Biguanides are a class of medication that work by preventing the overproduction of glucose in the liver, and increasing the uptake of glucose from our bloodstream into our cells by improving the body’s use of insulin. It reduces the amount of glucose absorbed in our intestines. The most common form of biguanides used to treat patients with type two diabetes is metformin hydrochloride.
It is important to note that patients in stage 4 or 5 of chronic kidney disease should not take metformin as it increases the patient’s risk for experiencing lactic acidosis. Patients with low kidney function should talk to their physician regarding alternative medications to manage their blood glucose.
Metglinides and Sulfonylureas
Metglinides and sulfonylureas are a class of drugs that work by stimulating the beta cells. The beta cells in our body are in charge of producing insulin, which is then released from our pancreas. When more insulin is released, more glucose can be taken from our bloodstream and stored in our cells for energy. The most common metglinides are Repaglinide (Pradin), and Nateglinide (Starlix). Commonly found sulfonylureas are Chloroproamide (Diabinese) and Glipizide (Glucotrol).
Thiazolidinediones
Thiazolidinediones is a class of drugs that help to use insulin effectively in muscle, fat cells and reduce the production of glucose in the liver. They are also effective in producing the A1C. A1C is a blood test that provides information regarding someone’s blood sugar levels over 3 months. Normal levels are below 5.7%. Commonly used thiazolidediones are rosiglitazone (Avandia) and pioglitazone (ACTOS). Notify your healthcare provider if you experience cold symptoms such as stuffy nose, sneezing, sore throat or severe headaches.
DPP-4 Inhibitors
DPP-4 inhibitors is a class of medication that prevents the breakdown of the compound GLP-1 in the body by blocking the enzyme DPP-4 (Dipetidly peptidase 4). GLP-1 is an enzyme that helps regulate blood sugar levels in body by encouraging the release of insulin and inhibiting the production of glucose from the liver. This alternatively lowers the amount of blood glucose in our bloodstream. Commonly used DDP-4 inhibitors are Sitagliptin (Januvia) and saxagliptin (Onglyza). Notify your healthcare provider if you experience upper abdominal pain that radiates to the back or severe headaches.
Alpha-glucosidase inhibitors
Alpha-glucosidiase inhibitors are a class of drugs that help the body to lower blood glucose levels by blocking the breakdown of carbohydrates and starches found in food such as bread, rice and potatoes. This results in a slow rise in blood glucose levels after a meal. Commonly used alpha-glucosidase inhibitors are Arcarbose (Precose) and Miglitol (Glyset). This medication is taken three times a day with the first bite of each meal. When taking insulin or any oral hyperglycemic medication it important to monitor and log your blood glucose levels to prevent episodes of hyperglycemia or hypoglycemia.