Oral Medications

Oral Medications

Oral diabetes medicines, or oral hypoglycemics, can lower blood glucose in people who have diabetes, but are able to make some insulin. They are an option if diet and exercise don't work. Oral diabetes medications are not insulin and are not a substitute for diet and exercise. Although experts don't understand exactly how each oral medicine works, they know that they increase insulin production and affect how insulin lowers blood glucose. These medications are most effective in people who developed diabetes after age 40, have had diabetes less than 5 years, are normal weight, and have never received insulin or have taken only 40 units or less of insulin a day. Pregnant and nursing women shouldn't take oral medications because their effect on the fetus and newborn is unknown, and because insulin provides better control of diabetes during pregnancy.

Six FDA-approved oral diabetes medications are now on the market. Their generic names are tolbutamide, chlorpropamide, tolazamide, acetohexamide, glyburide, and glipizide. The generic name refers to the chemical that gives each medicine its particular effect. Some of these medications are made by more than one pharmaceutical company and have more than one brand name. All six are different types of one class of medication, called sulfonylureas, but each affects metabolism differently. A doctor will choose a patient's medication based on the person's general health, the amount his or her blood glucose needs to be lowered, the person's eating habits, and the medicine's side effects.

The purpose of oral medications is to lower blood glucose. Therefore, the person taking them must eat regular meals and engage in only light to moderate exercise, to prevent blood glucose from dipping too low. Medications taken for other health problems, including illness, also can lower blood sugar and may react with the diabetes medicine. Therefore, a doctor needs to know all the medications a person is taking to prevent a harmful interaction. Lowering blood sugar too much can cause hypoglycemia with symptoms such as headache, weakness, shakiness, and if the condition is severe enough, collapse.

Oral diabetes medications usually don't cause side effects. However, a few people do experience nausea, skin rashes, headache, either water retention or diuresis (increased urination), and sensitivity to direct sunlight. These effects should gradually subside, but a person should see a doctor if they persist. For reasons that aren't always clear, sometimes oral diabetes medications don't help the person for whom they're prescribed. Investigations are under way to learn why this happens.