What's New in Diabetes Treatment: Impressive Data

Tablets to lower blood sugar levels.

Tuesday, September 28
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Content

• Types of diabetes
• Causes of type 2 diabetes mellitus
• How to choose diabetes pills
• Top 5 diabetes pills
• Diabetes
• Siofor
• Januvia
• NovoNorm
• Glucobay

To treat diabetes, it is not necessary to regularly inject insulin. In many cases, it is enough to simply lead a healthy lifestyle and take special medications. Let's figure out what types of diabetes there are and what pills doctors prescribe.

Diabetes mellitus is not one specific disease, but a group of diseases in which the metabolism in the body is disrupted (in particular, carbohydrate metabolism suffers).

Combination drugs

Drugs for the treatment of diabetes have a complex effect: Amaryl, Janumet, Glibomet. They reduce insulin resistance and enhance the synthesis of this substance in the body.

Amaryl enhances the production of insulin by the pancreas and also increases the sensitivity of body cells to it.

If diet and hypoglycemic drugs do not achieve the desired success, then patients are prescribed Glibomet.

Janumet prevents glucose from dropping sharply in the blood, which prevents spikes in sugar levels. Taking it allows you to increase the therapeutic effect of diet and exercise.

Types of diabetes

There are several types of diabetes.

1. Diabetes mellitus type 1.
   Usually this disease develops at a young age (up to 30-35 years). A feature of this type of diabetes is insulin dependence. Symptoms of type 1 diabetes: increased appetite, but weight loss against this background, frequent urination, constant thirst. With this type of diabetes, carbohydrate metabolism is impaired, and the pancreas produces too little insulin.
2. Diabetes mellitus type 2.
   This diabetes is non-insulin dependent. Most often, the disease develops in old age. Type 2 diabetes is often inherited. This kind of diabetes requires a special diet, physical activity (moderate) and strict adherence to the advice of your doctor.
3. Gestational diabetes.
   This type of diabetes occurs in pregnant women and usually goes away after childbirth. Sometimes gestational diabetes can negatively affect the fetus or recur after a few years.
4. MODY-diabetes.
   This kind of diabetes is rare; the disease occurs in 5% of diabetics. Develops at an early age. In MODY diabetes, a person has a very low need for insulin. The disease is considered an intermediate stage because it has features of the first two types of diabetes.

Treatment of diabetes depends on what caused it, how severe the disease is, what chronic diseases the person has, and what his age is. Tablets for diabetes, taking into account all the above factors, can only be prescribed by a doctor.

Treatment of the elderly

If elderly patients suffer from diabetes, then medications should be prescribed to them with extreme caution. Most often, such patients are recommended to take medications containing metformin.

Treatment is complicated by the following points:

• In old age, in addition to diabetes mellitus, people often have other concomitant pathologies.
• Not every elderly patient can afford to buy expensive medications.
• Symptoms of diabetes can be confused with manifestations of another pathology.
• Diabetes mellitus is often discovered very late, when the patient already has severe complications.

To prevent diabetes from remaining undiagnosed at an early stage, after the age of 45-55 you should regularly donate blood for sugar. Diabetes mellitus is a serious disease that can be accompanied by disturbances in the functioning of the cardiovascular system, urinary and hepatobiliary systems.

Serious complications of the disease include loss of vision and amputation of limbs.

Causes of type 2 diabetes mellitus

There are certain factors that influence the occurrence of diabetes.

Some metabolic disorders in the body can increase the risk of disease. Among them:

• presence of type 2 diabetes in close relatives;
• obesity or overweight;
• poor nutrition, an abundance of fatty or too carbohydrate foods in the diet;
• lack of physical activity, sedentary lifestyle;
• age factor;
• high blood pressure;
• impaired glucose tolerance (slight increase in blood sugar);
• gestational diabetes in the past;
• malnutrition during pregnancy.

