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What Types of Oral Diabetes Medications Are Available?
Oral diabetes medicines are grouped in categories based on type. There are several categories of oral diabetes medications -- each works differently.

Sulfonylureas. These diabetes pills lower blood glucose by stimulating the pancreas to release more insulin. The first drugs of this type that were developed -- Dymelor, Diabinese, Orinase and Tolinase -- are not as widely used since they tend to be less potent and shorter acting drugs than the newer sulfonylureas. They include Glucotrol, Glucotrol XL, DiaBeta, Micronase, Glynase PresTab and Amaryl. These drugs can cause a decrease in the hemoglobin A1c ( HbA1c) of up to 1%-2%.
Biguanides. These diabetes pills improve insulin's ability to move glucose into cells especially into the muscle cells. They also prevent the liver from releasing stored glucose. Biguanides should not be used in people who have kidney damage or heart failure because of the risk of precipitating a severe build up of acid (called lactic acidosis) in these patients. Biguanides can decrease the HbA1c 1%-2%. Examples include metformin (Glucophage, Glucophage XR, Riomet, Fortamet and Glumetza).

Thiazolidinediones. These diabetes pills improve insulin's effectiveness (improving insulin resistance) in muscle and in fat tissue. They lower the amount of glucose released by the liver and make fat cells more sensitive to the effects of insulin. Actos and Avandia are the two drugs of this class. A decrease in the HbA1c of 1%-2% can be seen with this class of oral diabetes medications. These drugs may take a few weeks before they have an effect in lowering blood glucose. They should be used with caution in people with heart failure. Your doctor will do periodic blood testing of your liver function when using this diabetes medicine.

Alpha-glucosidase inhibitors, including Precose and Glyset. These drugs block enzymes that help digest starches, slowing the rise in blood glucose. These diabetes pills may cause diarrhea or gas. They can lower hemoglobin A1c by 0.5%-1%.

Meglitinides, including Prandin and Starlix.
These diabetes medicines lower blood glucose by stimulating the pancreas to release more insulin. The effects of these oral diabetes medications depend on the level of glucose. They are said to be glucose dependent. High sugars make this class of diabetes medicines release insulin. This is unlike the sulfonylureas that cause an increase in insulin release, regardless of glucose levels, and can lead to hypoglycemia.

Dipeptidyl peptidase IV (DPP-IV) inhibitors, including Januvia. The DPP-IV inhibitors (Januvia) work to lower blood sugar in patients with type 2 diabetes by increasing insulin secretion from the pancreas and reducing sugar production. These diabetes pills increase insulin secretion when blood sugars are high. They also signal the liver to stop producing excess amounts of sugar. DPP-IV inhibitors control glucose without causing weight gain. The medication may be taken alone or with other medications such as metformin.

Combination therapy. There are several combination diabetes pills that combine two medications into one tablet. One example of this is Glucovance, which combines glyburide (a sulfonylurea) and metformin. Others include Metaglip, which combines glipizide (a sulfonylurea) and metformin, and Avandamet which utilizes both metformin and rosiglitazone (Avandia) in one pill.

Studies have been done showing that some oral diabetes medications may help prevent diabetes and diabetes-related complications. Both metformin and Precose have been shown to reduce a person's risk of developing type 2 diabetes, particularly when combined with lifestyle changes such as a proper diet and regular exercise program. Actos has been shown to reduce the risk of heart attack, stroke and premature death in those with type 2 diabetes. Researchers continue to look into the preventative benefits of other medications.

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Nice information about diabetes drugs. However, it will be appreciated if more information on its side effects and recent cases of patients becoming insulin resistant is provided to the forum. Thank you again.
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