Oral Medications
Oral diabetes medicines,
or oral hypoglycemics, can lower blood glucose in people who have
diabetes, but are able to make some insulin. They are an option if diet
and exercise don't work. Oral diabetes medications are not insulin and are
not a substitute for diet and exercise. Although experts don't understand
exactly how each oral medicine works, they know that they increase insulin
production and affect how insulin lowers blood glucose. These medications
are most effective in people who developed diabetes after age 40, have had
diabetes less than 5 years, are normal weight, and have never received
insulin or have taken only 40 units or less of insulin a day. Pregnant and
nursing women shouldn't take oral medications because their effect on the
fetus and newborn is unknown, and because insulin provides better control
of diabetes during pregnancy.
| Points to Remember
- Oral diabetes medications may be used when diet and exercise
alone don't control diabetes.
- Oral diabetes medicines aren't a substitute for diet and
exercise.
|
There is also some question
about whether oral diabetes medications increase the risk of a heart
attack. Experts disagree on this point and many people with
noninsulin-dependent diabetes use oral medicines safely and effectively.
The Food and Drug Administration (FDA), the agency of the Federal
Government that approves medications for use in this country, requires
that oral diabetes medicines carry a warning concerning the increased risk
of heart attack. Whether someone uses a medication depends on its benefits
and risks, something a doctor can help the patient decide.
Six FDA-approved oral diabetes medications are now on the market. Their
generic names are tolbutamide, chlorpropamide, tolazamide, acetohexamide,
glyburide, and glipizide. The generic name refers to the chemical that
gives each medicine its particular effect. Some of these medications are
made by more than one pharmaceutical company and have more than one brand
name. All six are different types of one class of medication, called
sulfonylureas, but each affects metabolism differently. A doctor will
choose a patient's medication based on the person's general health, the
amount his or her blood glucose needs to be lowered, the person's eating
habits, and the medicine's side effects.
The purpose of oral medications is to lower blood glucose. Therefore,
the person taking them must eat regular meals and engage in only light to
moderate exercise, to prevent blood glucose from dipping too low.
Medications taken for other health problems, including illness, also can
lower blood sugar and may react with the diabetes medicine. Therefore, a
doctor needs to know all the medications a person is taking to prevent a
harmful interaction. Lowering blood sugar too much can cause hypoglycemia
with symptoms such as headache, weakness, shakiness, and if the condition
is severe enough, collapse.
Oral diabetes medications usually don't cause side effects. However, a
few people do experience nausea, skin rashes, headache, either water
retention or diuresis (increased urination), and sensitivity to direct
sunlight. These effects should gradually subside, but a person should see
a doctor if they persist. For reasons that aren't always clear, sometimes
oral diabetes medications don't help the person for whom they're
prescribed. Investigations are under way to learn why this happens.