Type 2 diabetes mellitus is a metabolic disease caused when the body becomes resistant to the hormone insulin, which is needed for cells to use sugar in the blood. A variety of drugs are available for diabetes mellitus. Medication cannot cure this disease, but it can be used to help control blood sugar levels. In addition, research has shown that some Type 2 diabetes drugs can also help to prevent this disease from developing in at-risk individuals.
Drugs to Control Diabetes
Once type 2 diabetes has developed, several classes of drugs are available to treat the disease. Each class of drugs works in a different way. The major classes of drugs and their means of functioning are as follows (Consumer Reports 2007):
- Alpha-glucosidase inhibitors directly lower blood sugar by inhibiting absorption of glucose by the digestive system.
- Biguanides inhibits the liver’s production of glucose and decrease insulin resistance.
- DPP-4 inhibitors promote insulin release from the pancreas.
- Meglitinides increase insulin production.
- Sulfonylureas also increase insulin production.
- Thiazolidinediones (TZDs) decrease insulin resistance.
Drugs to Prevent Diabetes
Clinical studies have examined a number of type 2 diabetes drugs for their ability to prevent the onset of this disease in high-risk patients. The drugs that have been found effective are those that reduce insulin resistance: the biguanides (specifically metformin) and the TZDs.
A major clinical study, the Diabetes Prevention Program, found that the diabetes drug metformin, a biguanide-class drug, was effective at preventing type 2 diabetes, but less so than lifestyle changes (DPPRG 2002). The Diabetes Reduction Assessment with Ramipril and Rosiglitazone Medication (DREAM) Study looked at two drugs, ramipril and rosiglitazone. Only one of these medications, rosiglitazone, was shown to be effective in preventing type 2 diabetes (Scheen 2006).
Rosiglitazone is a TZD. Other studies have examined whether other TZDs can prevent diabetes. The Troglitazone In Prevention Of Diabetes (TRIPOD) study found the troglitazone confers a lasting protective effect, preserving the function of the insulin-secreting beta cells in the pancreas, but unfortunately, troglitazone was found to cause liver toxicity and was withdrawn from the market in 2000. Another TZD was tested in the Pioglitazone In Prevention Of Diabetes (PIPOD) study, whose results showed that pioglitazone also preserved the function of beta cells (Xiang et al. 2006).
- Consumer Reports, 2007. “Treating Type 2 Diabetes: The Oral Diabetes Drugs: Comparing Safety, Effectiveness, and Price.” Consumer Reports Best Buy Drugs special publication.
- The Diabetes Prevention Program Research Group (DPPRG), 2002. “Reduction in the Incidence of Type 2 Diabetes with Lifestyle Intervention or Metformin.” New England Journal of Medicine 6(346):393-403.
- Scheen, A. J., 2006. “DREAM study: prevention of type 2 diabetes with ramipril and/or rosiglitazone in persons with dysglycaemia but not cardiovascular disease.” Revue médicale de Liège (Medical Review of Liège) 61(10):728-32.
- Xiang, A. H.; R. K. Peters, S. L. Kjos, A. Marroquin, J. Goico, C. Ochoa, M. Kawakubo, and T. A. Buchanan, 2006. “Effect of Pioglitazone on Pacreatic ß-Cell Function and Diabetes Risk in Hispanic Women With Prior Gestational Diabetes.” Diabetes 55:517-522.