Do you have diabetes? Or does someone in your family or friend? Then you probably have a lot of questions about the pills and insulin injections that the doctor gives you. "Why did you give me this medicine?", "What does this pill actually do inside the body?", "Do I have to take this every day?" Things like that probably come to your mind. These are normal questions, don't worry about them. Today, let's understand all this very simply, as if we were talking to a friend.
Let's first see, why do we need medicine for diabetes?
Simply put, diabetes is a condition in which our bodies cannot properly control the level of sugar in our blood. Our bodies need a hormone called insulin to use the sugar (glucose) from the food we eat. In diabetes, the production of this hormone, insulin, is reduced, or the body does not respond properly to the insulin it produces.
If blood sugar levels remain high for a long time without control, our eyesight, kidneys, heart, and nerves can be damaged. Doctors prescribe medications to prevent these dangerous conditions. The main function of these medications is to help maintain blood sugar levels within a safe range.
What are the main medications for diabetes?
Medications for diabetes can be divided into two main categories.
1. Oral Medications: These are what most people start with first.
2. Injectable Medications: These include insulin and other newer types of injections.
Your doctor will decide whether you will be given pills, an injection, or both. This will depend on many factors, including your type of diabetes (Type 1 or Type 2), your blood sugar levels, your age, and any other medical conditions you may have.
Let's learn about the most commonly used pills.
There are several types of pills used for diabetes in Sri Lanka and around the world. Each of them works in the body in a slightly different way. Let's look at the main types.
| Drug Class Name | How it works inside the body (in simple terms) | Common examples |
|---|---|---|
| Biguanides | It reduces the production of sugar by the liver and increases the sensitivity of the body's cells to insulin. | Metformin - This is the first medication given to many people. |
| Sulfonylureas | It helps by talking to our pancreas and telling it to "make some more insulin." | Glimepiride, Gliclazide |
| DPP-4 Inhibitors | When blood sugar levels rise after eating, it helps produce insulin. When blood sugar levels are low, insulin is not produced for nothing. | Sitagliptin, Linagliptin |
| SGLT2 Inhibitors | It helps to expel some of the extra sugar in the body through the kidneys through urine. | Empagliflozin, Dapagliflozin |
The important thing is that all of these medications work differently, so the medication your friend is taking may not work for you. Take only the medication your doctor prescribes, exactly as prescribed.
Insulin and other injections
Sometimes it is difficult to control blood sugar with pills alone. Especially for people with Type 1 Diabetes and those who have had Type 2 Diabetes for a long time, insulin injections are required.
There are several types of insulin injections:
- Fast-acting insulin: These are usually taken about 15 minutes before a meal.
- Long-acting insulin: These work for about 24 hours when injected once a day.
In addition, there are new types of injections called `GLP-1 agonists` that are now used for diabetes (such as `Semaglutide (Ozempic)`, `Liraglutide (Victoza)`). These help produce insulin, and they also help reduce hunger and help with weight loss.
Things you need to remember about medication
1. Don't be afraid of side effects, be aware.
Like any medication, diabetes medications can have minor side effects. For example, some people may experience a slight stomach upset or nausea in the first few days after starting metformin. These usually go away within a few days.
2. Be especially careful about hypoglycemia.
This is very important. Especially those who take insulin and sulfonylureas need to be aware of this. Hypoglycemia is when the blood sugar level drops too low. When that happens,
- Sweating a lot.
- My body is shaking.
- I feel dizzy (vertigo).
- I feel very hungry.
- It's hard to concentrate.
If you experience these symptoms, you should immediately eat something sweet (2-3 teaspoons of sugar dissolved in water, some glucose, a sweet drink, or a piece of toffee). Then eat a starchy food like rice. If this happens frequently, be sure to see your doctor. Your medication may need to be adjusted.
3. Never stop or change medication on your own
Don't stop taking your medication on your own, thinking, "My blood sugar is perfectly normal now, so I don't need medication." That's very dangerous. Your blood sugar is under control because you're taking the medication. Only your doctor has the authority to change the dosage, stop, or start a new medication.
4. Tell your doctor if you are taking any other medications.
If you are taking any other medications, vitamins, or traditional medicines, please inform your diabetes doctor about all of these. Some medications may interact with each other.
Take-Home Message
- Diabetes medication is not your enemy, it is your best friend that helps you live a healthy life.
- Take the medicine your doctor prescribes, at the right time, in the right dosage. Never skip doses.
- Along with medication, proper diet and exercise are definitely important. You can't just take medication and not do these two things.
- Be aware of the symptoms of hypoglycemia. Remember what to do if it happens without panicking.
- If you have any questions or concerns about your medication or side effects, don't search the internet, but ask your doctor directly. He or she will give you the best advice.
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