contact an endocrinologist.
Incretinomimetics can become both monotherapy for type 2 diabetes, and part of complex drug therapy. The choice of the treatment regimen depends on the initial condition of the patient.
Acarbose is considered the most popular name for this type of inhibitor . These drugs are not prescribed as monotherapy for diabetes. But the effectiveness of the tool is still quite high. There are several features of the drug: its composition does not enter the bloodstream, and also has no effect on the production of insulin. Its main focus is the fight against carbohydrates that come from food. The active substances of the agent interact and bind with enzymes produced to break down these elements. So there is a decrease in their assimilation. As a result, jumps in sugar after a meal happen much less often.
Some drugs have a complex effect on the body of a diabetic due to their composition. These medicines include Glibomet , Amaryl , Yanumet . They help reduce insulin resistance, enhancing the synthesis of this substance along the way. If you take by name, then Amaryl has an auxiliary effect, enhancing the production of the hormone. At the same time, the susceptibility of body cells to it also increases. Accordingly, two goals are achieved at once in the course of therapy. In the absence of effect from diet therapy and taking hypoglycemic drugs, Glibomet is often prescribed . It helps to achieve the desired result. It is considered a strong enough drug among analogues. Yanumet does not allow blood glucose to drop sharply. Thus, there are no impressive drops in sugar. This remedy reinforces the effectiveness of training and diet.
Combined action drugs should be prescribed only by a doctor, especially if they require replacement with an analogue. Even the same component in different preparations can affect the body in different ways, and this must be taken into account when determining the dosage.
New generation of drugs
These drugs include mostly DPP-4 inhibitors. They are considered one of the best in antidiabetic therapy. On the one hand, they do not affect beta cells and, accordingly, insulin production, although they also prevent glucano- polypeptides from being destroyed by the DPP-4 enzyme. Such a compound allows the pancreas to function normally, which activates the already increased production of insulin. It is noteworthy that these drugs allow insulin synthesis to be maintained at the required level after entering into a reaction with glucan . That is, the DPP-4 inhibitor acts on the initial causes of the development of diabetes, providing some protective and stimulating effect. The advantages of the medicines of the presented group include:
- No drop in the sugar index, since the glucose volume is brought back to normal quickly enough, after which the composition ceases to act;
- They are well compatible with other drugs, with the exception of insulin, as well as insulin receptor antagonists;
- Medicines of this group do not affect the body of a diabetic in the context of weight gain.
But the disadvantages of the drug should also be taken into account even before the start of therapy. The most important is the violation of the digestive processes. It is manifested by nausea and pain in the abdominal region. Still medicines for diabetics from the group of DPP-4 inhibitors have their own prohibitions on taking them, including kidney and liver pathologies. The main popular names are Sitagliptin , Saxagliptin , Vildagliptin . Another type of the latest generation of drugs is GLP-1 antagonists. They are hormonal agents that promote the production of insulin by the body. In parallel, they help restore the structure of pancreatic cells damaged by autoimmune processes. Main name – Byetta , Viktoza . Their use helps to reduce weight in obese diabetics. One of the disadvantages is the production of drugs from the presented group only in the form of solutions. That is, only injections are performed with them.
Sometimes for diabetes, endocrinologists prescribe herbal medicines, which are considered the most optimal solution at a particular stage of treatment. They help bring blood sugar levels back to normal. But it is not worth taking them as the basis for the therapy of such a serious diagnosis; accordingly, all the instructions of the endocrinologist must be followed exactly.
Exclusively herbal medicines will not allow you to achieve recovery or remission, and therefore it is necessary to carry out full treatment with all drugs prescribed by the doctor in accordance with the scheme of use.
Despite the above, you should not refuse to take them. They help to improve the patient’s well-being. These medications are considered to be the most effective in the pre – diabetes stage . The most popular is Insulat . It helps to reduce the absorption of glucose in the intestines. This is how the sugar level gradually decreases. Due to the intake of Insulate , the pancreas is activated. In parallel, the weight of the diabetic is stabilized. It is often used to prevent type 2 diabetes. With prolonged use of the composition, the manufacturer promises a stable normalization of sugar indicators. But still, no one cancels the diet and the doctor’s recommendations, that is, they will have to be followed in any case. Also another herbal remedy is Diabenot . This is a two-phase medication that was developed in Germany, but it appeared on the Russian pharmaceutical market not so long ago. It is released in capsule form. This drug helps:
- Purify the blood with lymph;
- Stimulate the work of beta cells;
- Bring metabolic processes to a normal state;
- Reduce sugar levels;
- To prevent the manifestation of complications of pathology;
- Support the immune system.
The drug helps to increase the production of insulin, preventing glycemia under its influence, and the functionality of the liver is also restored. The drug has practically no side effects and contraindications.
Features of insulin therapy
If a person has diabetes for a long period of time – more than 5-10 years, then he is prescribed more specific drugs. Moreover, the same insulin can be prescribed both on a permanent basis and on a temporary basis. Everything will depend on the initial state of the diabetic. Often, these injections are prescribed earlier than the specified period. But before that, other antidiabetic medications with a more gentle effect are sure to be tried. Insulin has various classifications for the duration of exposure and the rate of onset of the effect:
- Short insulin has a minimum duration of effect and the onset of action of the composition 15 minutes after administration;
- Medium insulin has a moderate duration of action and gives an effect approximately 2 hours after injection;
- Long insulin is effective only 4-6 hours after the injection.
