The variety of diabetes pills available can be confusing as each deals with a particular function of insulin/glucose absorption and the various organs involved. Prior to and upon diagnosis of diabetes it is important to follow a healthy diet and perform some form of exercise in order to keep your organs healthy and functioning properly as well as regulate weight. Exercise and diet should be a constant part of your management strategy and cannot be substituted for by diabetes pills. In fact, studies show that exercise and diet programs and counseling alone or when paired with diabetes medicines can be more effective that medicines alone.
Diabetes Pills – Combination Therapy
In a paper from the Division of Endocrinology at the Mayo Clinic, researchers examined the use of acarbose for type 1 insulin-dependent diabetics. Acarbose has been clinically shown to lower postprandial glucose levels, which cannot be done with insulin alone. Other researchers have investigated combination therapy in order to tackle blood glucose levels in addition to complimentary treatment for diabetic risk factors such as cardiovascular disease.
The most common drug combinations are sulphonylureas and metformin, sulphonylureas and thiazolidinediones, and metformin and thiazolidinediones. Metformin is a “firstline” therapy for obese type 2 patients with insulin deficiency whereas thiazolidinediones and sulphonylureas are later prescribed if metformin is not well tolerated. Acarbose and miglitol DPP-4 inhibitors can effectively be combined with sulphonylureas. Repaglinide has been used in combination with thiazolidinediones or metformin. Rosiglitazone has been used with sulphonylureas in order to improve insulin resistance.
Diabetes Pills – Drug Interactions
Each form of diabetes pill comes with a set of risk factors and interactions. It is important that patients be diligent in communicating with their doctor(s) and pharmacist about the various medications and supplements they are taking as there are significant risks involved when combining medications.
The aforementioned medications have been shown to have interactions with other drugs and drug types. Metformin interacts with: vitamin B12 and antihypertensives, diuretics, glucocorticosteroids, iodinated contrast media, loop diuretics, meglitinides, non-steroidal anti-inflammatories, other oral antidiabetics, aulphonylureas, and aympathomimetics. Acarbose interacts with: amylase, charcoal, colestyramine, digoxin, hydrotalcite, neomycin, pancreatin, antacids, digestive enzyme preparations, and intestinal absorbents. Sulphonylureas interact with: aspirin, ACE inhibitors, antipsychotics, beta-adrenergic blockers, beta-blockers, calcium channel blockers, corticosteroids, diuretics, fibrates, oral contraseptives, progesterones, non-steroidal anti-inflammatories, and more. Actos, a common thiazolidinediones, interacts with: gemfibrozil, insulin, rifampicin, cytochrome P450 enzyme inducers, cytochrome P450 enzyme inhibitors, and sulphonylureas. Repaglinide interacts with: ACE inhibitors, anabolic steroids, antidiabetics, barbiturates, beta-blockers, corticosteroids, and more. Rosiglitazone has limited availability in the U.S.. Physicians should go over all interactions and risk factors with patients who take rosiglitazone.
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