Diabetes: The Basics - Taking Medications

Listen to Diabetes: The Basics—Taking Medications Audio

General Information About Diabetes Medicines

Most people with diabetes take diabetes medicines medication to help control it. Everyone who has Type 1 diabetes must take insulin to live. Some people who have Type 2 diabetes can control diabetes without medicines for a while, using only healthy eating and exercise. This happens most often right after someone is first diagnosed. For some people, this time may last only a short time. Or it may last several years. Usually, with Type 2 diabetes, the longer you have diabetes the less insulin the body makes. Therefore, after a while, most people need to start using a diabetes medicine.

There are many medicines that can be used for type 2 diabetes. Different types of medicines work in different ways. Sometimes one medicine is enough to control type 2 diabetes. But you may get better control if you use two (2) or more that work in different ways. For example, many people use a medicine that helps the body make more insulin along with one that helps the body use insulin more efficiently.

Some people who have Type 2 diabetes cannot make much of their own insulin at all, or there may be reasons they cannot use diabetes pills. If you are one of these people, you will need to use insulin. Insulin can be a very effective way to control diabetes when it is used correctly.

For any diabetes medicine, there are a few things you should know:

  • What are the brand name and the generic name of the medicine?
  • When and how much should you take?
  • Should you take this medicine with food or by itself?
  • How does this medicine work?
  • What are the most common side effects?
  • Does this medicine have "peaks" —times when it works most strongly to lower blood sugar? Can it cause hypoglycemia?
  • If you are sick, should you continue to take the medicine?

Your doctor, your pharmacist, or your diabetes educator can give you answers to these questions.



Diabetes Pills

Taking diabetes pills can help keep blood sugar levels in a normal range and control your diabetes. People who take diabetes pills still need to eat the right way, exercise and check their blood sugar.

Diabetes pills only work in people whose bodies still make some insulin. The pills are not insulin. Diabetes pills do not cure diabetes, but they can help control it.

Different pills work in different ways to help control blood sugar levels. Your doctor may decide that you need more than one kind of diabetes pill.

Important!

  • There are different types of diabetes pills, so know the type you take.
  • Pills have a brand name and a generic name. It is important to know both names.
  • Some pills start to work in a few days. Others may take weeks before they reach their full effect.
  • Do not skip taking your pills or stop taking them unless you talk to your doctor first.
  • Some diabetes pills work differently than others, so never share your pills with other people who have diabetes.

If you take diabetes pills, ask your doctor or pharmacist these questions:

  • What is the brand name and the generic name of the pill?
  • How many pills do I take at one time?
  • When (what time) do I take the pills?
  • Should I take the pills with food or without food?
  • What side effects might happen when I take the pills?
  • Should I take the pill if I am sick or cannot eat?

Here is a list of the 6 different types of diabetes pills. For each type, the list includes brand names and generic names of the pills, how the pills work, and what the side effects might be. These are the most common side effects, not all of them. You might not have any side effects at all. But if you notice any, you should talk to your doctor.

  1. Type of pill: Biguanide
    Brand name: Glucophage, Glucophage XL
    Generic name: Metformin
    How these pills work: They slow or decrease the amount of sugar or glucose that your body makes after eating and help your body use insulin. Common side effects: Upset stomach, diarrhea, gas, bloating. These side effects usually get better over time, within a few weeks.
  2. Type of pill: Sulfonylurea
    Brand names: Amaryl, Diabinese, Diabetes, Micronase, Glynase, Glucotrol, Glucotrol XL
    Generic Names: Glimepiride, chlorpropamide, glyburide, glipizide
    How these pills work: They help your body make more insulin for several hours up to a full day.
    Common side effects are Hypoglycemia (low blood sugar), weight gain, sun sensitivity
  3. Type of pill: Meglitinides
    Brand names: Starlix, Prandin
    Generic names: nateglinide, repaglinide
    How these pills work: They help your body make more insulin for a few hours right after you take them.
    Common side effects are hypoglycemia (low blood sugar), weight gain
  4. Type of pill: Thiozolidinediones, also called TZDs or glitazones
    Brand names: Actos, Avandia
    Generic names: pioglitazone, rosiglitazone
    How the pills work: They help your muscle cells use the insulin your body already makes.
    Common side effects: Weight gain, water retention, swelling of feet and legs.
  5. Type of pill: Dipeptidylpeptidase IV inhibitor, or DPP 4 inhibitor
    Brand name: Januvia
    Generic name: Sitagliptin
    How the pill works: This pill helps your body make more insulin and less sugar or glucose after you eat.
    Common side effects: stuffy or runny nose, sore throat, headache
  6. Type of pills: Alpha-glucosidase inhibitors
    Brand names: Precose, Glyset
    Generic names: Acarbose, miglitol
    How the pills work: They slow down digestion of carbohydrates, so sugar, or glucose, from the food goes into the blood slowly.
    Common side effects: Gas, bloating, diarrhea. These side effects usually get better over time, within a few weeks.


Insulin

Many people who have diabetes use insulin to help control it. If you use insulin, you need to know how it works in your body, how to store it and take it, what type you take, and when it will act in your body.

