The Type 2 Guide to Oral Medications
While a number of people with Type 2 diabetes may be able to maintain their disease with the implementation of a nutritious diet and an exercise regimen, some can be helped by oral medicine, whether it be through one medication or a combination of multiple.
Oral medications for T2D help bring glucose levels into the normal range necessary for optimal function. Because those with Type 2 diabetes are resistant to insulin rather than completely insulin deficient, oral medications can assist with the maintaining of proper glucose levels and the stimulating of insulin production, while people with T1D absolutely must rely on insulin injections for their treatment. Most people with T2D do eventually end up utilizing insulin injections along with prescribed medications because it can have a number of benefits or merely becomes a necessary requirement to maintain their condition.
Medications that increase insulin production include
- Help the pancreas produce more insulin, allow the cells to better use insulin
- Should be taken daily, at the same time, at mealtime
- Can cause low blood sugar
- Brand names: Diabinese (chlorpropamide), Diabeta (glyburide), Micronase (glyburide), Glucotrol (glipizide)
- Stimulate more insulin release from beta cells
- Are less likely to cause low blood sugar
- Should be taken with meals, do not skip eating and still dose yourself
- Brand names: Prandin (Repaglinide), Starlix (Nateglinide)
Medications that increase insulin production and decrease glucose production include
- Stop the release progress of the enzyme that increases insulin while decreasing the amount of glucose in the liver
- Should be taken once daily at the same time
- Do not cause low blood sugar
- Brand name: Januvia (Sitagliptin), Onglyza (Saxagliptin), Tradjenta (Linagliptin)
Medications that increase insulin sensitivity in muscles and decrease glucose production include
- Decrease amount of glucose released by the liver
- Should be taken twice a day, with morning and evening meals
- Likely to cause low blood sugar
- Brand names: Metformin (Glucophage)
- Increase the amount of glucose absorbed by muscles and keep liver from overproducing glucose
- Should be taken once a day, at the same time each day
- Do not cause low blood sugar when taken alone
- Brand names: Actos (Pioglitazone), Avandia (Rosiglitazone)
Medications that slow the breakdown of carbohydrates
- Make it difficult for the intestine to break down starches and work to keep blood sugar down after meals
- Should be taken with the first bite of meals, do not take without eating
- Do not cause low blood sugar
- Brand names: Precose (acarbose), Glyset (miglitol)
Medications that reduce the kidney absorption of glucose
- Block the reabsorption of glucose by the kidneys, increase glucose excretion in urine, and lower blood sugar as a result
- Should be taken once at the same time each day, with or without food
- Brand names: Sulisent (canagliflozin), Farxiga (dapagliflozin), Jardiance (empagliflozin)
Medications that slow carb absorption
GLP-1 Receptor Agonists:
- Slows glucose absorption and helps you feel full.
- Tells your pancreas when your blood sugar is high and the pancreas then excretes more insulin.
- GLP-1’s are usually injectables, but the first oral version, Rybelsus was approved by the FDA in 2019.
- Should be taken by mouth on an empty stomach when you first wake up with plain water — no more than 4 ounces.
- Rybelsus works best if you eat 30 to 60 minutes after taking it.
- Side effects: Pancreatitis, changes in vision, low blood sugar (hypoglycemia), kidney issues, and allergic reactions.