Diabetes Treatment: Medications For Type 2 Diabetes

By jigsaw Latest Reply 2014-03-21 12:50:20 -0500
Started 2014-03-13 06:57:00 -0500

Questions frequently come up regarding blood glucose lows or hypos. Some oral medications can play an important role in the potential cause of blood glucose lows. There are also medications that have little and possibly no effect in causing blood glucose to go low.

The more we understand about how, and why, medications do their job, the better we can manage our diabetes. It pays to take an active role in your health.

I believe the following link gives an excellent description of the available choices of diabetes medications, and what they do to help contol your blood glucose.

56 replies

"Sue" 2014-03-14 17:50:52 -0500 Report

When I was told in Dec. of 2006 that I have type 2 diabetes. I was not surprised at all that the drs had put me on Metformin. But , after being on it for about 3- years it started to give me some side effects (like , vomting , nausea ,and rashes ) with this med. . so they took me off of it 3 different times. And now for the two years they finally took me completely off of it. But, I have found that diabetes meds effect many people in different ways. I am now taking 2- different of insulin 1- I take 4 times day (that is U-500), and I take lantus . I have been on lantus since I have been told it. Since 2006 .

jigsaw 2014-03-14 18:22:15 -0500 Report

Sue, I had problems with Metformin after a year or two also. How are you doing with insulin?
I am doing well since I made the switch to insulin. I went 7 years with no meds, and roughly 11 years with oral meds.

"Sue" 2014-03-14 18:42:10 -0500 Report

Jigsaw; I'm not doing very good at all with my insulin. In the morning I take 32-units of U-500 , at lunch , and supper I take 38 units of U-500 , and then at bed time I take 10 units of U-500 with my 97 units of lantus. But, sometimes I can't eat anything . So I can't always take it .Plus I have other health isuess going on now.

jigsaw 2014-03-15 09:16:02 -0500 Report

Have you been able to gain good control of your blood glucose! That seems to be a substantial dose of insulin.

TopazDee 2014-03-14 04:47:34 -0500 Report

When first told I was T2D I was given metformin I had an traumatically bad reaction it was immediately stopped and changed to Gliclazide (U.K. name) 1 twice daily this lowered my BG's to much, as the 40mg tablet is the lowest dose made I have to break it in half so equally over 24hrs. I take the 40mg.
This seems to have cracked it my BG's are pretty stable in the rise and falls before and 2hrs. after meals, if I do get a dramatic rise after a meal I know I either have to lower my portion of the culprit food or cut it out of my new way of living.
Last night my husband gave me a dime bar I ate it without thinking as I was busy writing fortunately when taking my bedtime BG,s they were fine (nice to know a treat now and then is ok
Thanks for subject jigsaw.
Stay Safe x

jigsaw 2014-03-14 08:25:41 -0500 Report

I took Metformin for a while, with no serious side effects. It was only after about a year or so, that some nasty side effects began. I finally stopped taking it. It appears to be a relatively good medication, but not for everyone.

I believe it is extremely important to pay attention to ones bodily responses. If I stayed on metformin, I would probably have experienced some very damaging consquences.

Seems like you've got things under reasonable control. Good to hear your doing well!

Young1s 2014-03-13 23:52:42 -0500 Report

My Lantus seems to be doing the job for me so far, and I'm glad to be off the Met. The stories alone of what people go through on that one was enough to make me want to get off. MY issue is, since my last hospitalization, my doc went with the advice of the hospital and took me off the extra thiamin pill I was taking, plus the cinnamon pills, fish oil that I had incorporated into my meds routine. Plus they put me on this new colesterol pill (that I swear is trying to kill me).

Granted, I'm a big girl and can do what I want, but I agreed to all this. However, I've noticed that my highs are too high now, compared to when I was on my "normal" regimen. At first, I chocked it up to the stress of being through some stuff, then I said it was my body adjusting to change and the new med. But now I think, whether psychological or otherwise, that my routine worked for me. It was helping.

