Treatments for Type 2 diabetes: What do patients think?

There are various treatments available for people suffering from type 2 diabetes. These medications are prescribed when lifestyle and dietary measures have been inadequate in controlling blood sugar. The treatments currently available are taken orally or through injection.

Oral antidiabetic drugs

Drugs that improve insulin sensitivity

These medications will especially improve insulin efficiency of the liver or muscles. The class of treatment used is the biguanides with the only available molecule metformin.

When it is not sufficient in controlling blood sugar, metformin can be used in combination with medications which stimulate insulin production (sulfonylureas, glinides) or with insulin.

A patient from Carenity's UK platform about Stagid® describes "Apart from a few digestive problems from time to time, it's the best treatment"

With regard to metformin, another patient described: "With this drug, there must be questions involved in lifestyle habits (food, sleep, physical activity)"

<<< Don't hesitate to read our article on metformin>>>

Drugs that stimulate insulin production

Two classes of antidiabetic medication stimulate the release of a greater quantity of insulin by the pancreas: sulfonylureas (glibenclamide, gliclazide…) and the glinides (repaglinide).

The sulfonylureas are offered in combination with metformin.

The glinides have an action time which is slightly less than the sulfonylureas and must be taken right before the meal.

Just like other antidiabetic medicines, the issue raised in patients taking this treatment is hypoglycemia.

Such is the case for this patient from Carenity's UK platform: "Having several drugs to take orally each day and one injection per week, I don't know how much Gliclazide affects the improvement in blood sugar, whether it is truly effective. Right now, only this cocktail is convincing on the results if I pay attention to my diet and if I do enough walking."

Drugs that reduce the absorption of sugars

This concerns the class of alpha-glucosidase inhibitors composed of acarbose. It slows down the digestive process, which involves a delay in the transfer of sugar after meals. Due to its mode of action, it must be taken at the beginning of the meal.

It is normally used in combination with other antidiabetic drugs but it can be used alone in the case of contraindication to metformin and to sulfonylureas.

The main undesired and very frequent effects are digestive with flatulence, diarrhea...

Drugs that act through incretins

Incretins are two intestinal hormones: GLP-1 (glucagon like peptide-1) and GIP (glucose-dependent insuliontropic polypeptide). They are secreted after a meal and control the secretion of insulin by the pancreas. Secretion of glucagon is also limited.

Two drug classes exist, gliptins are a class of molecules that are taken orally. They inhibit the action of dipeptidyl peptidase-4 and therefore slow down the breakdown of GLP-1 (Januvia®, Galvus®…).

The risk of hypoglycaemia with gliptins is reduced because they only act when the blood sugar level is raised.

Drugs that favour the removal of sugars

Dapagliflozine belongs to a class of antidiabetic drugs called sodium-glucose co-transporter-2 (SGLT2) inhibitors. The sodium-glucose co-transporter-2 is present in the kidneys. These antidiabetics block its action, lower the reabsorption of glucose in the kidneys and, as a result, promote the removal of glucose in urine.

Oral antidiabetic drug combinations

The control of blood sugar sometimes requires the combination of two antidiabetic drugs which belong to classes that have different modes of action. There are fixed combinations of antidiabetic drugs that allow you to only take one tablet: metformin and sulfonylurea (Glucovance®), metformin and dipeptidyl peptidase-4 inhibitor (gliptin) (Eucreas®, Janumet®…).

With regard to Janumet®, a member of Carenity UK commented: "Satisfied by it overall but I carry a reservation given that I have diarrhea at times which would be caused by Janumet"

Injectable antidiabetic drugs

Drugs that act through incretins

As we have seen previously, certain molecules affect blood sugar through incretins. This is the case for glucagon-like peptide analogues, closely related substances to glucagon like peptide-1 (GLP-1), which resists action from dipeptidylpeptidase (Trulicity®, Ozempic®, Victoza®…)

A member of Carenity's UK platform has written on the subject of Trulicity® : "It's very good. For me, I had almost all the side effects, but I have acquaintances who had nothing, I perservered because I lost 11 kilos and my hemoglobin went from 8.8 to 6.7. An injection once a week done by myself"

Insulin injections

Insulin is a molecule recommended mainly for type 1 diabetes. It can however, be used for type 2 diabetes when the diabetes is not controlled.

 <<< Don't hesitate to read our article on intensive insulin therapy >>>

Injectable antidiabetic drug combinations

A medication combining a long-action insulin (insulin degludec) and an injectable antidiabetic (liraglutide, a glucagon-like peptide analogue) is now available. This is Xultophy®. It is used in the treatment of type 2 diabetes, in combination with other oral antidiabetics, when these antidiabetics combined with diet and physical exercise are shown to be inadequate in controlling diabetes.

"By paying attention to every meal, it provides a very effective insulin" commented a member of the UK platform.

Consult with your healthcare provider first for any questions regarding your treatment.

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