Everyone knows that there is the first type of diabetes mellitus (it is also called insulin-dependent) and the second type of diabetes mellitus ( non-insulin dependent ).
The first type occurs in patients with decreased insulin production. The second type of diabetes can develop even if there is an excess of insulin in the blood, but it does not work well. The mechanism of development of these two diseases is completely different, so it is obvious that completely different drugs are used in the treatment of each of them for diabetes mellitus .
In the first type of diabetes mellitus, the only method of treatment today is insulin. Moreover, it is introduced into the body exclusively with the help of injections (insulin therapy).
As for type 2 diabetes mellitus, very often a planned diet (diet) is sufficient for its treatment. If this method does not work, come to the aid hypoglycemic pills for type 2 diabetes .
The most common mistake among patients who take diabetes pills is the belief that they lower blood glucose because they contain insulin. This is a misconception, because it is known that insulin is a protein that is very quickly destroyed by the action of gastric juice, which means it loses its properties. Then why do diabetes drugs lower blood sugar? The diagram showing how the pills work will help to answer this question. We will also look at what is the main difference between them.
The diagram shows that normally digested food in the stomach in the form of sugar enters the bloodstream through its wall. At the same time, the level of glucose in the blood rises, and the pancreas begins to release insulin into the blood in diabetes mellitus in a certain amount. It goes to the cells and launches blood sugar into them. In cells, however, glucose is used as a source of energy. Obviously, maintaining normal blood sugar levels in people with diabetes can be done in three main ways:
- Limit the absorption of sugar into the bloodstream from food digested in the stomach.
- Increase insulin release in response to post-meal increases in blood sugar.
- Strengthen the work of insulin at the organ level.
It is on these principles that the action of hypoglycemic tablets is based . Moreover, each of them has its own characteristics. And this, in turn, makes it possible to choose the “ideal” diabetes medication for each patient. There are 3 main groups of such drugs.
Group # 1
These drugs for the treatment of diabetes mellitus affect the secretion of insulin by the pancreas ( arrow 1 in the diagram ). When taking such medications, the pancreas “wastes” all the reserves of insulin that it has produced up to this point. An insulin surge caused by drugs in group 1 is necessary when a rise in blood glucose is expected (that is, after a meal). Therefore, taking such pills should be associated with meals.
The side effects of drugs in this group include so-called allergic reactions. In addition, in rare cases, it is possible to change the blood count.
These drugs include:
- Maninil 5; 3.5; 1.75. – one of the most prescribed drugs today.
- Diabeton – in terms of the strength of the sugar – lowering effect, it is somewhat inferior to maninil , but at the same time it contributes to a more physiological profile of increasing insulin in the blood.
- Glurenorm is a medicine for those patients with diabetes who have concomitant kidney disease or renal complications of diabetes.
- Amaryl is a relatively new drug that appeared in Russia in 1998. It possesses new characteristics, due to which it can be attributed to the next generation of drugs.
Group No. 2
The point of application of these drugs for diabetes mellitus in the diagram is indicated by arrow 2.
These drugs do not interfere with the production of insulin by the pancreas and do not increase the amount of insulin in the blood . They enhance the work of insulin at the organ and tissue levels.
Side effects of these drugs include an increase in blood lactic acid levels. Their intake is undesirable for people with decreased function of the kidneys, liver, pulmonary and cardiovascular systems, as well as for patients who abuse alcohol.
These drugs include:
- Metformin ( Glucophage ) – in Russia, this group of drugs is represented by the drug Siofor .
Group No. 3
The place of action of drugs of group No. 3 is indicated on the diagram by arrow 3. These drugs do not affect the secretion of insulin, as well as the intensity of its functioning at the level of organs. They are designed to regulate the absorption and absorption of glucose from the gastrointestinal tract (GIT) into the blood.
A side effect of these drugs is inflammatory processes of the intestines, stomach, dysbiosis , cholecystitis.
These drugs include:
- Glucobay (may also be called Acarbose ).
Features of the combined treatment
Medicines of different groups affect different mechanisms in the development of an increase in blood glucose levels. Therefore, in the absence of positive results of treatment, a combination of drugs from different groups is possible – 1 + 2, 2 + 3, 1 + 3 , etc. Medicines belonging to the same group cannot be combined.
Remember, hypoglycemic medications are only aids in achieving positive diabetes management outcomes.