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Why Are There so Many Medicines for Diabetes?

Theoretically, since there are at least 300 genetic defects which cause Type 2 Diabetes, over 300 different classes of medications should exist.  One group for each defect.   Not there yet.

What do the drugs that we have do for someone with diabetes?  Metformin is usually the first one used to treat Type 2 Diabetes.  Why?  90% of people with Type 2 Diabetes are insulin resistant and metformin improves insulin resistance as well as decreases appetite and promotes weight loss.

What comes after metformin? If your blood sugar goes up after eating, you may want to try a medication which helps the pancreas release insulin at the correct time.  Those drugs are DPP-4 inhibitors (Januvia, Onglyza, Tradjenta) and GLP1 medications (Byetta, Victoza, Bydureon, Trulicity and Ozempic).  The last medications are injections.  They have the advantage of appetite suppression.

The newest group is the SGLT2 inhibitors.  These medications tell the kidneys to not hold onto sugar and release sugar from the body.

If the blood sugar is very high, a sulfonylurea may be added.  Glipizide, glyburide and glimepiride will cause the pancreas to make more insulin to lower the blood sugar.   Sugar and calories leave the body every time you go to the bathroom.

Keep in mind that by the time you are diagnosed with diabetes, over half of your ability to make insulin is gone forever.  It is likely that these medications will help prevent your pancreas from totally wearing out.  The real promise of the new diabetes drugs is that they will actually prevent the development of diabetes.

Join the Pancreas Protection Society and use not only medications but changes in diet and exercise to help your pancreas keep making insulin.

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