Metformin is the most commonly prescribes type 2 diabetes medication, and works by decreasing the amount of sugar your liver releases, and helps your body to use its own available insulin more efficiently. It can prevent many of the long-term complications of diabetes, is inexpensive, and may help to prevent obesity in unborn babies and even blindness. However, you should avoid metformin if you have a liver or kidney disorder as the drug can cause a dangerous build-up of acid in the blood.
According to Daniel Einhorn, MD, vice president of the American Association of Clinical Endocrinologists, using sulfonylurea medications ‘cause the insulin-producing [cells of the pancreas] to produce insulin almost constantly, which means they [increase the] risk for low blood sugar and for weight gain’. He adds that though they are inexpensive, ‘they are effective, and have been used for a long time’. However, these drugs, along with meglitinides, can cause your blood sugar levels to drop too low and so should be used with caution by the elderly and people with kidney or liver disease.
If your blood sugar tends to be the most out of control after eating, you might benefit from alpha-glucosidase inhibitors, as these impair the digestion of carbohydrates and offset spikes in blood sugar following meals. However, you could experience the adverse side effects of low blood sugar, an upset stomach, gas, and diarrhoea.
The thiazolidinediones (TZDs) family of type 2 diabetes medications improve your body’s ability to use the insulin it still makes. They don’t cause low blood sugar, but they are a little pricier than other drugs. Some types of TZDs can decrease your risk of heart disease, but others can actually lead to an increased risk of heart attack, and TZDs cause fluid retention, often leading to swollen legs and feet. Your heart may not be able to handle all that extra fluid, and so TZDs can aggravate underlying congestive heart failure (CHF). TZDs could also be a risk to your liver and bone wellness.
Finally, a newer group of drugs, known as DPP-4 inhibitors, block the production of your dipeptidyl peptidase 4 enzyme, which allows your body to release more insulin. It doesn’t cause hypoglycaemia or weight gain, and may even have a positive effect on your cholesterol levels, though common side effects of the drug include nausea, diarrhoea, and cold-like symptoms such as nasal congestion and throat pain. Remember that some of these drugs can come in combination form, which can be more effective and may make it easier to stick to your diabetes treatment plan, though it’s more difficult to determine which medication causes any side effects you might experience.