font size

Diabetes Treatment (cont.)

Medical Author:
Medical Editor:
Medical Editor:

Medications that decrease the amount of glucose produced by the liver

A class of drugs called biguanides has been used for many years in Europe and Canada. In 1994, the FDA approved the use of the biguanide metformin (Glucophage) for the treatment of type 2 diabetes in the U.S. Glucophage is unique in its ability to decrease glucose production by the liver. Briefly, because metformin does not increase insulin levels, when used alone, it does not usually cause hypoglycemia. In addition, metformin has an effect whereby it tends to suppress appetite, which may be beneficial in diabetics who tend to be overweight. Metformin may be used by itself or together with other oral drugs or insulin. It should not be used in patients with kidney impairment and should be used with caution in those with liver impairment. The older biguanides that preceded metformin were associated with a serious condition called lactic acidosis, a dangerous acid build up in the blood resulting from accumulation of the drug and its breakdown products. While metformin is safer in this regard, it is recommended that the drug be discontinued for 24 hours before any procedure involving the intravenous injection of dyes (such as for some x-ray studies of the kidney) or surgery is performed. The dyes may impair kidney function and cause a build up of the drug in the blood. Metformin can be restarted after these procedures once the patient is urinating normally.

Medications that increase glucose excretion by the kidney

In March 2013 the FDA approved canagliflozin (Invokana) tablets to improve glycemic control in adults with type 2 diabetes. It belongs to a class of drugs known as sodium-glucose co-transporter 2 (SGLT2) inhibitors. Invokana works by blocking reabsorption of glucose by the kidney, leading to increased glucose excretion and reduction of blood sugar levels. Clinical trials on over 10,000 patients showed improvement in both fasting glucose and hemoglobin A1c levels with canagliflozin. Side effects included vaginal yeast infection and urinary tract infection. Invokana has been used as a single therapy and in combination with other drugs such as metformin, sulfonylurea, pioglitazone, and insulin.

Medically Reviewed by a Doctor on 4/4/2013

Patient Comments

Viewers share their comments

Diabetes Treatment - Effective Treatments Question: Please describe what treatments have been effective for your diabetes.
Diabetes - Diet Question: Have you found diet, exercise, and medication effective to control your diabetes?
Diabetes Treatment - Medications Question: Please discuss the medications you take to manage your diabetes.
Diabetes Treatment - Insulin Pump Question: Do you use an insulin pump to treat your diabetes? Please describe the pros and cons of this type of treatment.
Diabetes Treatment - Insulin Pens Question: Describe how you use pre-filled insulin pens and the environment in which they are most convenient for you.
Source: MedicineNet.com
http://www.medicinenet.com/diabetes_treatment/article.htm

Women's Health

Find out what women really need.

advertisement
advertisement
Use Pill Finder Find it Now See Interactions

Pill Identifier on RxList

  • quick, easy,
    pill identification

Find a Local Pharmacy

  • including 24 hour, pharmacies

Interaction Checker

  • Check potential drug interactions
Search the Medical Dictionary for Health Definitions & Medical Abbreviations