There are several ways to treat type 2 diabetes. While people with type 1 diabetes must be treated with insulin, this is not necessarily the case for type 2 diabetes. There are so-called oral antidiabetics – these are tablets in the form of tablets. Exceptions are GLP-1 analogs that are also injected.
Metformin is the most important drug in type 2 diabetes and has been used for a long time. Metformin blocks the accumulation of glucose in the liver, reducing the amount of endogenous sugar in the blood. It also improves insulin sensitivity of cells. In addition, effects on the intestine and the brain are suspected, which can also lower blood sugar levels. For overweight people with type 2 diabetes, choice is considered the first choice. Side effects may be gastrointestinal problems such as nausea and diarrhea.
Sulfonylureas increase insulin production in beta cells of the pancreas. They can be used in patients with type 2 diabetes if metformin treatment is insufficient to effectively lower blood sugar or metformin intolerance. Side effects may be hypoglycaemia, which is more common than metformin, weight gain or allergic reactions.
DPP-4 Inhibitors (Gliptins)
DDP-4 inhibitors affect the intestinal hormone GLP 1. This helps reduce blood sugar levels in several ways, for example by releasing insulin. Gliptins inhibit the breakdown of GLP 1 after a meal, so the intestinal hormone can work longer, the diabetes adviser reports. They are used when metformin is not effective or is often given in combination with metformin. Side effects are low. DDP-4 inhibitors are among the newer drugs in type 2 diabetes.
GLP-1 analogs also act via the intestine. They mimic the effect of intestinal hormone GLP 1. As a result, the pancreas produces more insulin. They are used as a combination, even with insulin therapy. Since the drug is expensive, it only applies if other therapies do not help. GLP-1 analogs must be injected.
These drugs inhibit SGLT 2 in the kidney. This usually prevents urinary excretion of glucose. However, by inhibiting SGLT 2, the body releases more urine from the urine. Because SGLT-2 inhibitors support weight loss, they are suitable for overweight people with type 2 diabetes. They also lower blood pressure. Possible side effects are fungal infections, especially in the genital area.
Source: Diabetes findings 1/2019