Type 2 diabetes medications guide
The goal of combination therapy is to maximize the glucose-lowering effects of diabetes medications. By combining medications from different drug classes, the pills may work in two different ways to control your blood sugar levels. The most common combination therapy is to take two separate drugs at the same time. It also may be combined into one pill.
Main diabetes medications for treatment
Some doctors prescribe three drugs at a time. More studies are necessary to determine the benefits of triple-drug therapy, but this may be an option if a combination of two oral medications doesn’t achieve your goal. Each class of oral medication can be combined with one another.
A sulfonylurea and metformin
Sulfonylureas are often the base of combination therapy because of their ability to boost and maintain insulin secretion. A sulfonylurea combined with metformin is the most extensively studied drug combination.
The diabetes medications seem to work more effectively together than they do individually, reducing fasting blood sugar by up to 70 mg/dL and glycated hemoglobin by up to 2 percent. Metformin also is beneficial in that it can help people who are overweight avoid additional weight gain, and in some cases, lose weight. Common side effects of this drug combination include nausea, diarrhea and a risk of low blood sugar.
A sulfonylurea and an alpha-glucosidase inhibitor
Combining acarbose or miglitol with a sulfonylurea is especially effective if you experience significant spikes in your blood sugar immediately following meals. Possible side effects include abdominal cramping, gas and diarrhea. You also may experience low blood sugar. Again, be sure to treat episodes of hypoglycemia with milk or glucose tablets or gel because alpha-glucosidase inhibitors block the absorption of table sugar and fruit juice.
A sulfonylurea and a thiazolidinedione therapy
This is one of the newest approaches in combination therapy. Adding a thiazolidinedione medication to a sulfonylurea makes sense when the maximum dose of a sulfonylurea isn’t working for you, you’re overweight and your cells are highly insulin resistant. This combination also increases your risk of low blood sugar because thiazolidinediones improve your body’s use of insulin stimulated by sulfonylureas.
Metformin and an alpha-glucosidase inhibitor
Studies consistently show that the combination of acarbose (an alpha-glucosidase inhibitor) and metformin is more effective in reducing blood sugar following meals than metformin alone. Because miglitol (another alpha-glucosidase inhibitor) is a newer medication, it hasn’t been studied in combination with metformin as often as acarbose has been, but the same benefits are likely to apply.
Possible side effects from combining metformin and an alpha-glucosidase inhibitor are the same as those associated with using metformin or an alpha-glucosidase inhibitor alone. Gastrointestinal symptoms are the most common side effect.
Metformin and a thiazolidinedione
The FDA has approved the thiazolidinediones rosiglitazone and pioglitazone for use with metformin. The combination therapy is more effective at reducing blood sugar than either class of medication alone. The precautions and side effects are the same as those listed for these drugs individually.
This drugs and therapies usually used as diabetes medications at our days.
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