Controlling your diabetes can prevent long-term health problems

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Nearly 105 million Americans are living with pre-diabetes or diabetes, and as many as one-third don’t even know they have it, according to the 2011 National Diabetes Fact Sheet. It’s a devastating disease that can have debilitating consequences. But that doesn’t have to be the case. From primary care physicians to diabetes specialists to education programs, Adena Health System is here to help you control your diabetes and live a long and full life.

Lifestyle changes, including eating a healthier diet, losing weight and getting regular exercise, are the first steps to managing your diabetes. Indeed, these steps alone can reverse pre-diabetes in many people. But for some, lifestyle changes won’t be enough and they will need medications.

There are many different diabetes medications. Medicine changes are common the longer you have diabetes. Many of these medicines can be used individually or in combination to achieve the highest control of your diabetes. Here are some of the general classes of diabetes medicines:

Insulin: Diabetes occurs when the body doesn’t produce enough natural insulin. Artificial insulin is used instead. There are several types of insulin each having a different effect on blood glucose. Some are long lasting (up to 24 hours) while others are used prior to a meal to keep blood glucose levels from spiking. Insulin works differently according to duration and peak time. Your doctor will help to determine the type of insulin that will work best for you. The National Diabetes Information Clearinghouse, a division of US Department of Health and Human Services provides a chart that shows the various types of insulin and how long they last. Insulin can be injected through individual shots or an insulin pump that is attached to your body.

Biquanides: Generic name: Metformin. Brand name: Glucophage. This drug blocks the liver from making sugar. The benefits of this drug are that it lowers A1C levels by one point and lowers LDL (bad cholesterol) more than other diabetes drugs. Possible side effects: risk of low blood sugar, less weight gain than other medicines, higher risk of stomach problems. May rarely cause a serious, life-threatening condition called lactic acidosis.

Sufonylureas: Generic names: Glimepiride, Glipizide, and Glyburide. Brand names: Amaryl, Glucotrol, Diabeta, Glynase, Prestab and Micronase. These drugs raise the amount of insulin in the body. The benefits of these drugs are that they lower A1C levels by one point. Possible side effects: weight gain, 3-5 times more likely to cause low blood sugar, may cause stomach problems.

Meglitinides: Generic names: Repaglinide and Nateglinide. Brand names: Prandin and Starlix. These drugs raise the amount of insulin in the body. The benefits of these drugs are that they lower A1C levels by one point. Possible side effects: weight gain and risk of low blood sugar.

Thiazolidinediones (TZDs): Generic name: Pioglitazone. Brand name: Actos. This drug helps the body use insulin better. The benefits of this drug are that it lowers A1C levels by one point, lowers triglycerides more than other diabetes drugs and may protect kidney function. Possible side effects: weight gain, low blood sugar, may add to risk of heart failure or make it worse, increases the risk for fracture (mainly in women), may cause bladder cancer (if used longer than one year).

Dipeptidyl Peptidase – 4 (DPP-4) Inhibitors: Common names: Sitagliptin and Saxagliptin. Brand names: Januvia and Onglyza. These drugs raise the amount of insulin in the body after a meal. The benefit is that they will lower A1C levels by less than one point.

Glucagon – Like Peptide-1 (GLP-1) Receptor Agonists: Common names: Exenatide and Liraglutide. Brand names: Byetta and Victoza. These drugs raise the amount of insulin in the body. These drugs have been shown to cause less weight gain than with other medicines, but little is known if it lowers A1C levels. Not enough is known about the side effects of these drugs.

Source: US National Library of Medicine. Last updated Oct. 31, 2012


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