I find myself now in the position of either continuing along this path and seeing where it leads me. Or, disregarding the advice of the professionals in my life and doing what I think is best to remedy my currant situation. I think I'm leaning towards the latter. While I hate "going against the grain" so to speak, I feel I have to do what is right for my health and what I think is my overall well-being.

jigsaw 2014-03-14 08:48:45 -0500 Report

I think it's great that you take a pro-active stance with your health. I definitely do also. Just wondering though, can you discuss your situation, feelings, and opinions with your doc? If he won't listen, maybe it's time to look for a different doctor.

I have had my fair share of diplomatic battles with my doctors. I do my best to get them to listen to me. Team work with me actively included, is a must. One stands a better chance of getting good answers by being as well informed as possible, before asking questions. I always make sure that I have thought about my questions before approaching my doctor.

There was a doctor that I went to only once. He would not let me get a word in edgewise. I got my records from his office and fired him! Well, he actually surprised me and called me at home. He wanted to know why I cancelled my next appointment, and took my records. I told him why I did. He then told me that he was under extreme pressure to see many patients. My response, my health is more important to me, we all have to do what we have to do! He slammed down the phone! Oh well, Goodbye Charlie!!!

Young1s 2014-03-14 22:36:01 -0500 Report

Well my doctor and I have a really good repore. I think she is just trying to air on the side of caution, since my last hopitalization. Fair enough. But I need to do what works for me. So, while I will stick with the blood meds, at least til it comes down and stays, I will feel more comfortable and in control with going back to the other things that kept my levels within range. Thanks for the article.

jigsaw 2014-03-15 08:09:40 -0500 Report

Young1s, It definitely makes life a bit easier, when we have a good relationship with our doctors. I'm sure you will accomplish your goals, with the determination that you have displayed.

jayabee52 2014-03-14 01:29:53 -0500 Report

Howdy Young1
Cholesterol pill. Do you mean a Statin? Do you have trouble with your cholesterol? Can you keep it at or below 100? If you must continue with a statin, may I suggest add a CoQ 10 suppliment to your regimen? Statins are notorious for sucking up CoQ 10, which is necessary for muscle and heart (which is a muscle) health. Quite often MDs don't think about the CoQ 10 situation and ignore it.

I had a Dr who put me on a statin (simvistatin) to protect me, from heart problems I guess, but the visit just before he asked me if I was on a statin, because my total cholesterol was "perfect". The next session he put me on a statin, and I let him do it to me. I was on simvstatin for several years till I read about the CoQ 10 that it sucks up and since I didn't have problems with cholesterol before I was on simvi, I decided to discontinue it. I haven't had a problem with cholesterol since.

Not trying to come between you and your Dr, especially if you have a problem with Cholesterol.

My first wife was instructive for me about cholesterol problems. She could not get her cholesterol lowered no matter what she tried. Her Dr tried her on a statin (I forget which) and she started having muscle pain and a blood test showed she was having liver problems from it as well. She tried Niacin, which gave her flushes, and she tried cutting down on cholesterol laden foods, she couldn't get the count under 300.

The upshot was that she gave up and didn't think about it again until she had a massive heart attack. They opened her chest for surgery and found they had to bypass all 5 blood vessels in her heart because they were occluded by plaque. I wasn't in her life at that time because she had divorced me. I thought it fitting (if I believed in Karma - I don't) that she broke my heart, she gets her heart way broken. Our sons did keep me posted on her progeress because I didn't hate her, I was interested and cared about what happened to her. She is now doing well ahd has pretty much recovered and is currently driving a big rig cross country with the man she dumped me for and married.

God's best for you and yours

Young1s 2014-03-14 08:54:06 -0500 Report

Hey James. My apologies for my misinformation. It isn't a cholesterol pill that I'm on, it's a blood pressure pill called Lisinopril. I don't know what I was thinking, cause they are two completely different animals.

