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What are the oral medications for diabetes treatment?

Oral diabetes medicines, or oral hypoglycemics, can lower blood glucose in people who have diabetes, but are able to make some insulin. They are an option if diet and exercise don't work. Oral diabetes medications are not insulin and are not a substitute for diet and exercise. Although experts don't understand exactly how each oral medicine works, they know that they increase insulin production and affect how insulin lowers blood glucose.

These medications are most effective in people who developed diabetes after age 40, have had diabetes less than 5 years, are normal weight, and have never received insulin or have taken only 40 units or less of insulin a day. Pregnant and nursing women shouldn't take oral medications because their effect on the fetus and newborn is unknown, and because insulin provides better control of diabetes during pregnancy.

There is also some question about whether oral diabetes medications increase the risk of a heart attack. Experts disagree on this point and many people with noninsulin-dependent diabetes use oral medicines safely and effectively. The Food and Drug Administration (FDA), the agency of the Federal Government that approves medications for use in this country, requires that oral diabetes medicines carry a warning concerning the increased risk of heart attack. Whether someone uses a medication depends on its benefits and risks, something a doctor can help the patient decide.

Six FDA-approved oral diabetes medications are now on the market. Their generic names are tolbutamide, chlorpropamide, tolazamide, acetohexamide, glyburide, and glipizide. The generic name refers to the chemical that gives each medicine its particular effect. Some of these medications are made by more than one pharmaceutical company and have more than one brand name. All six are different types of one class of medication, called sulfonylureas, but each affects metabolism differently. A doctor will choose a patient's medication based on the person's general health, the amount his or her blood glucose needs to be lowered, the person's eating habits, and the medicine's side effects.

The purpose of oral medications is to lower blood glucose. Therefore, the person taking them must eat regular meals and engage in only light to moderate exercise, to prevent blood glucose from dipping too low. Medications taken for other health problems, including illness, also can lower blood sugar and may react with the diabetes medicine. Therefore, a doctor needs to know all the medications a person is taking to prevent a harmful interaction. Lowering blood sugar too much can cause hypoglycemia with symptoms such as headache, weakness, shakiness, and if the condition is severe enough, collapse.

Oral diabetes medications usually don't cause side effects. However, a few people do experience nausea, skin rashes, headache, either water retention or diuresis (increased urination), and sensitivity to direct sunlight. These effects should gradually subside, but a person should see a doctor if they persist. For reasons that aren't always clear, sometimes oral diabetes medications don't help the person for whom they're prescribed. Investigations are under way to learn why this happens.

More information on diabetes mellitus

What is diabetes mellitus? - Diabetes mellitus is a a condition characterized by hyperglycemia resulting from the body's inability to use blood glucose for energy. Diabetes mellitus can result in coma. Over time, complications can include nerve injury, blindness, kidney failure, and premature atherosclerosis with all of its complications.
What causes diabetes mellitus? - Diabetes mellitus is a disorder caused by insufficient production of the hormone insulin by the pancreas, or insensitivity of cells to the effects of insulin. Insulin is responsible for the absorption of glucose into cells for their energy needs and into the liver and fat cells for storage.
What is insulin? - Insulin is a hormone that is produced by specialized cells (beta cells) of the pancreas. In addition to helping glucose enter the cells, insulin is also important in tightly regulating the level of glucose in the blood.
What types of diabetes mellitus are there? - There are four main types of diabetes mellitus. They are type 1 diabetes mellitus, type 2 diabetes mellitus, type 3, and Gestational diabetes mellitus (type 4).
What is type 1 diabetes? - Formerly known as juvenile diabetes or insulin-dependent diabetes, type 1 diabetes is a life-long condition in which the pancreas stops making insulin. Type 1 diabetes develops most often in young people but can appear in adults.
What is type 2 diabetes? - Type 2 diabetes is the most common form of diabetes mellitus. People with type 2 diabetes produce insulin, but either do not make enough insulin or their bodies do not use the insulin they make. Type 2, also known as non-insulin dependent diabetes, typically occurs after the age of 40 years.
What're signs and symptoms of diabetes mellitus? - Type 2 diabetes almost always has a slow onset (often years). Early symptoms of Type 1 diabetes are often polyuria (frequent urination) and polydipsia (increased thirst, and consequent increased fluid intake).
What is diabetes insipidus? - Diabetes insipidus (DI) is a disease characterized by excretion of large amounts of severely diluted urine, which cannot be reduced when fluid intake is reduced.
What is diabetic coma? - Diabetic coma is a medical emergency in which a person with diabetes is unconscious because the blood glucose level is too low or too high. Patients with diabetes mellitus type 1 are especially prone to this condition.
What are the complications of diabetes mellitus? - Many people with diabetes mellitus eventually develop complications. A very common short-term complication of diabetes mellitus is hypoglycemia (abnormally low blood sugar levels).
How to diagnose diabetes mellitus? - The diagnosis of type 1 diabetes is usually prompted by recent symptoms of excessive urination (polyuria) and excessive thirst (polydipsia), often accompanied by weight loss. The diagnosis of other types of diabetes is made in many other ways.
Diagnosis protocol for diabetes - People over age 45 should be tested for diabetes. If the first blood glucose test is normal, they should be re-tested every three years. A diagnosis of diabetes is made when any three of these tests is positive, followed by a second positive test on a different day.
What is the treatment for diabetes? - Diabetes is a chronic disease with no cure, but it can almost always be managed effectively. Nowadays, the goal for diabetics is to avoid or minimize chronic diabetic complications, as well as to avoid acute problems of hyperglycemia or hypoglycemia.
What type of diabetes diet is suggested? - For some people with diabetes mellitus, a healthy diet and weight loss is enough to keep glucose levels in the blood normal.
What medications are available for diabetes? - Oral diabetes medicines, or oral hypoglycemics, can lower blood glucose in people who have diabetes, but are able to make some insulin. Six FDA-approved oral diabetes medications are now on the market.
How to prevent diabetes? - Diabetes prevention is proven, possible, and powerful. Studies show that people at high risk for type 2 diabetes can prevent or delay the onset of the disease by losing 5 to 7 percent of their body weight.
What should a child diabetes do every day? - To control diabetes and prevent complications, blood glucose levels must be as close to a "normal" range as safely possible. Families should work with a health care provider to help set a child's or teen's targets for blood glucose levels.
Smoking and diabetes - There is a growing body of evidence to suggest that smoking is an independent risk factor for diabetes and that among people with diabetes, smoking aggravates the risk of serious disease and premature death.
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