MEDICATIONS FOR TYPE 2 DIABETES.

If you have type 2 diabetes you are most likely to be treated with non-insulin medication, which may be taken as pills or injections. There are many types, all of which work to manage your blood glucose levels so that you stay healthy long-term.

Your Doctor will consider different factors when deciding which medication to recommend for you, including your weight, lifestyle, and blood glucose level. If you are overweight, drugs that cause weight gain won’t be the first choice. If your eating pattern is irregular, a drug that has a short duration of action will be better than a longer-acting one.

MEDICATION TYPE AND ACTION
1.Sulfonylureas.
They Increase the amount of insulin the pancreas produces and increase insulin’s effectiveness. #Examples: Glipizide, glimepiride, glyburide. The drug is in pills; taken once or twice a day, with or shortly before a meal. Possible side effects: Weight gain; hypoglycemia

2. Prandial glucose regulators (meglitinides)
   They are similar to sulfonylureas, increasing the insulin the pancreas produces. #Examples: Nateglinide, repaglinide. You need to take your pills within 30 minutes of starting a meal. Possible side effects; Weight gain; hypoglycemia (less than those produced by sulfonylureas)
3. Biguanides; They increase the body cells’ sensitivity to insulin; also reduce glucose production by the liver. #Examples: Metformin XR
   extended-release Metformin immediate release. The XR pills are taken once a day with food, and IR are taken two to three times daily with food. Possible Side effects may include Nausea, diarrhea & abdominal pain.
4. Alpha-glucosidase inhibitors; They slow down the digestion of
   carbohydrates in starchy foods, which slows glucose entering the bloodstream. #Examples: Acarbose, miglitol. The pills are taken at the start of or immediately before, a meal. Possible side effects; Flatulence; diarrhea.

5.Glitazones (thiazolidinediones); They reduce body cells’ resistance
to insulin so help cells to absorb insulin better. #Examples; Pioglitazone,
rosiglitazone. The pills are taken once or twice daily, with or without food. Possible side effects; Visual disturbance; weight gain; fluid retention

6. Gliptins (DPP-4 inhibitors); They slow down digestion and, decrease
   appetite; lower blood glucose levels. #Examples; Sitagliptin, vildagliptin,
   saxagliptin, alogliptin, linagliptin. The pills are taken once a day, with or
   without food. Possible side effects; Rash; upper respiratory infections; headache; nausea.

7.SGLT2 inhibitors; They cause kidneys to excrete excess glucose into the urine. #Examples; Dapagliflozin, canagliflozin, empagliflozin, ertugliflozin. The pills are taken once a day, with or without food. Possible side effects; Urinary tract infections; thrush (yeast infection); genital tract infections and itching.

8.Incretin mimetics (GLP-1 analogues); They increase insulin production and reduce glucose production by liver. #Examples; Exenatide, liraglutide, lixisenatide, dulaglutide, semaglutide (in oral or injection form). By injection (semaglutide is also available in an oral form); once or
twice daily or once weekly, depending on the specific medication. Possible side effect; Nausea and/or vomiting, which are often short-lived.

NEW ORAL DRUGS
These medications are all brand-name drugs that don’t have generic forms.

1) Xigduo XR
Xigduo XR, which comes as a 24-hour extended-release oral tablet, was approved for use in 2014. Xigduo XR combines metformin with dapagliflozin. Metformin helps make body tissues more sensitive to insulin.
Dapagliflozin blocks some of the glucose in your body from reentering your blood through your kidneys. This causes your body to get rid of more glucose through your urine.

2) Synjardy
Synjardy, also available as Synjardy XR and comes as an oral tablet, was approved for use in 2015. It combines the drugs metformin and empagliflozin. Empagliflozin works in a similar way to dapagliflozin.

3) Glyxambi
Glyxambi, which comes as an oral tablet, was approved for use in 2015. It combines the drugs linagliptin and empagliflozin.
Linagliptin blocks the breakdown of certain hormones in your body that tell your pancreas to make and release insulin. It also slows your digestion, which slows the release of glucose into your blood.

4.Steglujan
Steglujan, which comes as an oral tablet, was approved in late 2017. It combines ertugliflozin and sitagliptin. Ertugliflozin works through the same mechanism as empagliflozin.
Sitagliptin blocks the breakdown of certain hormones in your body that tell your pancreas to make and release insulin. It also slows your digestion, which slows the absorption of glucose into your blood.

5. Segluromet
   Segluromet, which comes as an oral tablet, was approved in late 2017. It combines ertugliflozin and metformin.
6. Steglatro
   Steglatro, which comes as an oral tablet, was approved in late 2017. It’s a brand-name form of the drug ertugliflozin. It works through the same mechanism as empagliflozin.
   Like the combination drugs in this list, Steglatro is used to treat type 2 diabetes.