What Is Diabetes? Are There Oral Medications for This Condition?

Diabetes is a group of metabolic disorders marked by elevated blood-sugar levels that extend for long periods of time. It usually results from insufficient quantities of insulin or from insulin’s resistance to properly regulating blood-sugar levels. Diabetes is typically a chronic condition, meaning that it can be controlled but not cured by medical intervention and personal behaviors. There are type 1, type 2, and gestational forms of this disease.

Oral medications are one means of controlling blood glucose levels in persons with type 2 diabetes. There are a wide range of medications available utilizing a variety of strategies for regulating blood sugar. These medicines also differ in their degrees of effectiveness and associated side effects. At Baptist Health, we care for persons with diabetes every day, helping them manage their condition, and enabling them to lead the lives they want to lead.

Who Should Take Oral Medications for Diabetes?

Individuals with type 2 diabetes produce some insulin, though often in quantities insufficient for properly governing metabolic processes. Oral medications are designed to assist in blood-sugar regulation. These drugs work in conjunction with other steps you can take, including exercise, improved diet, and weight loss. The goal in every case is to lower blood-glucose levels to healthy ranges.

Medications don’t work for everyone. Sometimes their effectiveness diminishes with time; in other cases, they require insulin as a supplement. Certain individuals, including expectant mothers, cannot safely take oral medications for diabetes. Likewise, oral medications are not prescribed for people with type 1 diabetes, whose bodies produce no insulin. They require insulin injections to regulate glucose levels instead.

Oral Diabetes Medication List

Among the most common oral medications for type 2 diabetes are:

Alpha-glucosidase Inhibitors

Drugs of this type reduce glucose levels by slowing down the stomach’s absorption of simple sugars. Acarbose and miglitol are two alpha-glucosidase inhibitors. Their chief side effect is gastrointestinal distress, including bloating and gas.

Biguanides

The primary drug in this category is metformin, a longstanding oral medication for diabetes. Metformin works by limiting the liver’s glucose production, and decreasing the amount of carbohydrate energy absorbed from food. It is sold under several brand names. Metformin can be a source of stomach upset and sometimes exacerbates kidney problems.

Bile-acid Sequestrants

Bile-acid sequestrants are effective in lowering blood-sugar levels when combined with other oral-diabetic medications. The best known of these drugs is colesevelam. Possible side effects include nausea and constipation. Blood cholesterol levels should be monitored when using a bile-acid sequestrant.

Dipeptidyl Petidase-4 (DPP-4) Inhibitors

DPP-4 inhibitors promote the longevity of a hormone called GLP-1, which increases insulin production and impedes the liver’s release of glucose. They also act as appetite suppressants. Examples of DPP-4 inhibitors are sitagliptin, saxagliptin, linagliptin, ertugliflozin and alogliptin. Potential complications include nausea, vomiting, and, in rare cases, pancreatitis.

Dopamine Agonists

Dopamine agonists appear to make the body’s use of insulin more efficient, but the science behind how this happens is unclear. A common dopamine agonist is bromocriptine. Possible side effects are nausea, sleepiness, dizziness, and headaches.

Sodium-glucose Contransporter-2 (SGLT2) Inhibitors

SGLT2 inhibitors promote the removal by kidneys of glucose from the bloodstream. Examples of SGLT2 inhibitors are canagliflozin, dapagliflozin, and empagliflozin. Potential complications include dehydration and genital yeast infections. The Food and Drug Administration (FDA) has also issued warnings that SGLT2 inhibitors may contribute to rare kidney, blood-acid, and groin-skin conditions.

Sulfonylureas

These medications work by increasing the release of insulin from the pancreas. Drugs in this category include glipizide, glimepiride, and glyburide.

Meglitinides

Medications of these types increase insulin production by the pancreas but are much shorter-acting than sulfonylureas. They can be taken as supplemental to metformin. Drugs in this category include repaglinide and nateglinide. Possible side effects are weight gain and hypoglycemia (low blood sugar).

Thiazolidinediones

Drugs in this category slow the liver’s glucose production and improve the body’s use of insulin in metabolic processes. Medications of this type include pioglitazone and rosiglitazone. Potential complications are fluid retention and an increased incidence of bone fractures.

Some people with type 2 diabetes also benefit from supplemental insulin. It is inhaled rather than injected. Inhaled insulin is not recommended for people who smoke or who have asthma or chronic obstructive pulmonary disorder (COPD). 

Speak with Your Physician

A great variety of oral medications are available for individuals with type 2 diabetes. Speak with your physician to determine which might be right for you, depending on the nature of your condition, your overall health, and other relevant factors.

Learn More About Oral Medications for Diabetes at Baptist Health

If you have questions about oral medications for diabetes, or want to schedule an appointment with one of our specialists, contact your Baptist Health primary care physician.