Medications for type 2 diabetes (4/5)

Medications are given to people with type 2 diabetes to help manage their blood glucose levels in conjunction with healthy dietary habits and daily physical activities. As a consultant pharmacist, I aim to enhance quality use of medicines. PLEASE SPEAK WITH YOUR DOCTOR REGARDING YOUR SPECIFIC TREATMENTS.

The following information is designed to give you an overview of current treatment options available in Australia to help lowering blood glucose levels. For more detailed information, such as side effects and precautions, please speak with your pharmacist and ask for a CMI (Consumer Medicine Information) printout on your particular medication. Since there may be many brands on some medications, I have provided the chemical name of each medication to avoid confusion.

Acarbose

  • Mode of action: slows absorption of certain dietary carbohydrates, such as sucrose (cane sugar), in the small intestine and reduces the risk of hyperglycaemia (high blood glucose level) after meals
  • Best taken IMMEDIATELY BEFORE A MEAL or CHEW WITH THE FIRST MOUTHFULS OF FOOD
  • Does not cause hypoglycaemia by itself. However hypo may occur when it is used with other blood glucose lowering medications.
  • If hypoglycaemia occurs (usually due to other diabetes medications) treat it with PURE GLUCOSE, e.g. Lucozade or glucose tablets or gel. DO NOT GIVE SUCROSE due to slowed absorption of sucrose.
  • Side effects: flatulence, diarrhoea, bloating and abdominal pain.
  • The gastrointestinal side effects are unlikely to be relieved by any antacid.
  • Not recommended for pregnancy

SGLT2 inhibitors (include canagliflozin, dapagliflozin, epagliflozin)

  • These are the new kids on the block! The latest medicine available in Australia.
  • Mode of action: reduces glucose reabsorption in the kidney and increases glucose excretion in the urine
  • Hypo may occur when it is used with other blood glucose lowering medications such as insulin or a sulfonylurea.
  • Side effects: gential infections, urinary tract infections, thirst and constipation
  • Not recommended for people with severe liver or kidney disease.
  • Not recommended for pregnancy and breastfeeding.

 

Viv Hsu
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