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Alpha-glucosidase inhibitors slow down the digestion of carbohydrates
Alpha-glucosidase inhibitors (AGIs), sometimes referred to as starch blockers, are anti-diabetic medicines that help to reduce post-meal blood glucose levels.
Unlike most other types of diabetes drugs, they don’t have a direct effect on insulin secretion or sensitivity. Instead, they work by slowing down the digestion of carbohydrates found in starchy foods.
Drugs in this class are:
-Glucobay (Acarbose)
-Glyset (Miglitol)
-Brand names in brackets.
The pill/s can be either chewed with the first bite of a meal or swallowed whole with some water immediately before the meal.
It is normally used as a single treatment, but in some cases can be taken in combination with sulphonylurea.

-Flatulence (wind)
-Diarrhea is a common problem for users.
**However, these effects usually reduce as your body adjusts to the medication.
Amylin is a hormone produced by the pancreas and assists insulin in controlling post-meal glucose levels
Amylin analogues, or #Agonists, are injectable drugs used in the treatment of both type 1 diabetes and type 2 diabetes. These compounds are administered before meals and work similarly to the hormone amylin.
Amylin has a number of benefits in terms of weight loss and reducing blood glucose levels.
Drug/s in this class:
-Pramlintide acetate (marketed as Symlin) is the only available drug in this class.
Like insulin, it is administered by subcutaneous (applied under the skin) injection.
Side effects
-Hypoglycemia, if taken alongside insulin
***These side effects occur mostly at the start of treatment and gradually decline as the body adjusts to the new medication.

Biguanides prevent the production of glucose in the liver The term biguanide refers to a group of oral type 2 diabetes drugs that work by preventing the production of glucose in the liver, improving the body’s sensitivity towards insulin, and reducing the amount of sugar absorbed by the intestines.
The only available biguanide medication is #metformin, which is commonly used as a first-line treatment for type 2 diabetes (i.e. the first option for type 2 diabetics who are unable to control their blood sugars through diet and exercise alone).
Metformin is usually prescribed as a single treatment (monotherapy), but it can also be combined with other medication in a single tablet – for example, metformin + pioglitazone (Competact), metformin + vildagliptin (Eucreas) and metformin + sitagliptin (Janumet). It’s also sometimes prescribed in combination with insulin for people with type 1 diabetes.

Drugs in this class
-Metformin IR (immediate-release) – taken up to three times a day
-Metformin SR (slow release) – usually taken once per day
-Other Names for Metformin
Metformin is sold both under brand names and also as a #GenericDrug. Common brand names include:
-Metformin SR
#Metformin is also available as #MetforminSR, a slow-release or modified release form of the medication. Modified release versions of metformin may be prescribed for people experiencing significant gastro-intestinal intolerance as a result of standard metformin.

-How the drug works…
Metformin helps the body to control blood sugar in several ways. The drug helps type 2 diabetics respond better to their own insulin, lower the amount of sugar created by the liver, and decreasing the amount of sugar absorbed by the intestines.

Metformin Side Effects
-Disturbance to the gut
-Abdominal pain
-Loss of appetite
**If you find your breathing is being affected, along with drowsiness, dizziness and confusion you should stop taking Metformin at once and seek urgent medical attention.

4#DPP-4 Inhibitors #Gliptins
DPP-4 inhibitors are prescribed for type 2 diabetes patients who do not respond well to metformin and sulphonylureas
Dipeptidyl peptidase-4 (DPP-4) inhibitors are a relatively new class of oral diabetes drugs. Also known as #gliptins, they are usually prescribed for people with type 2 diabetes who have not responded well to drugs such as metformin and sulphonylureas.
DPP-4 inhibitors may help with weight loss as well as decreasing blood glucose levels, but have been linked with higher rates of #pancreatitis.
#Drugs in this class-
-Januvia (Sitagliptin)
-Galvus (Vildagliptin)
-Onglyza (Saxagliptin)
-Tradjenta (Linagliptin)
(trade name first, generic name in brackets):

5#IncretinMimetics (GLP-1 Agonists)
-An injectable drug for patients unable to control diabetes with tablet medication
Incretin mimetics are a relatively new group of injectable drugs for treatment of type 2 diabetes.
The drugs, also commonly known as glucagon-like peptide 1 (GLP-1) receptor agonists or GLP-1 analogues, are normally prescribed for patients who have not been able to control their condition with tablet medication.
Drugs in this class
-Victoza (Liraglutide)
-Byetta (Exenatide)
-Bydureon (Exenatide)
(trade name first, generic name in brackets):
#Byetta and #Bydureon are the #same medical drug. The only difference is that Bydureon is long-lasting, requiring only one injection per week, whereas Byetta is taken twice-daily due to its much shorter-term effects.
How do they work
-They work by copying, or mimicking, the functions of the natural incretin hormones in your body that help lower post-meal blood sugar levels. These functions include:
-Stimulating the release of insulin by the pancreas after eating, even before blood sugars start to rise.
-Inhibiting the release of glucagon by the pancreas. Glucagon is a hormone that causes the liver to release its stored sugar into the bloodstream.
-Slowing glucose absorption into the bloodstream by reducing the speed at which the stomach empties after eating, thus making you feel more satisfied after a meal.
Side effects
-Increased sweating
-Loss of appetite
-Gastrointestinal problems – including nausea, diarrhoea and stomach pain
-Flu-like symptoms – headache, runny nose, sore throat
-Skin reactions – painful skin followed by a red or purple rash

