Alternative Diabetes Drugs
What other dibetes drugs are available for patients with Type
2 diabetes?
There are several types of drugs for the disease, and patients
often take more than one of these drugs at a time. Aside from
insulin, there is a group of drugs called sulfonylureas, which
are older and sold generically as glyburide, glimepiride,
and glipizide. Another widely prescribed generic drug is metformin.
Among newer drugs for the disease are Merck & Co.'s pill
Januvia, which is in a new class called DPP-4 inhibitors,
and Eli Lilly & Co. and Amylin Pharmaceuticals Inc.'s
Byetta, which is injected. The oldest drug for diabetes is
insulin, which is typically injected, though Pfizer Inc.'s
Exubera form is inhaled.
M. Angelyn Bethel, at endocrinologist at Duke University
Medical Center in Durham, N.C., says, "I have been very
cautious about this drug class [the class that Avandia is
in -- peroxisome proliferator-activated receptors] in general
just because of the risks we knew about already -- the exacerbation
of heart failure events. ...In the past the classic [treatment]
has been considered to be metformin, particularly for patients
who are overweight."
Diabetes is a "progressive" disease, meaning that
patients tend to need more drugs over time, says Dr. Kirkman.
Different classes of drugs work in the body in different ways
and have different effects. For instance, metformin is associated
with some weight loss, or at least is weight-neutral, Dr.
Kirkman says, while the sulfonylureas and insulin can cause
weight gain. The TZDs have also been associated with weight
gain and fluid retention.
Byetta has been associated with weight loss, while Januvia
is weight-neutral. However, there are also side effects and
other issues for patients to consider. For instance, Byetta
can cause nausea and vomiting. And while some doctors are
enthusiastic about Januvia, others say they aren't impressed
by its ability to reduce patients' blood-sugar levels.
Avandia Patient Handouts
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