In recent decades, due to changes in diet and physical activity, urbanization and the fast pace of life, the number of people with type 2 diabetes has increased sharply.

Types 1 and 2 diabetes: differences

Photos from open sources

Newest drugs for diabetes

Most often, drugs for the treatment of type 2 diabetes are administered in the form of tablets. However, the development of new injectable drugs could radically change the situation. Thus, scientists working in Denmark have created a drug that reduces insulin, which works on the basis of an active substance called liraglutide. In Russia it is known as Victoza, and in Europe it is produced under the Saxenda brand. It has been approved as a new drug for the treatment of diabetes in obese patients with a BMI over 30.

The advantage of this medicine is that it helps fight excess weight. This is rare for drugs of this series. While obesity is a risk factor for the development of severe complications of diabetes. Studies have shown that the use of liraglutide reduced the weight of patients by 9%. No other hypoglycemic drug can boast of such an effect.

The study was completed in 2021 and included 9,000 participants. It lasted for 4 years. It proved that taking liraglutide can reduce the risk of developing cardiovascular diseases. The development was not completed at this point. Scientists have presented another innovative drug for the treatment of diabetes called Semaglutide.

At this point in time, this drug is at the stage of clinical trials, but it has already become known to a wide circle of scientists. This was due to the fact that Semaglutide has the ability to reduce the risk of developing cardiovascular diseases in patients with diabetes. The studies involved 3,000 patients. Treatment with this innovative drug continued for 2 years. It was possible to establish that the risk of heart attack and stroke decreased by 26%, which is very impressive.

All patients with diabetes are at risk for developing heart attack and stroke. Therefore, the developments of Danish scientists can be called a real breakthrough, which will save the lives of a huge number of people. Both liraglutide and semaglutide must be administered subcutaneously. To achieve a therapeutic effect, you will need to give only 1 injection per week. Therefore, we can now say with confidence that diabetes is not a death sentence.

How to choose diabetes pills

The most important thing in treating diabetes is proper nutrition and moderate physical activity, giving up bad habits and controlling weight. In the initial stages of the disease, these measures are enough to keep blood sugar levels normal, but over time, as diabetes progresses, only such measures become insufficient. Some people with type 2 diabetes need to take medications to lower their sugar levels. If one remedy is not enough, the doctor may prescribe both tablets and insulin in parallel.

Most often, type 2 diabetes is treated with the following groups of drugs:

• Metformin from the biguanide group reduces insulin resistance and helps the body properly consume its own insulin. All over the world, drugs from this group are used as the main drugs in the treatment of type 2 diabetes.
• Sulfonylureas are stimulants for the pancreas to produce insulin. This group includes active ingredients such as gliclazide, glipizide, glimepiride, tolbutamide and glibenclamide. Read also: Popular drugs for lowering cholesterol Top 5 drugs for lowering cholesterol levels in the blood.

New generation drugs

DPP-4 inhibitors are a new generation of drugs for the treatment of diabetes mellitus. They do not affect the production of insulin by beta cells, but protect a special glucan polypeptide from its destruction by the DPP-4 enzyme. This glucano-polypeptide is necessary for the normal functioning of the pancreas, as it activates the production of insulin. In addition, DPP-4 inhibitors support the normal functioning of the glucose-lowering hormone by reacting with glucagon.

The advantages of new generation drugs include:

• The patient does not experience a sharp decrease in blood sugar levels, since after bringing the glucose level back to normal, the drug stops working.
• The drugs do not promote weight gain.
• They can be used with any medications except insulin and insulin receptor agonists.

The main disadvantage of DPP-4 inhibitors is that they interfere with food digestion. This is manifested by abdominal pain and nausea.

It is not recommended to take drugs from this group if there is a problem with the liver or kidneys. Names of new generation drugs: Sitagliptin, Saxagliptin, Vildagliptin.