At any rate, I take this thing and 10-15 minutes later I am buckled over in pain from some of the most awful cramps in the belly. I've spoken to my doc about this but she still wants me to stick with it until I can get my pressure under control. Admittedly, it's still a little too high, so I will endure the pain for now.

So sorry to have had you tell that story for nothing. But hey, maybe it was meant for another who needed to read it. Blessings to you.

Just Joyce
Just Joyce 2014-03-14 09:45:21 -0500 Report

Young my sister was in Lisinopril. She is not diabetic. My neighbor is on it and she is a diabetic. They both have a problem with bad coughing especially at night. They both are now off of it because of that. Both said they have had coughing so bad they thought they were going to have to go to the hospital.

Someone posted the same problem on this site last year and I think the doctor took them off of it. Coughing is a side effect.

Young1s 2014-03-14 22:38:46 -0500 Report

Haven't experienced that but like I said to James, almost unbearable cramps. Someone sugessted cutting the pill in half and taking it twice a day but it is so small, I don't see how I could ever make that happen.

Young1s 2014-03-21 12:50:20 -0500 Report

Yup Joyce, kinda what I figured. Like I said, too small to do so anyways. Thank you though for the heads up on the coughing. I have been coughing a lot lately. Just thought it was because of dry mouth. And not coughing so much that it's detrimental…but yeah, coughing a lot more. Mostly in the morn when I just wake up and in the eve when I'm about to go to sleep.

peewee0618 2014-03-13 17:36:38 -0500 Report

I have taken oral medication for my t2d before and it got so it did not control my sugar levels so now I am on victoza which is medicine in the form of a needed. Things are under control now but sometimes I just tired of having to stick myself everyday.

jigsaw 2014-03-13 18:07:11 -0500 Report

I had similar experiences with oral medications. They can stop working after a while. Fortunately, there are many alternatives though.

I'm with you, concerning the needle experience, and sticking myself. It's definitley better then the alternative!

valentine lady
valentine lady 2014-03-13 10:16:03 -0500 Report

Jigsaw, great subject but since I don't take an oral medication for my Type 2 diabetes I really don't have the right to give an opinion. However, I want to agree with Just Joyce in the fact one needs to keep the lines of communication open between the Doctor and your Pharmacist and ask questions and fully understand a new medication and the side effects. Actually, I have found that it's best to refer to my Pharmacist. He has caught mistakes my Primary Care Physician has made concerning drug inter-actions or problems I may experience with a certain drug according to my present health condition.

jigsaw 2014-03-13 16:47:04 -0500 Report

I agree with both you and Joyce. Pharmacists have extensive training with medications. I have been questioning my pharmacist for years. I find the pharmacist to be better informed most of the time.

GabbyPA 2014-03-13 18:52:58 -0500 Report

When it comes to mixing my medications and other OTC things, my pharmacist is my best friend. She's great.

Just Joyce
Just Joyce 2014-03-13 19:42:21 -0500 Report

I agree Gabby. I was diagnosed in August and caught a cold in December. Normally I would have grabbed my Nyquil but was worried about doing that. The pharmacist said I could take it. I didn't have sugar free. I took it waited an two hours and tested. Had no problem. I never take over the counter meds that are not cleared by my pharmacist.

Just Joyce
Just Joyce 2014-03-13 14:29:30 -0500 Report

Valentine I agree with you the Pharmacist is the best to refer to. My pharmacist has also caught mistakes. Pharmacist are often more knowledgeable about medications including new ones than doctors are. Also if you go to the same pharmacist, they can review your current RX and know immediately about potential drug interactions. My Pharmacist has even called and faxed my doctor about medications and dosage and he has changed it. Communications with doctors and pharmacist is the key to taking care of your health.

Just Joyce
Just Joyce 2014-03-13 09:37:12 -0500 Report

Jigsaw the one thing the doctor and pharmacist told me was to not take my metformin if my BG was 90 or under because it will lower it further.

