There are several ways to treat type 2 diabetes. While people with type 1 diabetes have to be treated with insulin, it is not necessarily the case of type 2 diabetes. This is where the so-called oral antidiabetic drugs come into play: it is of tablets medications. An exception is the GLP-1 analogs, which are also injected.
Metformin is the most important drug in type 2 diabetes and has been used for a long time. Metformin acts by blocking the accumulation of glucose in the liver, which reduces the amount of endogenous sugar in the blood. It also improves the sensitivity of cells to insulin. In addition, effects on the intestine and the brain are suspected, which can also reduce blood sugar. For people overweight with type 2 diabetes, it is considered the first preferred drug. Side effects can be gastrointestinal discomforts, such as nausea and diarrhea.
Sulphonylureas increase the production of insulin in the beta cells of the pancreas. They can be used in patients with type 2 diabetes when metformin therapy is insufficient to effectively reduce blood sugar or when metformin intolerance occurs. Side effects may be hypoglycemia, which is more frequent than metformin, weight gain or allergic reactions.
Inhibitors of DPP-4 (gliptines)
DDP-4 inhibitors have an effect on intestinal hormone GLP 1. This helps reduce blood sugar levels in several ways, for example through the release of insulin. Gliptins inhibit the breakdown of GLP 1 after meals, so that the intestinal hormone can work more, informs the counselor of diabetes. They are used when metformin is not effective or is often done in combination with metformin. The side effects are low. DDP-4 inhibitors are among the newest medications for type 2 diabetes.
analogues of GLP-1
GLP-1 analogs also act through the intestine. They imitate the effect of intestinal hormone GLP1. As a result, the pancreas produces more insulin. They are used as a combination, even under insulin therapy. Because the drug is expensive, it only pays if other therapies do not help. They should inject GLP-1 analogues.
These drugs inhibit the SGLT 2 protein in the kidneys. This usually prevents the glucose from being excreted through the urine. Although it inhibits SGLT 2, the body releases more urine sugar. Because SGLT-2 inhibitors promote weight loss, they are suitable for people overweight with type 2 diabetes. They also reduce blood pressure. The possible side effects are fungal infections, especially in the genital area.
Source: Results Diabetes 1/2019