6#PrandialGlucoseRegulators (#Glinides)
Prandial glucose regulators stimulate pancreatic beta cells to produce insulin
Prandial glucose regulators, also known as glinides, are a family of oral medicines developed for the treatment of people with type 2 diabetes mellitus.
They are taken up to three times a day prior to meals – up to 30 minutes before eating – in order to limit subsequent post-meal spikes inblood glucose levels.
The way they achieve this is by stimulating the pancreatic beta cells to produce more insulin for the body – similar to sulphonylureas.
Prandial glucose regulators have a relatively rapid-onset, but unlike sulphonylureas only last for a short time.
Drugs in this class
-Prandin (Repaglinide)
-Starlix (Nateglinide)
(trade name first, generic name in brackets):
-Prandial glucose regulators can significantly lower blood glucose levels, and because they are rapid acting, have benefits for people with non-routine lifestyles.

Side Effects
-Liver problems
-Abdominal pain

Sulphonylureas are a class of oral (tablet) medications that control blood sugar levels in patients with type 2 diabetes by stimulating the production of insulin in the pancreas and increasing the effectiveess of insulin in the body.
They are generally taken once or twice a day, with or shortly before a meal, and can be taken on their own or prescribed for use alongside other diabetes drugs such as metformin.
Drugs in this class
-Amaryl (Glimepiride)
-Daonil (Gilbenclamide)
-Diamicron (Gilclazide)
-Diamicron MR (Gilclazide)
-Glibenese (Gilpizide)
-Minodiab (Gilpizide)
-Tolbutamide (Tolbutamide)
(trade name first, generic name in brackets):
Side effects of sulfonylurea agents
-Hypoglycemia or low blood glucose is the most common.
Other side effects, although uncommon are:
-Skin reaction
-Dark urine
-Stomach upset (nausea, diarrhea, tendency to pass gas)
-Increased sensitivity to sun
– Sulphonylureas are not recommended for people who are overweight or obese, as their mode of action (increase in insulin production and secretion) means that weight gain can be a relatively common side effect.
8#SGLT2Inhibitors (#Gliflozins)
SGLT2 inhibitors help kidneys lower blood glucose levels. Sodium-glucose co-transporter-2 (SGLT2) inhibitors are a new group of oral medications used for treating type 2 diabetes. The drugs work by helping the kidneys to lower blood glucose levels.
*Drugs in this class
-Forxiga (Dapagliflozin)
-Invokana (Canagliflozin)
(trade name first, generic name in brackets):
*How do SGLT2 inhibitors work?
-SGLT2 inhibitors work by preventing the kidneys from reabsorbing glucose back into the blood. This allows the kidneys to lower blood glucose levels and the excess glucose in the blood is removed from the body via urine.
The more technical answer is that the drugs inhibit a form of proteins, which help to reabsorb glucose into the blood, called sodium-glucose transport proteins (SGLT2). By blocking these proteins, less glucose is reabsorbed into the blood and the excess glucose is passed out as urine.

Side effects
As the drugs cause more glucose to be excreted in the urine, there is a higher chance of getting genital and urinary tract infections. These side effects are more common in women than in men.
-Patients taking SGLT2 inhibitors with insulin should be aware of the risks of #hypoglycemia.
9#Thiazolidinediones (Glitazones)
Works effectively at improving blood glucose control by reducing resistance to insulin. Thiazolidinediones, also known as glitazones, are a group of oral anti-diabetic drugs designed to treat patients with type 2 diabetes.
Classed as #OralHypoglycemic drugs along with #biguanides, they are taken once or twice daily with or without food and work by targeting insulin resistance – a core physiologic defect in those with type 2 diabetes.
By reducing the body’s resistance to insulin, the hormone is allowed to work more effectively at improving blood glucose control.
#Glitazones also help lower blood pressure and improve lipid metabolism by increasing levels of HDL (or ‘good’) cholesterol and reducing levels of #triglycerides – a type of fat in the bloodstream and fat tissue it also decreases blood glucose levels and preservation of the pancreas’s ability to produce sufficient levels of insulin.

Drugs in this class
-Pioglitazone (Actos)
-Rosiglitazone (Avandia).

Avandia (rosiglitazone) is banned in Europe as it is associated with a high risk of serious heart ailments including congestive heart failure, heart attack and death compared with a similar drug also used to combat diabetes, pioglitazone (Actos).
*Actos is also linked with instances of bladder cancer.
The tablet/s improves insulin sensitivity and also helps to protect the insulin-producing cells in the pancreas.
It can be used on its own as a monotherapy or as a combination treatment with either asulphonylurea or metformin, or insulin.
Side effects
-water retention
-Eyesight problems
-Reduced sense of touch
-Chest pain and infections
*Remember, not everyone will have the side effects for using the drugs


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