Diabetes is an illness that makes it hard for your body to use the food you eat the right way. Insulin helps your body use food for energy. Some of the food you eat turns into glucose. Glucose is also called 'sugar,' and is your body"s main source of energy. Glucose travels through your body in your blood. Insulin is a substance made in the pancreas, a small organ behind your stomach. Insulin helps get the glucose out of the blood and into your cells. Just like a key that unlocks a door, insulin is like the key that unlocks the door to the cells in your body, and lets the glucose in to be used as energy.

People with Type 1 diabetes must take insulin to live because their pancreas does not make it anymore. People with Type 2 diabetes may need to take insulin if their pancreas does not make enough, or if the insulin cannot get into the cells as easily as it should.

Insulin can be taken with an insulin syringe (or needle) an insulin pen, or an insulin pump. Insulin does not come in a pill. If you need to learn how to give yourself insulin, see your diabetes educator.

These points are important!

  • There are different kinds of insulin that act at different times
  • You may need to take more than one kind of insulin.
  • You may need to take insulin only once a day, or 2, 3, or 4 times each day or more.

Types of Insulin

  • Humalog, Novolog and Apidra are types of insulin that start to work 10 to 20 minutes after you take them. They work their best 30 minutes to 3 hours after they are taken and stay in your body for 3 to 5 hours. These insulins should look clear.
  • Humulin R and Novolin R insulin start to work 30 to 60 minutes after you take them. They work their best 1-1/2 to 4 hours after they are taken and stay in your body for 5 to 8 hours. These insulins should look clear.
  • Humulin N and Novolin N insulin start to work 1 to 2 hours after you take them. They work their best 2 to 12 hours after they are taken and stay in your body 14 to 24 hours. These insulins should look cloudy and white.
  • Lantus and Levamir insulin start to work 50 minutes to 2 hours after you take them. They stay in your body for 20 to 24 hours. These insulins should look clear.
  • Humalog Mix 75/25, Humalog Mix 50/50 and Novolog Mix 70/30 insulin start to work 10 to 20 minutes after you take them. They work their best 30 minutes to 2 ½ hours after they are taken and stay in your body for up to 24 hours. These insulins should look cloudy.
  • Humulin 70/30, Humulin 50/50 and Novolin 70/30 insulin start to work 30 to 60 minutes after you take them. They work their best 2 to 12 hours after they are taken and stay in your body up to 24 hours. These insulins should look cloudy.

Things you should know if you take insulin:

  • Bottles of insulin or insulin pens that have not been opened should be kept in the refrigerator until the 'use by' date. This date is marked on the insulin package.
  • Once you open the insulin, you do not have to keep it in the refrigerator. Keep it some place where it will not get too hot or too cold.
  • Once you open a bottle of insulin, it is only good for 28 days. Write the date you open it on the bottle and throw it away after 28 days.
  • If you use insulin pens, check with your pharmacist about how long the are good after opening.
  • Insulin should not have clumps, crystals or strings in it. It should not look discolored.
  • When you pick up your insulin at the pharmacy, check to be sure you have the right kind of insulin. Look at the brand name, strength, and type.
  • Do not mix Lantus or Levamir in the same syringe with any other insulin.


Diabetes Injections that are Not Insulin

For many years, the medicines used to control diabetes were either pills or insulin. But recently there are some new choices for controlling diabetes —medicines that are injected, but are not insulin.

All of these medicines are available in pens, much like insulin pens. One is also available for use with a vial and syringe. If you need to learn how to give yourself an injection in order to use one of these medicines, see your diabetes educator.

These new medicines work in different ways from diabetes pills. One is used with type 1 diabetes, and all can be used with type 2 diabetes.

Just as with any other type of medication, you should ask your doctor or pharmacist:

  • What is the brand name and the generic name of the medicine?
  • How much do I take at one time?
  • When (what time) do I take this medicine?
  • Should I take it with food or without food?
  • What side effects might happen when I take this medicine?
  • Should I take it if I am sick or cannot eat?

Here is a list of the 2 diabetes medicines that are injected and are not insulin. The list includes the type of medicine, their brand names, generic names, how they work, and what the side effects might be. These are the most common side effects, not all of them. You might not have any side effects at all. But if you notice any, you should talk to your doctor.

  1. Type of medicine: Synthetic amylin
    Brand name: Symlin
    Generic name: Pramlintide
    How it works: This medicine is given at meals along with insulin injections. It slows digestion of food, slows or decreases the amount of sugar or glucose that your body makes after eating, and decreases appetite.
    Side effects: nausea (usually gets better over time), hypoglycemia (low blood sugar), weight loss.
  2. Type of medicine: Incretin mimetic, GLP-1 analog
    Brand names: Byetta, Victoza
    Generic names: Exenatide, Liraglutide
    How they work: These medicines slow digestion, increase insulin secretion, and decrease appetite.
    Side effects: nausea (usually gets better over time), gas, weight loss.

Personal Stories

  • Vivian: Living with Diabetes and Visual Impairment
    Vivian was diagnosed with diabetes twenty years ago, at age 58. Ten years later, she was diagnosed with diabetic retinopathy and spinal stenosis. She talks about how she is living and coping with her diabetes and some of the tools and techniques she uses.

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