I think the problems people have with medication is that they do not ask the doctor or the pharmacist.about any new medication. If a doctor gives me a new medication, I ask for samples and take the prescription with me. If the medication causes a problem I do not fill the prescription and call the doctor to tell him about the problem I have with the medication.

camerashy 2014-03-15 14:39:39 -0500 Report

I do the same thing. He changed my insulin twice, and I wasn't sure how to use the two he gave me, and guess what - he voluntarily gave me samples and wrote on a sheet of paper the instructions!

jigsaw 2014-03-13 16:58:15 -0500 Report

I am no longer taking Metformin because of some uncommon side effects that developed. I was taking Metformin back in time when I first started taking insulin. My endo who is also a diabetes specialist said the reason he prescribes Metformin in conjunction with insulin, is because Metformin does not usually cause hypos, or low blood sugar. That's why the two are commonly prescribed together. That's not the same as saying that it can't lower blood glucose.

I say let my doctor and your doctor argue it out. After all they're the pros. I never had a low while I was on both. It obviously has alot to do with the individual in more ways then one.

Just Joyce
Just Joyce 2014-03-13 19:49:52 -0500 Report

It does for me. My endo nor my GP will give me insulin because the metformin does what it should do. I agree medications work differently for each person or groups of people. I noticed that when I had highs around the time I was to take the met, my blood sugar started to lower.

My coworker was put on both insulin and metformin. Once she got under control they stopped the insulin. She got sick and lost a lot of weight and went off the met.

jigsaw 2014-03-14 06:27:55 -0500 Report

Correction, I meant to say that my doctor said that Metformin does not normally cause Hypos. Not that it can't lower blood glucose. Sorry for the error.

It does not cause the pancreas to produce or release more insulin. It does stop the liver from releasing insulin though.

camerashy 2014-03-13 08:33:23 -0500 Report

I have to tell ya - I'd rather stay on insulin injections than suffer the side-effects of the oral medications.

jigsaw 2014-03-13 17:10:40 -0500 Report

I feel the same way! I had some horrible side effects of which some were caused by oral medications, and others I am fairly sure about. I also suspect a few of these medications may have caused me some permanent damage. Fortunately, none are life threatening.

In my case, and with insulin, I have experienced no side effects. I have questioned every doctor that I see about potential side effects. Everyone of them agreed that the potential for glucose lows and potential weight gain are the only concerns with insulin. Both of these side effects can usually be avoided, or at least kept under control. I feel better with insulin, and have excellent bg control so far.

Just Joyce
Just Joyce 2014-03-13 09:27:17 -0500 Report

Insulin has side effects. Every medication does. Some people may never experience them while others will.

camerashy 2014-03-13 13:55:46 -0500 Report

Well, in the 11 years I've been on insulin, I haven't had any adverse side effects. The side effects listed as those you could expect from the oral medications have a tendency to shorten one's life.

jigsaw 2014-03-13 19:32:23 -0500 Report

Many oral medications are relatively new. The long term side effects are not necessarily known as of yet! Guess who the guinea pigs are? I am not trying to insinuate that I am for or against oral meds, just stating some known facts. Actually, I'm for whatever works best with a reasonable safety record. I take insulin because I believe it is the best choice for me in my specific circumstances. It's also been around longer then I have, and with a good safety record to boot!

JaredLahti 2014-03-16 10:00:58 -0500 Report

One thing to remember with type 2 diabetes is that it is insulin resistant. This creates a big problem for people that start with insulin even though they still produce insulin. Maybe the oral meds have some side effects but it's a matter of the dr figuring out what works for each patient and the goal should be staying off insulin for as long as possible. Going on insulin is most of the time a life time thing. This is why my dr calls this a bad situation because you are a insulin resistant diabetic that becomes insulin dependent. This also means that you typically will require more and more insulin as time goes on because a type 2 will always be insulin resistant. So I don't believe that safety records are everything to think about.

