The body makes insulin but may be insufficiently (impaired insulin secretion) or insulin resistance (impaired biological response to insulin in the tissue).
Insulin resistance and lack of insulin secretion are considering being the cause of type 2 diabetes.
Classes of Diabetes Drugs
Different diabetes pills are available in the market that works differently in lowering blood glucose levels. Oral medication for diabetes come under the following categories:
- Insulin Sensitizers are working to reduce your blood glucose level by increasing insulin sensitivity of your muscle, fat, and liver. Some insulin sensitizers are Biguanides, Thiazolidinediones (TZDs) or glitazones
- Insulin Secretagogues (insulin-secreting medications) are diabetes drugs that work by making the pancreas to release (or secrete) more insulin to help lower your blood glucose level. Some insulin secretagogues are Sulfonylureas, Meglitinides or glinides, GLP-1 agonists, DPP-4 inhibitors
- Starch blockers - are working to reduce blood glucose level by delaying digestion and absorption of carbohydrates. Starch blocker class of medication is Alpha-glucosidase inhibitors.
- Glucose re-absorption inhibitors - It works by blocking the reabsorption of glucose and allow it to leave the body. Thus lower the blood glucose level — glucose re-absorption inhibitor class of diabetes drug as SGLT2 inhibitors.
- Another drug is Amylin analog.
How is diabetes oral medication works?
Diabetes medication helps to control your blood glucose level in people whose body still produces insulin (in case of type 2 diabetes). Several kinds of diabetes medicine are available in the market, which works differently, such as:
- It stimulates your body to increase insulin secretion by the pancreas.
- It makes your liver to limit or stop producing & dumping glucose into the bloodstream.
- It makes your body cells to better utilizing the glucose in the bloodstream.
- It inhibits your small intestine from absorbing glucose in the food.
In the beginning, your doctor may try one and two medications or its combination to assess, which one best suitable for your body system. Be in close coordination with your doctor to get an individualized diabetes treatment.
When do you need diabetes medication?
If your A1C is more than 7% or FBG level more than 130 mg/dl or 7.223 mmol/l even after following a lifestyle change, then you have to add medication along with lifestyle changes.
Derive maximum benefits from your diabetes medications
Your daily routine such as eating habits, physical activities and other health conditions can have an influence over your medication effectiveness.
Your medication works best when it is combining with proper meal planning, consistent regular exercise, getting enough sleep, and effective stress management. You should take the diabetes medication at the same time every day. If you are a forgetful person like me, then you can set a reminder on your phone to alert you. Store the medication as directed by your doctor or as instructed by the manufacturer. Closely monitor your medicine’s effectiveness. And if there are any side effects it produces; discuss with your doctor. So that he may change the medication or dosage that best suits you.
What should be your diabetes target?
Every diabetes type 2 should try to achieve a target:
- A1C of less than 7.0 % (4 to 6 % non-diabetic normal range),
- a pre-prandial glucose level of 90 to 130 mg/dl or 5 to 7.223 mmol/l,
- A postprandial glucose level of less than 180 mg/dl or 10 mmol/l, and
- Bedtime glucose level 110 to 150 mg/dl or 6.111 to 8.334 mmol/l.
Is it possible to adjust diabetes medication to cover whatever ate?
No, the diabetes medication works as intended, and you cannot adjust it concerning the food you ate. However, if you are in insulin treatment, then you can learn and adjust the dosage concerning the food intake and the physical activity you had. Still, you shouldn't eat whatever you want, and take drugs to normalize your blood glucose levels.
Is it possible to manage diabetes without medication?
During diagnosis, if you are asymptomatic with an A1C of less than 7% or fasting blood glucose less than 130mg/dl or 7.22mmol/l; then, you can manage your diabetes without medication. However, with lifestyle changes (diet and exercise) and by losing some weight.
Diet, exercise and weight reduction should be the cornerstone of diabetes management.
You can manage your diabetes by losing some weight, increased physical activity (or regular exercise) and with proper diet. Losing 10 or 15 pounds or 4.5 to 6.8 Kg can sometimes help you reach your target. Always check with your doctor before you stop taking your diabetes pills or start your treatment by lifestyle change alone (without medication).