When you think of diabetes, insulin injections come to mind, right? True, many people use insulin to control their diabetes. But did you know that there are also injectable medications, oral pills, and even inhaled medications to control diabetes? These are called non-injectable diabetes medications. Today, we'll talk about these non-injectable medications. Let's take a look at how they work, what the pros and cons are, and how to choose the one that's right for you.
These pills work in different ways!
Not all diabetes pills work the same way. Some pills increase the production of insulin in our bodies. Others control the absorption of sugar from the food we eat. There is another type, which helps our body's cells respond better to insulin. So your doctor will assess your condition and recommend the type of medicine or several types of medicine that are most suitable for you.
To make it easier to understand, let's look at these main drug classes and how they work in a table like this.
| Drug Class | The way it works is simple. | Common side effects |
|---|---|---|
| Biguanides (e.g. Metformin) | This is the most commonly prescribed medication for Type 2 Diabetes. It reduces the production of sugar by the liver. It also helps the body's cells use insulin. | Stomach upset (nausea, vomiting), metallic taste in the mouth. |
| Sulfonylureas (e.g. Glimepiride, Gliclazide) | It stimulates the pancreas to produce more insulin. | Low blood sugar levels (Hypoglycemia), stomach upset, itchy skin, weight gain. |
| Meglitinides (e.g. Repaglinide) | These also increase insulin production from the pancreas, but they work quickly and for a short period of time. | Low blood sugar levels, stomach upset. |
| DPP-4 Inhibitors (e.g. Sitagliptin, Vildagliptin) | When blood sugar levels rise, insulin levels increase. It also helps reduce sugar production by the liver. These do not cause weight gain . | Side effects are usually minimal. Sometimes joint pain and throat infections can occur. |
| SGLT2 Inhibitors (eg Dapagliflozin, Empagliflozin) | They stop the kidneys from reabsorbing sugar back into the body, allowing excess sugar to be excreted in the urine. These can also be beneficial for people with heart disease. | Urinary tract infections, vaginal yeast infections, fainting. |
| Thiazolidinediones (TZDs) (e.g. Pioglitazone) | It helps muscle and fat tissues respond better to insulin and reduces sugar production by the liver. | Fluid retention, weight gain, and the risk of heart disease should be discussed with your doctor. |
| Alpha-glucosidase inhibitors (Ex: Acarbose) | The starches and sugars we eat are digested in the intestines and absorbed into the body. | Gas, stomach cramps, bloating. |
Combination Pills
Sometimes, your blood sugar levels may not be well controlled with just one medication. In such cases, your doctor may prescribe two medications. Wouldn't it be easier to take one pill that combines two medications instead of taking two pills every day? That's what combination pills are for.
For example, medications like metformin with Glimepiride, or metformin with Sitagliptin, come in the same pill. This reduces the number of pills you need to take per day, making it easier to take the medication at regular intervals.
Inhaled Insulin
This is a new thing. It's a fast-acting type of insulin. This insulin comes in the form of a capsule and is inhaled through a special inhaler. It's usually used before a meal. This allows the insulin to quickly enter the bloodstream through the lungs.
But remember, this is not for everyone. If you are a smoker, or have a lung condition like asthma or COPD, this is not for you. Also, it is not a substitute for long-acting insulin.
How do you choose the right medicine for you?
Now you may be thinking, "Wow, with so many medications out there, how do I choose the right one for me?" That's not a decision you should make alone. It's a decision you and your doctor should make together. When making this decision, you should consider these things:
- How is your blood sugar level? Some people can control their blood sugar well with one medicine. Others need several medications.
- How much do these medications cost? Some of the newer medications are a bit more expensive. Talk to your doctor about this as well.
- Do you have other medical conditions? If you have heart disease, kidney disease, or liver problems, some medications may be more appropriate than others. For example, SGLT2 inhibitors have been found to be beneficial for some heart conditions.
- Are the side effects tolerable? The same medicine does not affect everyone in the same way. Some people experience things like stomach upset and weight gain. If you have a side effect that is difficult to tolerate, you should tell your doctor about it.
Talk openly with your doctor about all of this so that together you can choose the healthiest, safest, and most effective treatment for you.
Take-Home Message
- There are insulin injections for diabetes, as well as oral pills and inhaled medications.
- Each of these medications controls the body's sugar levels in different ways.
- Choosing the medication that is best for you should be done in consultation with your doctor, taking into account your health condition, lifestyle, and other factors.
- Never stop taking your medication, change the dosage, or start a new medication without medical advice.
- If you experience any side effects from the medication, don't panic and inform your doctor immediately.
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