Antidiabetic agents are medications that help keep the levels of blood sugar (blood glucose) normal and relieve the symptoms of diabetes, such as thirst, increased urination, weight loss and ketoacidosis. The ultimate goal of a treatment based on these drugs is to reduce the risk of the complications typically associated with diabetes, or at least slow its progression.
Relative to the type of diabetes the appropriate medications may include:
- Insulin: a molecule that reduces the levels of blood sugar as would naturally produced insulin from the pancreas. Its injection is the only choice available to those who suffer from Type 1 diabetes , but it can also be prescribed in some cases of type 2 diabetes ;
- Oral agents: they act by increasing the production of insulin by the pancreas, or by reducing the secretion of glucagon (another hormone that controls blood sugar), reduces the organism’s requirements of insulin, reduces glucose synthesis in the liver or acts on the absorption of glucose or free fatty acids. The most commonly used oral agents include sulfonylureas, biguanides, acarbose, and repaglinide. These are the drugs of first choice in the case of type 2 diabetes, unless they are not sufficient to maintain glucose in a standard treatment. In that case their consumption is typically added to the therapy based on insulin;
How should anti-diabetes medications be taken?
Both the insulin and the oral agents can be taken only on prescription.
The insulin is typically injected (spray forms are not yet fully available); the number of required daily injections depends on the patient and the type of insulin. There are in fact insulin injections that act ultra fast, fast, intermediate and slow, which should be taken in different ways with the possibility of being combined. This is the case of mixed insulin injections, obtained by the combination of ultra-fast insulin or insulin with a rapid intermediate reaction. Furthermore, the injections can be made in different ways (syringes, insulin devices, such as pens, or an insulin pump).
On the other hand, the alternatives are the oral agents, taken orally. In this case the dosage varies according to the situations and the type of drug taken. In general, if they cause gastric problems, the oral anti-diabetes medications should be taken with food. Their use must also be combined with regular blood glucose control associated with diet and regular exercise.
Contraindications and warnings associated with the use of anti-diabetes medications
The side effects associated with the anti-diabetes therapies vary according to the type of drug taken. In general, therapy with other medications taken by mouth can trigger gastrointestinal, skin, blood, and vision problems. In some cases you can also experience an increase in liver enzymes. It is also important not to exclude the risk of hypoglycemia, which is associated with insulin-based therapies.
The oral agents may also interfere with the intake of other drugs. Sulfonylureas, for example, reduce the effectiveness of diuretics and estrogen hormone rifampicin, while increasing that of the sulfonamides. Metformin, a popular biguanide may instead increase the effect of coagulants, while reducing the absorption of vitamin B12.
Insulin may cause the following side effects:
- Hypoglycemia
- Alterations of blood parameters
- Diabetic ketoacidosis
- Blurred vision
- Swelling
- Bloating
- Lipodystrophy
- Allergic reactions