GLP-1 agonists are hormonal drugs that stimulate insulin production and help restore the structure of damaged cells. Names of drugs: Victoza and Byeta. Taking them promotes weight loss in obese people. GLP-1 agonists are produced only in the form of solutions for injection.

[Video] Briefly and clearly - how GLP-1 agonists work, their pros and cons:

Top 5 diabetes pills

Let us remind you once again that only a doctor can choose the right drug to lower blood sugar levels. Often a combination of several drugs or even parallel insulin injections may be needed. Self-medication for diabetes is unacceptable, because only an experienced endocrinologist, having studied the results of your tests, can prescribe a certain drug and then adjust its dosage. Without the participation of a doctor, such treatment can cause serious complications, including hypoglycemia and coma. We have compiled a list of the most effective and commonly prescribed diabetes pills.

Features of insulin treatment

If a patient has diabetes for many years (from 5 to 10), then the patient requires specific medications. Such patients are prescribed insulin injections temporarily or permanently.

Sometimes insulin is prescribed even earlier than 5 years from the onset of diabetes mellitus. The doctor decides to take this measure when other drugs do not achieve the desired effect.

In years past, people who took medications and dieted had a high glycemic index. By the time they were prescribed insulin, such patients had already experienced severe diabetic complications.

Video: Insulin therapy for diabetes:

Today, insulin is recognized as the most effective substance for lowering blood sugar levels. Unlike other drugs, it is somewhat more difficult to administer, and its price is higher.

About 30-40% of all patients who suffer from diabetes need insulin. However, the decision on insulin therapy should be made only by an endocrinologist based on a comprehensive examination of the patient.

It is impossible to delay the diagnosis of diabetes mellitus. People who are overweight, suffer from pancreatic pathologies, or have a hereditary predisposition to diabetes should be especially attentive to their own health.

Antihyperglycemic drugs are dangerous because they can lead to a sharp drop in blood glucose levels. Therefore, some patients are advised to maintain sugar levels at fairly high levels (5-100 mmol/l).

Read more: Instructions for using insulin, prices

Diabetes

Diabeton tablets from the group of sulfonylurea derivatives can only be purchased with a prescription. The active ingredient of the drug - gliclazide - is released slowly after taking the tablet, therefore it gently reduces blood sugar levels. “Diabeton” is prescribed to those patients who monitor their diet, eat regularly and get enough carbohydrate foods. These tablets are prescribed for type 2 diabetes, when diet, physical activity and weight correction do not help reduce sugar. The drug has also proven itself well as a prevention of diabetic complications (strokes, heart attacks, kidney diseases, eye diseases, etc.).

Contraindications:

allergies to the components of the drug, type 1 diabetes, severe kidney and liver diseases, ketoacidosis, taking antifungal drugs, age under 18 years, pregnancy and breastfeeding. When a doctor prescribes these pills for diabetes, he must evaluate the patient’s age, his diet, the state of the cardiovascular system, the presence of problems with the thyroid gland and the functioning of the adrenal glands.

Diabeton MV

SERVIER (Servier), France

A drug to lower blood glucose levels.
Used for: Type 2 diabetes mellitus with insufficient effectiveness of diet therapy, physical activity and weight loss; - prevention of complications of diabetes mellitus: reducing the risk of microvascular (nephropathy, retinopathy) and macrovascular complications (myocardial infarction, stroke) in patients with type 2 diabetes mellitus through intensive glycemic control. from 175

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Oral medications for type 2 diabetes

The list of hypoglycemic drugs is so impressive that even patients with diabetes sometimes have a very poor understanding of this variety of medications. Six pharmacological groups, which differ in their mechanism of action and have their own positive and negative sides, and dozens of drugs used for type 2 diabetes, create confusion in the minds of consumers. Let's try to put everything on the shelves.

