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Oral Diabetes Medicines

There are many types of medicines used in the treatment of diabetes. These medicines are generally grouped into classes. Each class works in a slightly different way to lower blood sugar levels. The different classes of diabetes medicines include:
 
  • Alpha-glucosidase inhibitors
  • Biguanides
  • Dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors)
  • Ergot alkaloids
  • Meglitinides
  • Sulfonylureas
  • Thiazolidinediones (more commonly known as "glitazones")
  • Sodium-glucose co-transporter 2 inhibitors (SGLT2 inhibitors)
  • Bile acid sequestrants.
 
In addition, some medicines are available as combination products that combine medications from different classes into one pill.
 
Alpha-Glucosidase Inhibitors
Alpha-glucosidase inhibitors work by slowing down the absorption of carbohydrates from the gastrointestinal (GI) tract. This helps lower post-meal blood sugar levels. Available medicines in this class include acarbose (Precose®) and miglitol (Glyset®).
 
Biguanides
Biguanides work by helping cells in the body take up and use insulin better. This class of medicines also decreases the amount of glucose made by the liver. Metformin (Fortamet®, Glucophage®, Glucophage XR®, Glumetza®, Riomet®) is the only currently available biguanide.
 
DPP-4 Inhibitors
As previously mentioned, Nesina is a DPP-4 inhibitor. This class of medicines is also sometimes simply called "gliptins." They work by slowing the breakdown of incretin, a hormone that helps to control blood sugar. Other DPP-4 inhibitors include:
   
Ergot Alkaloids
Ergot alkaloids are more commonly known to treat Parkinson's disease and migraine headaches. However, there is one ergot alkaloid approved for the treatment of diabetes -- bromocriptine (Cycloset®).
 
Although the exact way it works to control blood sugar is not completely understood, it is thought to work by binding to and stimulating dopamine receptors. People with diabetes have low dopamine levels in the morning, which may interfere with the ability of the body to control blood sugar. By increasing dopamine receptor activity, bromocriptine lowers blood sugar without increasing insulin.
 
Meglitinides
Meglitinides work by stimulating the pancreas to make more insulin. They are quite effective at controlling blood sugar, but also carry the risk of causing dangerously low blood sugar (hypoglycemia). Available meglitinides include nateglinide (Starlix®) and repaglinide (Prandin®).
 
Sulfonylureas
This class of medicines also works by stimulating insulin secretion by the pancreas. They are also quite effective, and have a risk for causing hypoglycemia. There are many sulfonylurea medicines available, including:
   
Glitazones
Glitazones work by making the body more sensitive to insulin, which means they help the body use its natural insulin better. This class includes the medications pioglitazone (Actos®) and rosiglitazone (Avandia®).
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Nesina Medication Information

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