For newly diagnosed type 2 I would want my dr focusing on getting me to change my eating habits and for a lot of people medications like byetta and bydureon or Victoza do wonders. I realize this may not work for everyone but it should work for the majority of people that are producing insulin still. Of course a huge part of this would be determine by how long you have had diabetes before being diagnosed.

Just Joyce
Just Joyce 2014-03-13 14:24:16 -0500 Report

You should consider yourself lucky but just because you have not had any adverse effects is a very good thing. Others are not so lucky if you read some of the posts here. People on insulin have had side effects.

So are you saying that those of us on oral medications will not live as long as you? I better get my affairs in order if that is the case.

You are not guaranteed a long life whether you are on oral or liquid medications. None of us come with a guarantee or a warranty. I am sorry you see it that way because for all any of us on oral medications knows, we could out live you. I do pray that we all live a long life and enjoy it to the best of our abilities.

Just Joyce
Just Joyce 2014-03-14 21:25:42 -0500 Report

Camera, I am not the least bit upset. You didn't say anything wrong you voiced your opinion. I don't get upset over peoples opinions. I just thought you were saying that those of us on oral medications had a shortened life. I was curious about what your response would be. So please turn that frown into a smile. I love debating. I am also a very direct person. Life made me that way. So please don't you be offended, that is never my intention.

jigsaw 2014-03-14 18:12:03 -0500 Report

I think it's great that we can express our opinions, even if we disagree!

I found your reply to be validating and encouraging. Nothing wrong with disagreeing in a respectable way. It's often stimulating in many ways, and initiates food for thought. It a great way to learn in some instances.

I like the fact that Joyce is courageous enough to stand and and speak her mind. I also enjoy the fact that you seem to say what you believe.

Unfortunately, some folks seem to get offended, even when a disagreement takes place with diplomacy.
If all of us agreed all the time, then we would be nothing more then high tech robots.

Can't we express our opinions without insulting or hurting the feelings of others?
I certainly hope we can, when we disagree. I wouldn't want this to be a site where everything is expressed and seen through rose colored glasses!

ICDA250 2014-03-13 07:20:56 -0500 Report

I am not sure I got to read the entire article and it might be a "senior moment" but I could not figure how to navigate any further. One thing I would like to share is that one of the most commonly prescribed drugs for type 2 diabetes is Metformin. I know that for me and many others Metformin can cause serious kidney complications and other side effects. I was required to discontinue its use.

jigsaw 2014-03-13 07:45:24 -0500 Report

If you scroll down to the bottom right side of the page, you'll see a button that says next. Press next to arrive at page 2!

According to medical experts, metformin has no history of being the cause of kidney malfunction. On the other hand, if you already have kidney problems, then there are explicit warnings on the Metformin labels not to take it. This is why it is important to have kidney function monitored routinely by a doctor, especially with diabetes, and when on Metformin.

Just Joyce
Just Joyce 2014-03-13 09:24:14 -0500 Report

Jigsaw, you are correct. You cannot take metformin if you have a history of kidney disease. It does not cause kidney disease. My doctor and endo told me this as well as the pharmacist.

People who have had prior kidney problems should not take it. Sometimes you really have to talk to your doctors.

jigsaw 2014-03-13 17:14:06 -0500 Report

Pharmacist George, who use to be on DC agreed and put up an entire post on the subject. Not sure if you saw it.

Just Joyce
Just Joyce 2014-03-13 19:52:51 -0500 Report

No I didn't see it I read about the medication when the doctor first prescribed it.The I asked the pharmacist so many questions, she gave me the pamphlet that came with the medication order to read. I miss her she was so good. She moved out of state to be closer to her ailing parents.

ICDA250 2014-03-13 07:58:40 -0500 Report

Not sure all my nephrologists and pharmacologists could be so wrong. What experts are you referring to? I had no prior history of kidney problems.

jigsaw 2014-03-13 11:54:26 -0500 Report

ICDA250, there have been numerous posts on this subject in the past. I posted a link that discussed extensive studies involving Metformin, and kidneys. If I find it, I'll send it to you, or post it again.