Six groups

So, modern oral hypoglycemic agents belong to one of six groups:

• Biguanides are the main representative of metformin, which we have already written about.
• Sulfonylurea derivatives - glibenclamide, gliclazide, glimepiride, glipizide.
• Alpha-glucosidase inhibitors - acarbose, miglitol.
• Thiazolidinediones, or glitazones - pioglitazone, englitazone.
• DPP-4 inhibitors, or gliptins - sitagliptin, vildagliptin, saxagliptin.
• SGLT2 inhibitors - dapagliflozin, canagliflozin, empagliflozin.

Despite the names of pharmacological groups that are difficult for the inexperienced consumer to perceive, the mechanism of action of the drugs included in their composition is quite transparent, and the advantages and disadvantages are obvious. And, putting aside the fear of terms, let’s get to know them better.

Sulfonylurea derivatives

They “force” the body to produce (secrete) insulin, which is why they are sometimes called secretagogues.

How do they work?

Sulfonylurea derivatives bind to receptors located on the membranes of pancreatic beta cells. This triggers a sequence of events within the cells that results in an increase in the amount of insulin produced by the beta cells. Reduce the level of glycated hemoglobin (HbA1c - an indicator that reflects the level of glucose in the blood over a long period of time) by an average of 1-2%.

Who is it prescribed to?

Drugs in this group are prescribed for type 2 diabetes, when the level of glycated hemoglobin is above 6.5%. As a rule, they are approached in the absence or insufficient response to treatment with metformin.

Advantages:

• Affordable price.
• Fast onset of action.
• No effect on pressure levels.
• Convenient dosing.
• Reduction of microvascular complications (retinopathy, neuropathy).

Flaws:

• Risk of hypoglycemia.
• Gain in body weight.
• Low long-term effect.

Alpha-glucosidase inhibitors

Drugs in this group slow down the absorption of carbohydrates from food and the flow of glucose into the blood. Reduce HbA1c levels by 0.5–0.8%.

How do they work?

The mechanism of action is based on blocking intestinal enzymes - alpha-glucosidase - which are involved in the breakdown of saccharides.

Who is it prescribed to?

Drugs in this group are used when difficulties arise in controlling glucose levels after meals.

Advantages:

• The ability to reduce glucose levels after meals (postprandial), especially in combination with other glucose-lowering drugs.
• Low risk of hypoglycemia.
• No effect on body weight.
• Reduced triglyceride levels.

Flaws:

• Low hypoglycemic activity.
• Side effects from the gastrointestinal tract.
• Inconvenient dosing (need for frequent selection, dose titration).
• High price.

Thiazolidinediones

Drugs in this group increase the body's sensitivity to insulin, which is why they are sometimes called insulin sensitizers. HbA1c levels decrease by 0.5–1.4% when taking thiazolidinediones.

How do they work?

Thiazolidinediones bind to PPARg receptors, which are found in the liver, vascular endothelium, adipose and muscle tissues. This leads to an increase in the synthesis of proteins involved in glucose metabolism.

Who is it prescribed to?

Drugs in this group are used in cases where metformin or sulfonylurea derivatives are poorly tolerated or do not compensate for diabetes.

Advantages:

• Low risk of hypoglycemia.
• Long-term effect.
• Increasing the level of “good” cholesterol, decreasing the level of triglycerides (pioglitazone).
• Reducing the risk of coronary heart disease (pioglitazone).

Flaws:

• Gain in body weight.
• Fluid retention in the body.
• Contributes to the destruction of bone tissue and frequent bone fractures.
• Increased levels of “bad” cholesterol.
• High price.

DPP-4 inhibitors

This is a fairly new class of oral hypoglycemic drugs that can reduce HbA1c levels by 0.5–0.8%, as well as reduce body weight.

How do they work?

Drugs of this class block the action of the DPP-4 enzyme, which destroys a group of gastrointestinal hormones - incretins. Incretins help stimulate the production of insulin when it is needed (for example, after meals), and also reduce the liver's production of glucagon when it is not needed (during digestion). In addition, they slow down digestion and reduce appetite.

