Diabetes Drugs

Part 2: Types of diabetes drugs

The drugs used to combat diabetes fall into several main categories:

• The first, alpha glucosidase inhibitors such as Acarbose, stop the absorption of glucose from the gut. (But if you are going to stop the absorption of a food, why waste money on buying it in the first place?)
• Second (they're usually used first) are the biguanides such as Metformin . These force muscle cells to absorb more glucose. (Wouldn't it be better not to get too much glucose in the blood in the first place?)
• Next we have thiazolidinediones such as Pioglitazone or Rosiglitazone . These drugs enhance uptake of glucose into the liver, muscles or fat cells (so you put on weight!).
• Then there are sulphonylureas such as Glimiparide which make the pancreas produce more insulin. (Wouldn't it be better not to raise glucose levels in the first place?)
• Then we have Prandial Glucose Regulators such as Nateglinide which stimulate the release of ever more insulin to combat the rising levels of glucose in the blood. (Again, wouldn't it be better not to get too much glucose in the blood in the first place?)
• Lastly there are two drugs, Actos and Avandia which you would have to be really stupid to take. These drugs activate PPAR-gamma receptors, which are nuclear receptors designed to multiply fat cells. So, these drugs lower your blood sugar by increasing the number of fat cells faster to accommodate more fat! They don't fix the underlying problem: over-consumption of carbohydrates, they merely allow your body to reduce its blood glucose by storing more of it as fat. And once those fat cells become resistant to insulin you're back to where you started - only a lot fatter! So your drug doses are increased (again), and you end up in a never-ending vicious cycle of increasing weight and deteriorating health. It doesn't help that Avandia significantly increases your risk of a heart attack.

Eventually, as these drugs invariably fail, diabetics' pancreases are finally worn out by this constant excessive production of insulin and give up. At this stage, Type-2 diabetics are generally forced to inject insulin.

This is an extremely unhealthy step. And it gets worse:

Polypharmacy May Be Unavoidable

Looking at the problem of increasing drug use, Dr PH Winocour noted that:

"Given the cardiovascular risk profile of type 2 diabetes, up to 10 percent of patients could require two or three hypoglycaemic agents (ultimately including insulin), at least three antihypertensive agents, two hypolipidaemic agents,and aspirin. A high proportion will also require treatment for coexistent cardiovascular disease and coincidental unrelated chronic disease. It is difficult to see how we can realistically expect patients to comply for long with such a draconian regimen requiring so many separate drugs."

This, then, is what you may well be in for unless you get your diabetes under control. And all that entails is a change of diet to one that does not raise blood glucose levels. It's that simple.

Reference

Winocour PH. Effective diabetes care: a need for realistic targets. BMJ 2002; 324: 1577-1580