Diabetes is a group of diseases that cause high blood sugar (glucose) levels. The high blood glucose levels are caused by problems in insulin production or function.
Insulin is a hormone released by the pancreas when you eat food. It allows sugar to move from the blood into the cells, where it’s used for energy. If the cells of the body aren’t using insulin well, or if the body is unable to make enough insulin, glucose can build up in the blood.
The increase in blood glucose levels may lead to uncomfortable symptoms, such as:
- constant thirst
- increased urination
- excessive hunger
- unintentional or unexplained weight loss
- fatigue or lack of energy
- blurry vision
- wounds that heal more slowly than normal
- recurring or frequent infections
There are two main types of diabetes. Type 1 diabetes develops when the body doesn’t make any insulin. It’s most often diagnosed during childhood, but it may be diagnosed later in life. Type 2 diabetes occurs when the body doesn’t produce enough insulin or doesn’t use insulin properly. It’s more commonly seen in adults, but the number of children with type 2 diabetes is increasing.
Both types of diabetes cause a buildup of glucose in the bloodstream. This can lead to serious health problems, including:
- vision loss
- kidney damage
- skin problems
- hearing impairment
- heart disease
- blood circulation problems
- limb amputation
Most of these complications are preventable with treatment. Treatment plans for diabetes often involve monitoring blood glucose levels, following a healthy diet, and taking medications. Many of these medications work by raising the body’s insulin levels. Increased insulin production helps deliver the glucose in your blood to your cells. This prevents glucose from building up in your bloodstream.
Numerous classes of medications can be used to increase insulin production in people with diabetes. Most of these medications are effective in treating type 2 diabetes. People with this form of diabetes still have the ability to produce insulin, so they often respond better to treatment. Some of these medications may be used along with insulin injections to manage blood glucose levels in people with type 1 diabetes.
Amylin mimetics are injectable drugs that stimulate the release of insulin. These medications are used in combination with injectable insulin. They’re used when symptoms of type 1 diabetes don’t improve with insulin injections alone. An example of this type of medication is pramlintide (SymlinPen).
Sodium glucose transporter 2 inhibitors
Sodium glucose transporter 2 inhibitors (SGLT2s) are injectable medications that help increase the production of insulin in the body. They’re sometimes prescribed along with other medication to people with type 2 diabetes. In most cases, people taking SGLT2s are asked to change their diet and exercise routines to help control blood glucose levels. An example of an SGLT2 is canagliflozin (Invokana).
Incretin mimetics are another class of injectable insulin-increasing drugs. Like SGLT2s, they’re often prescribed along with other types of medication to help manage glucose levels. People taking these medications are also encouraged to eat more healthful foods and to exercise more frequently. Types of incretin mimetics include:
- exenatide immediate-release (Byetta)
- exenatide extended-release (Bydureon)
- liraglutide (Victoza)
Dipeptidyl-peptidase 4 inhibitors
Dipeptidyl peptidase 4 inhibitors (DPP-4s) are oral pills that increase the release of insulin from the pancreas. They also reduce the release of glucose from the liver. These drugs are often combined with other types of medications to treat people with type 2 diabetes. Examples of DPP-4s include:
Sulfonylureas are an older class of medication used to treat people with diabetes. They’re usually given orally to those who are unable to control their blood glucose levels through diet and exercise. They work by increasing the release of insulin from the pancreas to reduce blood glucose levels. Examples of sulfonylureas include:
- glyburide (Micronase)
- glipizide (Glucotrol)
- glimepiride (Amaryl)
- chlorpropamide (generic only in U.S.)
- tolazamide (generic only in U.S.)
- tolbutamide (generic only in U.S.)
Glinides are oral insulin-increasing drugs given to people with type 2 diabetes. They usually take effect more quickly than other medications. However, they don’t last long and need to be taken multiple times per day. They’re often prescribed with another medication, especially if symptoms don’t improve with diet and lifestyle changes. Examples of glinides include:
Sticking to a healthy diet and exercising regularly usually help to control blood glucose levels. These lifestyle changes are especially helpful in complementing medical treatment.
If you have either type of diabetes, you should make some simple changes to your diet, including:
- eating more fruits, vegetables, and whole grains
- reducing your intake of processed foods
- consuming a moderate amount of animal products, including chicken, seafood, and lean cuts of meat
- avoiding sweets and high-fat foods
Some doctors may recommend that people with diabetes count carbohydrates to better regulate their blood sugar. In these cases, it may be helpful to meet regularly with a registered dietician to make sure you’re staying on track.
A variety of herbs and supplements also appear to help control blood glucose levels. Examples include magnesium, green tea, and vitamin B-1. Before you start taking any natural supplements, however, make sure to speak with your doctor. Some supplements may interfere with the effectiveness of certain medications and should only be taken under the direction of a doctor.
Everyone’s body is different, so you may respond differently to a medication than someone with the same type of diabetes. Talk to your doctor about your treatment options so they can help you find a medication that works best for you.
You asked, we answered
- What are some common side effects of insulin-increasing medications?
Insulin-increasing drugs are often added to other treatments, like metformin or insulin. This can increase the risk of lowering your blood glucose too much. You will need to test your blood sugar more often for the first few weeks. You should also stay in touch with your doctor while you adjust to the new medication.
Combination treatment may also increase nausea and diarrhea. Increasing the dose gradually may reduce these side effects. Finally, some of these drugs have additional risks if you have kidney disease or other illnesses.- Susan J. Bliss, RPh, MBA