Who is it prescribed to?

DPP-4 inhibitors are considered second or third line drugs. They are used if treatment with metformin and sulfonylurea derivatives has not given the desired result. They often become an alternative to thiazolidinediones.

Advantages:

• Low risk of hypoglycemia.
• Good tolerance.
• Decreased appetite (used for increased body weight or obesity).

Flaws:

• Not as intense a decrease in HbA1c compared to drugs from other groups.

SGLT2 inhibitors

The newest class of glucose-lowering drugs. Their action is based on the ability to “help” the kidneys reduce blood glucose levels. Approved by one of the most authoritative health organizations in the world, the American Food and Drug Administration (FDA), for the treatment of diabetes in 2013.

How do they work?

The kidneys constantly filter glucose from the blood, after which it returns to the bloodstream again - glucose is reabsorbed. This process involves proteins called sodium-glucose glucose cotransporters - SGLT1 and SGLT2. SGLT2 inhibitors block type 2 proteins, causing less glucose to return to the blood and more to be excreted from the body in the urine.

Who is it prescribed to?

Drugs in this group are used in cases of insufficient response to treatment with metformin and insulin. They are not recommended for patients with impaired kidney function (nephropathy), since in such cases the effectiveness of SGLT2 inhibitors is reduced.

Advantages:

• High hypoglycemic activity.
• Loss of body weight.

Flaws:

• Risk of urinary tract infections.
• Risk of hypoglycemia.
• High price.

Marina Pozdeeva

Photo istockphoto.com

Products by topic: (metformin), (glibenclamide), (gliclazide), (glimepiride), (acarbose), [product strict="sitagliptin"](sitagliptin), (vildagliptin), (saxagliptin), (dapagliflozin), (canagliflozin ),(empagliflozin)

Siofor

You can buy Siofor tablets in different dosages, strictly according to your prescription. The active ingredient of Siofora is metformin. The drug belongs to the biguanide group and affects the uptake of glucose by cells. The drug is prescribed to people with type 2 diabetes (including those who are overweight). The drug is suitable for those who do not benefit from lifestyle changes. "Siofor" is used both as monotherapy and as part of a complex treatment of severe diabetes (together with other tablets or against the background of insulin injections). The drug is indicated for children over 10 years of age (as a single drug or in combination with insulin).

Contraindications:

ketoacidosis, intolerance to the drug components, serious kidney and liver diseases, pregnancy and breastfeeding, low-calorie diet. Also, Siofor should not be used simultaneously with contrast agents containing iodine.

Siofor

Berlin-Chemie/Menarini, Germany

- type 2 diabetes mellitus, especially in overweight patients with ineffective diet therapy and physical activity.
It can be used as monotherapy or in combination with other oral hypoglycemic drugs and insulin. from 359

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Treatment regimen

Taking medications for type 2 diabetes is aimed at achieving the following goals:

• Reduce tissue insulin resistance.
• Stimulate the process of insulin synthesis.
• Resist the rapid absorption of glucose into the blood.
• Normalize the balance of lipids in the body.

Therapy should start with one drug. In the future, it is possible to introduce other drugs. If the desired effect cannot be achieved, the doctor recommends insulin therapy to the patient.

Januvia

These tablets from the gliptin group are sold exclusively by prescription. The active substance of the drug is sitagliptin. Januvia is used in combination therapy: together with metformin or with insulin injections. The dosage of the drug is selected very carefully, only after collecting all the data on the patient’s health. Januvia tablets are prescribed to lower sugar levels while following a diet and physical activity. In combination with other means, if lifestyle changes have not shown positive results.

Contraindications:

age under 18 years, type 1 diabetes, ketoacidosis, pregnancy and breastfeeding. The drug is prescribed with caution to people with kidney disease, pancreatitis and while taking other medications.

