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home > what is diabetes > type 2 > Tablets & Non-Insulin Injections

Non Insulin Medication (Tablets & Injectables)


If it is not possible to control the sugar levels in your blood by following healthy eating recommendations, your doctor may prescribe a diabetes tablet.

This does not mean your diabetes is more severe, just that you need some extra help to control your blood sugar levels. You still need to follow the healthy eating guidelines you have been given.

Some people need to take a combination of tablets to control their blood sugar levels. You may find your tablet requirements change so it is important to have regular checks. Sometimes tablets are not enough to control diabetes and your diabetes team may need to add insulin. Most medicines have at least two names. One is the drug (generic) name and the other is the brand (proprietary) name given to it by each manufacturer. Always try to use the generic name.

Oral Medications

Sulphonylureas

Sulphonylureas stimulate your pancreas (the body gland that makes insulin) to produce more insulin, which will then lower your blood sugar.

The sulphonylureas include:

  • Gliclazide
  • Glipizide
  • Glimepiride

Sulphonylureas may cause mild indigestion, headache, skin rashes and weight gain.They can make your face flush if you drink alcohol. They can cause your blood sugar to go too low increasing risk of hypoglycaemia, see the hypoglycaemia leaflet.

Metformin

Is usually used in people with diabetes who are overweight because it does not encourage weight gain. It works by helping your body use insulin more effectively, so that it can properly dispose of the sugar in the blood. Some people may find starting metformin causes stomach upsets such as diarrhoea, indigestion, and loss of appetite or vomiting. Starting at low dose and taking metformin with food can help this. Metformin does not cause hypoglycaemia. Metformin is also available in slow release form. This is known as Prolongued Release or Glucophage Slow Release.

Acarbose

This works by delaying the rate at which you digest sugars, which slows down the rate at which your blood sugar rises after you have eaten. It can cause a rumbling stomach, wind, feeling full and diarrhoea. The drug needs to be taken with the first mouthful of food to be effective.

Thiazolidinediones

These can be used alone or as an add-on treatment. They help by sensitizing the body to the effects of your own insulin. They act on the fat cells; removing fat from around the internal organs, and may have an effect on the muscle, liver and pancreas. The only thiazolidinedione on the market in the UK at present is Pioglitazone. It can cause weight gain and there have been report of increased risk of breaking bones in older patients. Also, there are reports of a small increased risk of bladder cancer, although this is very rare. Pioglitazone doesn't cause hypos. If you have any concerns about the side effects of pioglitazone, discuss this with your diabetes health care provider.

Pioglitazone

Pioglitazone + Metformin (Competact)

Prandial Glucose regulators

Prandial Glucose Regulators stimulate the cells in the pancreas to produce more insulin. However, these tablets last for a shorter period of time. If a meal is missed, the dose must be omitted.

Repaglinide   (Prandin)
Nateglinide   (Starlix)

DPP4 inhibitors

Dipeptidyl peptidase 4 inhibitors also known as gliptins work by blocking the action of DPP-4, an enzyme which destroys the hormone incretin.

Incretins help the body produce more insulin only when it is needed and reduce the amount of glucose being produced by the liver when it is not needed. These hormones are released throughout the day and levels are increased at meal times

Sitagliptin   (Januvia)
Sitagliptin + Metformin   (Janumet)
Vildagliptin   (Galvus)
Vildagliptin + Metformin   (Eucreas)
Saxagliptin   (Onglyza)
Linagliptin   (Trajenta)
Linagliptin + Metformin   (Jentadueto)

SGLT2 inhibitors (sodium-glucose transporter (2) inhibitors

Forxiga (dapagliflozin)

This medication introduced in Scotland 2013 can be used in adults with Type 2 Diabetes Mellitus to improve diabetes control. It works by removing excess glucose from the body through the kidney, causing more glucose to appear in the urine.

Regular monitoring of kidney function is recommended, and it cannot be used in people with any degree of kidney impairment. Caution should be exercised in those patients with low blood pressure. It may increase the risk of urinary infection. It may cause slight weight loss. It is not for use in pregnancy.

Non insulin injections - Glucagon- Like Peptide (GLP-1)

Exenatide (Byetta)   injection twice daily before breakfast & evening meal
Liraglutide (Victoza)   injection once daily
Exenatide Extended Release (Bydureon)   injection once weekly
Lixisenatide (Lixumia)

 

GLP -1 injections mimic the action of the naturally occurring hormone GLP -1, increasing insulin production, reducing the amount of glucose being produced by the liver when it is not needed, slowing food passage through stomach, reducing appetite with the aim of improving blood sugar levels.

Troubleshooting

What if I forget a tablet?

If you remember a forgotten tablet an hour or two late, take it then. If it is longer, miss that dose and take your next one as usual. Never double your dose because you have missed a dose.

What if I am ill?

Do not stop taking your tablets See the coping with illness leaflet.

Free prescriptions

If you need to take tablets for your diabetes, you are entitled to free prescriptions for these tablets and any other medication you need. Ask your doctor, nurse or pharmacist for a 'medical exemption' form EC92A.


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