It is possible in rare cases to develop lactic acidoses with the use of Metformin. This in turn could effect your kidneys if not monitored and caught early.

Metformin is probably the most commonly,and widely prescribed medication for diabetes!

Here is an article, and a link that may clarify it !

Medscape Diabetes & Endocrinology > Ask the Experts > Diabetes & Endocrinology

Metformin in Patients with Cardiovascular Disease?
Stephen Schneider, MD
October 31, 2000

rug & Reference Information
Urinary Tract Infections in Diabetes Mellitus
Pediatric Type 1 Diabetes Mellitus
Infection in Patients With Diabetes Mellitus

A 65-year-old woman with type 2 diabetes and a history of cardiovascular complications (congestive heart failure [New York Heart Association class III], post-coronary artery bypass graft with multiple myocardial scars after anterior wall/posterior wall myocardial infarctions, and significant peripheral arterial occlusive disease [mainly small vessel disease] with intermittent resting pain in the lower extremities) was being treated with 850 mg of metformin twice daily when she was referred to our cardiac rehabilitation clinic. I believe that the metformin therapy in this case might provoke tissue acidosis and worsen her condition. Her blood glucose is not well controlled with this regimen (150-250 mg/dL). Her renal function is good, with no other significant disease states. Would you use a different oral antidiabetic in this situation?

Michael McCabe, MD

Metformin, a biguanide, is widely used to treat diabetes and has an excellent overall safety record. Lactic acidosis was a serious and life-threatening complication with the older biguanide, phenformin, which was removed from the market. Lactic acidosis related to metformin is very rare. It results when the breakdown of sugars to energy in the mitochondria of the cells is impaired. Lactic acid accumulates as the partially metabolized breakdown product of glucose. Very rarely this can occur in individuals with a genetically unusual sensitivity to the drug. Otherwise, the problem occurs only in the presence of an unusual accumulation of the drug in the blood.

Since metformin is cleared from the body through the kidneys, caution should be used in administering metformin when kidney function is impaired or when the kidneys are at a high risk of becoming impaired. Metformin does not cause kidney damage, but the drug is avoided in patients with diabetes with significant kidney disease. Patients with very poor heart function or significant heart failure often do not perfuse their kidneys adequately. Kidney function in these individuals may change relatively rapidly and, as a result, metformin levels in the blood may increase unexpectedly to dangerous levels. Metformin is probably best avoided in that situation. Some other medical conditions, such as recurrent pancreatitis, cause lactic acidosis and have the potential to impair kidney function. Again, the drug should not be used in individuals at high risk for these problems. In patients with congestive heart failure, the clinician needs to determine if the degree of cardiac impairment is enough to place kidney function at risk. If it is, then metformin should be avoided. The so-called "glitazone" class of drugs should also be avoided in these situations because of the drugs' tendency to contribute to salt and fluid retention. Sulfonylureas and insulin remain the drugs of choice for such patients.



Just Joyce
Just Joyce 2014-03-13 09:21:48 -0500 Report

metformin oral

Who should not take metformin oral?
Check with your physician if you have any of the following:
Alcohol Intoxication, Heart Attack, Suddenly Serious Symptoms of Heart Failure, Liver Problems, Kidney Disease, Recent Operation, Fever, Shock, Blood Circulation Failure due to Serious Heart Condition, Severe Vomiting, Severe Diarrhea, Serious Lack of Oxygen in the Blood, Weakened Patient, Injury, Infection, Sepsis Syndrome, Low Blood Sugar, Pituitary Hormone Deficiency, Decreased Function of the Adrenal Gland, Inadequate Vitamin B12, Ketoacidosis, Increased Blood Acidity due to High Levels of Lactic Acid, Excess Body Acid, Extreme Loss of Body Water, X-Ray Study with Intravenous Iodine Contrast Agent, Habit of Drinking Too Much Alcohol