Januvia

Merck Sharp and Dome, Netherlands

Monotherapy: as an adjunct to diet and exercise to improve glycemic control in type 2 diabetes mellitus. Combination therapy: in type 2 diabetes mellitus to improve glycemic control in combination with metformin or a PPAR-γ agonist (eg, thiazolidinedione) when diet and physical activity in combination with monotherapy with the listed drugs does not lead to adequate glycemic control.
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NovoNorm

This is a prescription drug for diabetes from the group of glinides, the main active ingredient of which is repaglinide. Effectively reduces blood sugar against the background of metabolic disorders in people with diabetes. NovoNorm is prescribed for type 2 diabetes, when diet and exercise are ineffective. Also, taking these tablets is indicated when treatment with metformin is low (in this case, combination treatment is indicated).

Contraindications:

type 1 diabetes, ketoacidosis, surgical interventions, conditions requiring insulin, pregnancy and breastfeeding, intolerance to drug components, age under 18 years. Diabetes tablets should be used with caution in those who have liver and kidney diseases, and also have an unhealthy diet.

New norm

Novo Nordisk (Novo Nordisk), Denmark

NovoNorm is a short-acting oral hypoglycemic drug. Rapidly reduces blood glucose levels, stimulating the release of insulin by the pancreas. Binds on the β-cell membrane to a receptor protein specific for this drug. This leads to blocking of ATP-dependent potassium channels and depolarization of the cell membrane, which in turn promotes the opening of calcium channels. The entry of calcium into the β-cell stimulates the secretion of insulin.
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The most popular sugar-lowering tablets

The table below describes the most popular glucose-lowering tablets.

Popular pills for type 2 diabetes:

Drugs for the treatment of type 2 diabetes may belong to the following groups:

• Biguanides (metformin).
• Sulfonylurea derivatives.
• Glinides (meglitinides).
• Thiazolidinediones (glitazones).
• Alpha-glucosidase inhibitors.
• Glucagon-like peptide-1 receptor agonists.
• Dipeptidyl peptidase-4 inhibitors (gliptins).
• Sodium-glucose contransporter type 2 inhibitors (gliflozins). These are the most modern drugs.
• Combination drugs that contain two main active ingredients at once.
• Insulin.

Glucobay

Prescription tablets "Glucobay" are an alpha-glucosidase inhibitor, the active substance of the drug is acarbose. Glucobay is prescribed for type 2 diabetes while following a diet. The drug perfectly lowers blood sugar levels.

Contraindications:

gastrointestinal diseases (ulcers, flatulence, intestinal obstruction, malabsorption of nutrients), severe kidney disease, pregnancy and breastfeeding, intolerance to the components of the drug. Glucobay should be taken with caution against the background of infectious diseases, at elevated temperatures, after operations and injuries. In the first six months of taking diabetes pills, it is important to monitor your liver function.

Glucobay

Bayer AG, Germany

Glucobay is a hypoglycemic agent for oral use.
Indicated for the treatment of type 2 diabetes mellitus in combination with diet. The medication is recommended for people with a predisposition to developing diabetes, in combination with exercise and diet. from 528

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Herbal preparations

Sometimes, with diabetes, the patient is recommended to take medications based on herbal ingredients. They are designed to normalize blood sugar levels. Some patients take such nutritional supplements as full-fledged medicines, but in reality this is not the case. They will not allow you to achieve recovery.

However, you should not refuse to take them. These drugs help improve the patient’s well-being, but treatment must be comprehensive. They can be taken at the stage of prediabetes.

Insulate is the most commonly prescribed herbal drug. Its action is aimed at reducing the absorption of glucose in the intestine. This reduces its level in the blood.

Taking Insulate allows you to activate the work of the pancreas and stabilize the patient’s weight. It can be taken both to prevent the development of type 2 diabetes and in combination with other drugs. If you do not interrupt the therapeutic course, you will be able to achieve stable normalization of blood sugar levels. In this case, it is necessary to adhere to the diet and not deviate from medical recommendations.