The choice of dose volume and type of drug is carried out by an endocrinologist. Moreover, the patient’s condition should be taken into account, indicators of laboratory tests and other factors. The introduction can be carried out by injection using special syringes or other devices. Sewing an insulin pump is considered the most convenient. She independently regulates the dosage of the injected drug, calculating it on the basis of the data derived from her blood test. Previously, people could take such drugs and not lead an appropriate lifestyle. Therefore, an increased glycemic index was noted. As a result, when they were prescribed insulin, there were already significant complications of the disease. Today, this drug is considered one of the most effective in lowering sugar levels. But if you compare it with other medicines, then its price is slightly higher. You should also take into account some complexity with the introduction of the composition.
According to statistics, about 30-40% of patients with diabetes need insulin. But only after a complete examination, the endocrinologist can prescribe the use of this remedy.
It is impossible to delay the diagnosis. This is especially true for those people who have a history of obesity, pancreatic disease, or a genetic predisposition. Self – prescription of drugs is strictly prohibited, since improper use is fraught with rather serious consequences.
Type 1 diabetes drugs
Therapy of the first type of diabetes is based on a number of groups of medicines, including:
- ACE inhibitors, which help normalize blood pressure;
- Medicines aimed at treating the gastrointestinal tract, whose diseases are most often manifested in this type of pathology;
- Drugs for the treatment of the cardiovascular system, if there are violations in its work;
- Pain relievers for peripheral neuropathy;
- Cholesterol drugs to fight atherosclerosis.
These are second-line treatments. The main one is insulin therapy, which will help fill the deficiency of the substance in the body.
Treatment of the elderly
Diabetes mellitus is often detected already in old age. In this case, a number of factors should be taken into account that can affect not only the patient’s condition, but also the assimilation , as well as the effect of drugs. Accordingly, diabetes drugs should be prescribed with extreme caution. Usually, the elderly and the elderly are prescribed drugs based on metmorphine . Even the safest medicines can be complicated by a number of issues, including:
- The presence of concomitant pathologies of acute and chronic type;
- Impossibility of purchasing expensive drugs by some retirees;
- Symptoms of diabetes are often confused with signs of other diseases;
- Often, the disease is found in older people even when serious complications of diabetes began to appear, that is, in advanced stages.
The last point is found literally all the time. In order to prevent such a development of events, ideally, after 45 years, it is necessary to periodically donate blood for sugar. You cannot let the state go by itself, since diabetes mellitus affects the hepatobiliary, cardiovascular, and urinary systems.
Loss of vision up to complete blindness, as well as amputation of limbs due to gangrene are considered one of the most terrible complications.
Therapy for diabetes mellitus should be carried out from the first stages. If it is not carried out, then serious complications will develop one way or another. If, after the diagnosis is made, the patient does not conduct appropriate therapy and does not change his lifestyle, then the following consequences develop:
- Renal failure;
- Heart attack;
- Retinopathy of diabetic type with complete loss of visual function;
- Glycemic coma;
As you can see from the list, diabetes itself is not so much terrible as its consequences. It is at their prevention that treatment is directed. In the process, the blood sugar level is monitored.
Popular drugs that lower sugar
There are certain medications that can help lower blood sugar levels. At the same time, they can belong to completely different groups, and therefore it is prohibited to change one medication to another without a doctor’s prescription, since there is a risk of severe side effects, up to and including damage to internal organs.
|A drug||Group||Active substance|
|Forsiga||Inhibitor of the SGLT2 group (sodium glucose cotransporter of the second type)||Dapagliflozin|
|Jardins||SGLT2 group inhibitor||Empagliflozin|
Of the above list, it is the SGLT2 inhibitors that are considered the most effective and easily tolerated in comparison with their older counterparts. But their cost is also appropriate. For the same drug called Forsiga, you can pay about 2.5 thousand rubles.
What is the best diabetes medication?
If we talk about the best drug in the context of efficiency, quality and price, then this is what doctors consider Metmorphin . It rarely provokes serious side effects. But patients often complain of diarrhea. To avoid it, the dosage is gradually increased to the required level. But, despite all the advantages of the drug, the drug cannot completely get rid of diabetes. Therefore, diet therapy and exercise therapy are required in parallel. Almost everyone can use it, with the exception of patients who have a history of cirrhosis of the liver and renal failure.
Glucophage is an imported substitute for Metmorphine . Opinions differ on the quality of the drugs. Some experts believe that the former is better tolerated, while others argue that their effectiveness and side effects are at the same level.
Endocrinologists also call the combined drugs Galvus Met and Yanumet good drugs . They are quite effective and well tolerated by patients. But even they have a significant drawback – a rather high cost.
Diabetes most often develops because the body is simply unable to absorb carbohydrates from food. The second most frequent cause is the patient’s physical inactivity. Therefore, the first measures to be taken are diet therapy and exercise therapy. Drug therapy is also an important part of the impact on diabetes, but without changing the patient’s lifestyle, results that are significant for health in a positive context will not be achieved. If the patient is unable to stop eating harmful products, then sooner or later the reserves of the pancreas will run out. This will stop the production of insulin. In such a situation, even the most expensive diabetes drugs will no longer be able to help. The only thing left for the patient at this stage is insulin injections. Without this, a diabetic coma develops, after which a fatal outcome occurs.