Type 2 diabetes can sometimes initially be managed through lifestyle modification including a healthy diet and regular exercise. However, as the disease progresses, people with type 2 diabetes are often prescribed tablets to control their blood glucose levels. These tablets are intended to be used in conjunction with healthy eating and regular physical activity, not as a substitute. Diabetes tablets are not an oral form of insulin and they require insulin to be present in the body to be effective.
Eventually it may be necessary to start taking
insulin to control blood glucose levels, when your body is no longer producing enough insulin of its own. Sometimes tablets may be continued in addition to insulin.
The aim of diabetes management is to keep blood glucose levels as close to ‘normal' as possible, that is between 4 to 6 mmol/L (fasting), as this will help prevent both short-term and long-term complications.
Regular
blood glucose monitoring is necessary to see if the treatment being followed is adequately controlling blood glucose levels.
No matter which medication or management plan your doctor prescribes, make sure you follow their instructions. The pattern and frequency will depend on the individual, the tables and your circumstances.
In this Section
This group of insulin tablets helps to lower blood glucose levels by:
- Reducing the amount of stored glucose released by the liver
- Slowing the absorption of glucose from the intestine
- Helping the body to become more sensitive to insulin so that your own insulin works better.
| Chemical Name |
Some Brand Names |
Metformin
|
Diabex |
Diaformin |
| Diabex XR |
Formet |
| Glucohexal |
Glucomet |
| Glucophage |
Genrx metformin |
| Metformin-BC |
|
When to take: with meals.
Possible side effects include: nausea, diarrhoea and a metallic taste in the mouth. These can be reduced by taking the tablets with or after a meal. Speak with your doctor if you experience any side effects to find the right solution for you.
Dosage: they should be started at a low dose. Over time, your doctor may need to gradually increase the dose. The dosage may differ for individuals so ONLY take the dosage prescribed by YOUR doctor.
Not to be taken by: women who are pregnant or breast-feeding.
Points to remember:
- They generally don’t cause weight-gain, and may actually help to lose a few kilos. It is often prescribed as the first diabetes tablet for people with type 2 diabetes.
- They should not be used by people with severe liver, kidney or heart disease. Metformin may need to be stopped before surgery or procedures that require injecting a radio-opaque dye such as a coronary angiogram. Always check with your doctor.
- They may need to be combined with the sulphonylurea class of tablets.
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This group of insulin tablets stimulates the pancreas to produce more insulin.
| Chemical Name |
Some Brand Names |
Gliclazide
|
Diamicron |
Glyade |
| Diamicron MR |
Mellihexal |
| Nidem |
Genrx gliclazide |
| Glibenclamide |
Daonil |
Glimel |
| Glipizide |
Melizide |
Minidiab |
| Glimepiride |
Amaryl |
Dimirel |
When to take: before with meals.
Possible side effects include: weight gain, skin rashes, gastric upsets, jaundice and
hypoglycaemia. Speak with your doctor if you experience any side effects to find the right solution for you.
Dosage: over time, your doctor may need to gradually increase the dose. The dosage may differ for individuals so ONLY take the dosage prescribed by YOUR doctor.
Not to be taken by: women who are pregnant or breast-feeding. On a rare occasion a doctor may prescribe them.
Points to remember:They may need to be combined with biguanides tablets.
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This group of insulin tablets is also known as glitazones. They help to lower blood glucose levels by increasing the effect of your own insulin, especially on muscle and fat cells i.e. they improve insulin resistance.
| Chemical Name |
Some Brand Names |
| Rosiglitazone |
Avandia |
| Pioglitazone |
Actos |
When to take: they don’t need to be taken with a meal and can be taken once or twice daily at any convenient time.
Possible side effects include: a small weight gain. Fat is moved from areas where it is bad for your health (around the tummy) to other areas such as the top of the thighs, where you still may not want it but it is not as harmful to your health.
Speak with your doctor if you experience any side effects to find the right solution for you.
Dosage: once or twice daily. The dosage may differ for individuals so ONLY take the dosage prescribed by YOUR doctor.
Not to be taken by: women who are pregnant or breast-feeding or people with who have had heart failure or some types of heart problems.
Points to remember:
- Their effect is slow, taking days to weeks to begin working and one to two months for their full effect.
- They work well in conjunction with some of the other diabetes tablets.
- They will not cause hypoglycaemia [Link to Hypo page] unless taken with a sulphonylurea.
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This group of insulin tablets lower blood glucose levels by stimulating the pancreas to release more insulin, although they are not chemically related to the sulphonylureas.
| Chemical Name |
Some Brand Names |
| Repaglinide |
Novonorm Prandin |
When to take: before a meal
Possible side effects include: low blood glucose level
(hypoglycaemia) and possibly gastro upsets and abnormalities of liver function tests. Speak with your doctor if you experience any side effects to find the right solution for you.
Dosage: one to three times daily. The dosage may differ for individuals so ONLY take the dosage prescribed by YOUR doctor.
Not to be taken by: women who are pregnant or breast-feeding.
Points to remember:
- They are quick acting and don’t last long so a tablet is taken before each meal to stimulate insulin to cope with that meal. They offer flexibility for people with erratic eating patterns, e.g. shift workers.
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They help to slow down the digestion and absorption of certain dietary carbohydrates in the stomach (intestine). Taken on their own, they don’t cause hypoglycaemia.
| Chemical Name |
Some Brand Names |
| Acarbose |
Glucobay Precose |
When to take: just before eating.
Possible side effects include: weight loss, flatulence (wind), bloating and diarrhoea. Speak with your doctor if you experience any side effects to find the right solution for you.
Dosage: started at low doses and increased slowly to reduce side effects. The dosage may differ for individuals so ONLY take the dosage prescribed by YOUR doctor.
Not to be taken by: women who are pregnant or breast-feeding
Points to remember:
- If hypoglycaemia [Link to Hypo page] occurs, due to another diabetes tablet you may be taking, it must be treated with pure glucose such as glucose tablets, gel or Lucozade.
At some stage your doctor may decide to add a second or even a third type of tablet to maintain your blood glucose levels. For example, metformin plus a sulphonylurea is a common combination.
As an alternative to taking two separate tablets there is currently one product that is a metformin and a sulphonylurea (glibenclamide) combined into a single tablet:
| Chemical Name |
Some Brand Names |
| Metformin/glibenclamide |
Glucovance |
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