Has your doctor told you that you have diabetes, or that you are close to developing diabetes (prediabetes)? When you say that, you may have heard the term "insulin resistance". You may be wondering what this new word is. Don't be afraid. Today we will talk about this and the medications given for this condition. Let's understand these things simply, just like talking to a friend.
What is Insulin Sensitivity?
Simply put, insulin is a very important hormone produced by an organ in our body called the pancreas. When the sugar (glucose) in the food we eat enters the bloodstream, it is the key that helps the sugar enter the body's cells and create energy.
Imagine that the cells in your body are doors, and insulin is the key that opens those doors.
- Having good insulin sensitivity means: When you put this key (insulin) in, the door (cell) opens easily. The sugar in the blood easily enters the cells and is converted into energy.
- Insulin resistance means: That key has a hard time opening the door. It's like the door is stuck. So because the door can't be opened, blood sugar levels rise. Then the pancreas starts making more insulin, like bringing more keys to open a stuck door. Over time, this is what causes diabetes (type 2 diabetes).
So, what insulin sensitivity drugs do is make those stuck doors easier to open. That is, they help insulin work properly.
What are the main medications for this?
The best way to improve insulin sensitivity is through lifestyle changes. This includes exercising regularly, eating a nutritious diet, and controlling your weight. However, your doctor may also prescribe medication along with these.
There are two main categories of medications.
1. Biguanides - The only drug in this category is the well-known Metformin.
2. Thiazolidinediones (TZDs) - There are also medications in this group.
Let's now look at each of these types separately.
Metformin, which we all know
Metformin is the most widely used medication for type 2 diabetes in the world. If you have diabetes, you are most likely taking this medication.
How does metformin work?
Metformin helps control blood sugar in two main ways:
- Reduces sugar production by the liver: Our liver also produces sugar when the body needs it. Since metformin controls this process, the amount of unnecessary sugar that accumulates in the blood is reduced.
- Increases insulin sensitivity in muscles: This is the most important thing. Muscle cells start responding well to insulin. Then the sugar in the blood easily goes into the muscles and is converted into energy.
Studies have shown that taking metformin can help delay the onset of diabetes in people at risk and protect against conditions like heart disease.
| Briefly about Metformin | |
|---|---|
| Dosage | Your doctor will determine the dosage. They will usually start with a low dose and gradually increase it. You may be told to take it once or twice a day with meals. |
| Common Side Effects | Stomach upset, nausea, vomiting, and especially diarrhea may occur. These usually subside within a few days as the body adjusts to the medication. These can be greatly reduced by taking the medication with food. |
| Things to watch out for | This medicine is not suitable if you have severe kidney disease . Also, a very rare but dangerous condition called "lactic acidosis" may occur. If you experience symptoms such as muscle cramps, extreme fatigue, nausea, and rapid breathing, go to a hospital's emergency department (ETU) immediately. |
Unlike other diabetes medications, metformin does not usually cause weight gain. Some people may even lose some weight.
Thiazolidinediones (TZDs)
This is the other group of drugs. These also increase insulin sensitivity. There are two main types of drugs in this group: Pioglitazone and Rosiglitazone .
Doctors usually recommend metformin first. If it is difficult to control with it or for other reasons, you may consider this TZD class of medication.
Very important: If you have or have had congestive heart failure, these TZD medications are not suitable at all , as they can make the condition worse.
| Type of medicine | Things to know |
|---|---|
| Pioglitazone | This also increases insulin sensitivity. Some studies have suggested that it may have effects on the liver, increase the risk of bladder cancer, and increase the risk of bone fractures. |
| Rosiglitazone | This also works in the same way as the above drug. Although concerns have been raised in the past about the risk of heart disease, later studies have not confirmed this. However, it is important to be aware of heart disease when using both of these drugs. |
| Common side effects of TZDs | Symptoms may include weight gain, swelling due to fluid retention, chest pain, and difficulty breathing. If you experience any of these symptoms, contact your doctor immediately. |
How do you choose the right medicine for you?
This is a very important question. But it's not for you to answer, it's for your doctor . Because he takes many factors into account when choosing the right medicine for you.
- How is your diabetes?
- Do you have any other medical conditions (heart disease, kidney disease, liver disease)?
- What is your age and lifestyle?
- What are the side effects and advantages and disadvantages of the medication?
It is after considering all of this that he determines the most appropriate and safe medicine and its dosage for you.Never use a medicine that a friend is taking, or a medicine that someone else recommends, for revenge.
Take-Home Message
- Insulin resistance is when your body's cells don't respond properly to insulin. This is the main cause of type 2 diabetes.
- Metformin and TZD drugs are the main medications that help increase insulin sensitivity.
- Just as important as medication, and perhaps even more so, a proper diet and regular exercise are essential for increasing insulin sensitivity.
- Only your doctor can prescribe medicine for you. Take the dose he prescribes, exactly as prescribed, and at the right time.
- Before starting any new medication, talk openly with your doctor about its benefits, risks, and possible side effects. Don't be afraid or embarrassed. It's your right.
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