Sulfonylureas

Glibenclamide (Daonil) Glipizide (Minidab) Glimepride (Amaryl) Other brands available in private sector.

Dose.

Take with a meal once or twice a day.

Effect:

Stimulate the pancreases to release more insulin, both right after a meal and then over several hours

Side effect

Can cause low blood glucose, occasional skin rash, irritability, upset stomach

Note

Because these medicines can cause low blood glucose, always carry a source of carbohydrate with you.

Follow your meal plan and activity program and call your healthcare provider if your blood glucose levels are consistently low.

If there is an increase in your activity level or reduction in your weight or calorie intake, the dose may need to be lowered.

Biguanides

Metformin (Glucophage, Diaformin, Diabex) Metformin extended release (Diabex XR)

Dose

Metformin: usually taken twice a day with breakfast and evening meals

Metformin extended release: usually taken once a day in the morning.

Take with food to minimize symptoms.

Effect

Works by decreasing the amount of glucose released from liver and by making cells more sensitive to insulin.

Side effect

Include bloating, gas, diarrhea, upset stomach, loss of appetite (usually within the first few weeks of starting).

Other note: Always tell healthcare providers that it may need to be stopped when you having a surgical procedure.

DPP-4 Inhibitors

Sitagliptin, linagliptin (Januvia)

Dose:

Take once a day at the same time each day.

Effect

Improve insulin level after a meal and lowers the amount of glucose made by your body

Side effect

Can cause stomach discomfort, diarrhea, sore throat, stuffy nose, upper respiratory infection.

Note

Can be taken alone or with Metformin, a Sulfonylurea or Actos

Tell your healthcare provider if you have any side effects that bother you or that don’t go away. Does not cause low blood glucose.

Short- acting soluble insulin (Actapid HM. Humulin R)

Dose

<25units has duration of insulin action 4hrs or less

25- 30 units has duration of insulin action 4hrs or less

Effect

Absorbed quickly from fat tissue into bloodstream. Used to control blood sugar during meals and snacks and correct high blood sugar.

Intermediate – acting isophane (Protaphane HM, Humulin NPH)

Effect:

• Is absorbed more slowly, and lasts longer
• Is used to control the blood sugar overnight, while fasting and between meals

Biphasis isophane insulin (Miztard)

Effect

• Is absorbed slowly, has a minimal peak effect, and a stable plateau effect that lasts most of the day
• Is used to control the blood sugar overnight, while fasting and between meals

Side effect of insulin:

• initial weight gain as the cells start to take in glucose.
• blood sugar that drops too low, or hypoglycemia.
• rashes, bumps, or swelling at an injection site.
• anxiety or depression.
• a cough when taking inhaled insulin.

Note:

Insulin syringes: Most common insulin delivery method. The insulin is injected into the layer of fat just under the skin.

Insulin Pen: it has a cartridge holding insulin with replacement needle to puncture the skin and deliver insulin

Insulin Pump: computerized devise, programmed to deliver insulin under skin.