Drugs that Alter Insulin Production

The treatment of diabetes can require medications that alter how much insulin your pancreas produces. The main classification of diabetes medications used to increase insulin production are sulfonylureas, meglitinides, and GLP-1 agonists. There are a number of types of drugs within each of these classifications.

Sulfonylureas and Diabetes

This class of drug is an oral hypoglycemic, meaning it is an anti-diabetic drug that is administered as a pill. It is frequently prescribed to type 2 diabetics who have reached the point where diet and exercise alone are insufficient in regulating blood sugar.

How It Works

Sulfonylureas stimulate the beta cells in the pancreas. The beta cells make and release insulin. Stimulation by sulfonylureas increases the amount of insulin your pancreas can make and release.

Types

Commonly prescribed sulfonylureas include:

  • chlorpropamide (Diabinese)
  • glimepiride (Amaryl)
  • glipizide (Glucotrol and Glucotrol XL)
  • glyburide (Micronase, Glynase, and Diabeta)

Risks and Side Effects of Sulfonylureas

Use sulfonylureas only as directed. While some patients respond well to a combination of sulfonylureas and improved diet, others need to use sulfonylureas in combination with other medications. Always monitor your blood sugar levels while taking sulfonylureas. Talk to your doctor about any severe side effects, any other concerns you have while taking sulfonylureas, and about any other medications or herbs you take while taking sulfonylureas.

Possible side effects include:

  • severe allergic reaction
  • low blood sugar
  • weakness
  • bruising
  • pale skin
  • yellow skin
  • stomach pain
  • nausea
  • diarrhea
  • vomiting
  • fast heart rate
  • blurred vision
  • lightheadedness
  • skin rash
  • loss of appetite
  • hallucinations
  • blurred vision

Common drug interactions to be aware of include:

  • alcohol
  • diuretics
  • steroids
  • thyroid medication
  • birth control pills
  • seizure medications
  • cold medication
  • asthma medication
  • allergy medication
  • NSAIDs (such as ibuprofen, naproxen aspirin, etc.)
  • sulfa drugs
  • MAOIs
  • beta blockers
  • blood thinners
  • other diabetes medications.

You should be sure to talk to your doctor before using sulfonylureas if you have a or ever had any of the following health problems:

  • liver disease
  • kidney disease
  • chronic diarrhea
  • intestinal blockage
  • a glucose-6phosphate dehydrogenase (G6PD) deficiency
  • malnourishment
  • pituitary disease
  • adrenal disease
  • heart disease

Also, if you have ever been pregnant, be sure to mention that to your doctor as well.

Meglitinides and Diabetes

Meglitinides are typically used to decrease how high your blood sugar increases after meals. Take your meglitinide 10 minutes before each of your three main meals, as directed by your doctor. Regularly check your blood sugar levels while taking meglitinides to ensure proper blood sugar control.

How Meglitinides Work

Meglitinides also increase insulin production by simulating the beta cells in your pancreas. The main difference between meglitinides and sulfonylureas is that the former bind to different site on the cells’ membranes, causing those cells to work in a slightly different manner. Meglitinides have a shorter duration of action than sulfonylureas, and are meant to be taken to cover a specific meal.

Types

Commonly prescribed meglitinides include:

  • nateglinie (Starlix)
  • repaglinide (Prandin)
  • repaglinide combined with metformin (Prandimet)

Meglinitide Side Effects and Risks

Talk to your doctor if you experience any serious side effects or have other concerns while taking this medication. Remember to tell your doctor about any other medication, dietary supplements or herbal remedies you take.

Side effects of meglitinides can include:

  • severe allergic reaction
  • seizure
  • jaundice
  • runny nose
  • sneezing
  • cold symptoms
  • diarrhea
  • back pain
  • flu symptoms
  • nausea
  • dizziness
  • low blood sugar
  • joint pain

Be aware that meglitinides may interact negatively with a number of other drugs, including:

  • alcohol
  • somatropin
  • isoniazid
  • diuretics
  • steroids
  • heart medications
  • blood pressure medications
  • niacin
  • thyroid medication
  • phenothiazines
  • birth control pills
  • seizure medications
  • diet pills
  • cold medications
  • allergy medications
  • asthma medications
  • NSAIDs
  • probenecid
  • oral antifungal medications
  • blood thinners
  • sulfa drugs
  • MAOIs
  • other diabetes medications

Meglinitides are not right for everyone. If you have suffered from any of the following health issues, be sure to bring it up with your doctor, as it may indicate that this class of drugs will not work for you:

  • allergy to other meglitinides
  • type 1 diabetes
  • ketoacidosis
  • liver disease

Also, if you have ever been pregnant, be sure to mention that to your doctor as well.

GLP-1 agonists and Diabetes

Exenatide (Byetta), Bydureon, and Victoza are the currently available GLP-1 agonists. They are typically prescribed if you have type 2 diabetes and have not reached and maintained your recommended A1C level using other types of diabetes medications. Exanatide is administered as a subcutaneous injection.

How GLP-1 agonists Work

Each time your blood glucose levels increase, typically in response to carbohydrate consumption, your pancreas secretes insulin. GLP-1 agonists stimulate your pancreas to produce even more insulin when your blood sugar is elevated, similar to the way it would if you did not have diabetes. GLP-1 agonists also decrease the speed at which food passes through your stomach and decreases your appetite. GLP-1 agonists also promote a sense of feeling full, or satiety, and decrease the effect of the hormone glucagon which decreases sugar production from the liver.

Exenatide Side Effects and Risks

Talk to your doctor about any concerns you have while taking exanatide, including serious side effects and the use of any other medications, supplements, or herbal remedies.

Some potential side effects of this class of drugs include:

  • jitteriness
  • diarrhea
  • vomiting
  • nausea
  • headache
  • dizziness
  • weakness
  • increased stomach acid production
  • weight loss
  • rash
  • pain that starts in the stomach and moves toward your back
  • difficulty breathing
  • changes in urine color and frequency
  • swelling
  • drowsiness
  • changes in appetite

Exanatide can also interact negatively with a number of other drugs, including:

  • alcohol
  • ACE inhibitors
  • Diuretics
  • NSAIDs
  • high blood pressure medications
  • blood thinners
  • birth control pills
  • antibiotics
  • other diabetes medications

This class of drug is not right for everyone. You should be sure to talk to your doctor before using exanatide if you have a or ever had any of the following health problems:

  • alcoholism
  • dehydration
  • pancreatitis
  • gallstones
  • high triglycerides
  • high blood pressure
  • kidney disease
  • pregnancy
  • high blood pressure