Best Medicine of Diabetes
Looking for the best medicine to control your diabetes? You first need an insight into the disease mechanism, its types and how different pills are needed to manage the different conditions of the same disease.
What Does Insulin Do in Our Body?
When we consume any carbohydrate or fat, insulin is released from the pancreas. It is a protein produced by this gland.
The function of this hormone is to regulate the metabolism of sugar and fat.
Let’s try to understand what this means.
When we take a meal, our food is broken down into tiny particles during its digestion in the stomach and intestine. The idea is to make it very small, so that it enters the blood stream.
Finally, after breakdown, the food is assimilated, that is, absorbed into the blood from the intestines.
Now, there’s a glucose surge in the blood. All of this blood glucose cannot, possibly be, utilized by body cells, as the consumption would depend upon the age, gender and levels of activity at that moment.
Here comes the role of insulin. Insulin gets recruited near the liver, muscle and fatty tissues, just as a policemen gets posted at sites of activity.
It makes an assessment of blood glucose. If found too much, it helps the liver, muscles and fat to take up and store the excess glucose.
The idea is to maintain a constant optimum level of glucose in blood and this is done very quick. It is not good to expose body cells to increased glucose levels. They work best in an optimally assigned narrow range of blood glucose.
What is Diabetes?
Diabetes is a condition where we see increased levels of blood glucose. This happens either because the body is not able to synthesize insulin for glucose regulation, or else, though it’s synthesizing the hormone, the body cells are not able to recognize it and take its help for the same.
This gives us the two types of diabetes. The former one, where insulin synthesis is reduced or sometimes almost absent, is termed as Type 1 Diabetes.
The latter one, where body makes insulin, but tissues are not able to recognize it, is called Type 2 variety of Diabetes.
Popular Medications And Their Actions
Biguanides
If you are obese, have any history of hypertension, around middle age, and have type 2 Diabetes, your doctor may prescribe you this drug.
Most common biguanide used is Metformin.
Action of the Drug
Biguanides would make your body cells more sensitive to the insulin molecule. So, the bluntness of the muscle, liver and fatty cells towards insulin is somewhat reverted back.
This is very helpful, as insulin is able to work better and effectively regulates blood glucose. Muscles are able to absorb excess sugars, and so do the liver and fatty stores.
Also, metformin reduces the absorption of glucose from the intestine into the blood stream, so that the over all load of sugar to be tackled is less.
Common Drugs Containing Metformin
Metformin Alone, as in Riomet, Fortamet
Metaformin-glipizide
Glipizide belongs to the class, Sulphonylurea, and is detailed below.
Metformin-sitagliptin
Sitaglipitin is a DPP4 inhibitor and is detailed below.
More and more doctor are now prescribing this drug. Comes under the name Janumet.
DPP4 Inhibitors
These are one of the recent ones used in medical practice.
These medicines inhibit the enzyme dipeptidyl peptidase 4 (DPP4). As a result, the blood levels of Glucagon reduces.
Glucagon is a hormone that acts opposite of insulin. It promotes the release of glucose in blood from various sources.
So, a decrease in glucagon would mean that less glucose would be absorbed from the gut. Gastric emptying would be slowed down.
Release of glucose from the muscles, liver and other stores also reduces.
So, ultimately, blood sugar levels stay low. These drugs have an advantage over others. They do not carry the risk of giving hypoglycemic attacks.
Commonest among them is Sitagliptin.
Often used in combination with another drug, as metformin, in Janumet.
Sulphonylureas
These are commonest and oldest of anti diabetic medications. They are still used popularly, either alone or in combination.
They stimulate the beta cells of pancreas to produce more insulin. More of insulin helps to regulate blood sugar better.
Common among them are Glimepiride, comes by the name Amaryl
Glicazide
Glipizide, comes by the name Glucotrol.
Glyburide, comes as DiaBeta.