Best Medicine For Type 2 Diabetes Without Side Effects
Best Medicine For Type 2 Diabetes Without Side Effects
Do You Have a Type 2 Diabetes Risk?
Two of the most important and urgent health problems in the country are diabetes and prediabetes. According to recent projections from the Centers for Disease Control (CDC), 130 million Americans are estimated to have diabetes or prediabetes. In 2019, around 1.4 million adult patients received a new diagnosis of diabetes.
When blood sugar levels are above normal but not yet high enough to be categorised as type 2 diabetes, prediabetes is present. A diagnosis of type 2 diabetes can be avoided with weight loss and increased exercise.
The amount of people who will eventually be at risk for these illnesses is much more alarming. The CDC reported the following:
8.5 million persons (or 23% of adults) out of the 37.3 million people with diabetes have an undiagnosed condition.
Nearly half of the 96 million persons in the US with prediabetes—or 38.0% of the adult population—are 65 years of age or older.
Heart disease, cancer, and COVID-19 are the top three killers in the US, while diabetes is still the eighth-leading cause of death (2020 data).
Diabetes Type 2 treatment
Although type 2 diabetes has no known cure, people may be able to control their illness by eating a good diet, remaining active through regular exercise, and maintaining a normal weight. But occasionally, this is simply insufficient.
Oral metformin, the cornerstone of oral diabetes treatment regimens, is frequently used as the first step in the treatment of type 2 diabetes. The use of injectable insulin may then be required for some patients, and from there, several medication types may be added to metformin.
The hormone insulin is necessary for the body to use the glucose (sugar) from food as energy.
Since the pancreas cannot produce insulin, it must be supplemented in type 1 diabetes. In type 2 diabetes, the pancreas either produces insufficient insulin, the body is resistant to insulin’s effects, or both.
Hemoglobin A1C (HbA1C or simply A1C), a blood sugar goal that provides an average blood glucose level over the previous three months, is used to monitor the effectiveness of diabetes treatments.
The American College of Physicians (ACP) released revised recommendations in March 2018 establishing objectives between 7% and 8% for adults, contrary to the American Diabetes Association’s (ADA) recommendation of a target HbA1C of less than 7%.
Adhering to a more customised approach to type 2 diabetes therapy is one of the ACP’s main justifications. For instance, very low blood sugar levels in the elderly might be associated with major health problems like confusion and dizziness.
Serious complications from diabetes, such as: can be made more likely by high blood sugar levels.
injury to peripheral nerves
The most recent information on diabetes is positive, though. Improved monitoring tools, newer medicines that prevent heart disease and death, and knowledge of how diet and exercise affect diabetes all contribute to better patient outcomes.
Because of improved treatments and increased knowledge of type 2 diabetes, including all of its myriad consequences, the vast majority of people with the illness are living longer.
The U.S. Food and Drug Administration (FDA) continues to approve and improve type 2 diabetes drugs and make dosing regimens easier for patients in response to the type 2 diabetes epidemic.
Here is a list of some of the best type 2 diabetes therapies and the most recent discoveries:
1. Mount Kenya
Mounjaro (tirzepatide), a first-of-its-kind adjuvant used in combination with diet and exercise to improve glycemic (blood sugar) control in individuals with type 2 diabetes mellitus, received FDA approval in May 2022.
Mounjaro helps people with type 2 diabetes mellitus lose weight and regulate blood sugar levels.
Mounjaro is categorised as a glucagon-like peptide-1 (GLP-1) receptor agonist and a glucose-dependent insulinotropic polypeptide (GIP) receptor, both of which are natural incretin hormones.
It is offered as subcutaneous (under the skin) injections in strengths of 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg in an auto-injector. Starting with 2.5 mg administered subcutaneously once per week, the dosage is advised to be increased to 5 mg once per week after four weeks. The highest dose is 15 mg administered subcutaneously once per week.
FDA approval was based on the Phase 3 SURPASS programme, which included five clinical trials with over 6,200 participants that lasted 40 to 52 weeks. Studies compared insulin glargine, insulin degludec, and injectable semaglutide 1 mg. The effectiveness of Mounjaro 5 mg, 10 mg, and 15 mg when administered alone (monotherapy) or in combination with metformin, SGLT2 inhibitors, sulfonylureas, and insulin glargine was assessed.
Participants reduced their A1C levels on average by 1.8% to 2.4%. Although it wasn’t intended for weight loss, those who took Mounjaro on average lost between 5.5 kg (12 lbs) and 11 kg (25 lbs) of weight.
Constipation, indigestion (dyspepsia), stomach (abdominal) discomfort, vomiting, diarrhoea, decreased appetite, and nausea are side effects that at least 5% of individuals have experienced. There is a Boxed Warning for thyroid C-cell tumours on the package insert.
2.Humalog (insulin lispro)
Blood glucose (also known as blood sugar) is lowered by the hormone insulin, which can either be produced naturally in the body or artificially and either intravenously or orally. One of the greatest medical discoveries in the history of medicine was the creation of insulin, which can save the lives of diabetics.
Low blood sugar, or hypoglycemia, is the most frequent adverse effect of insulin. Always keep a rapid supply of some kind of sugar on hand in case of hypoglycemic episodes, such as:
Jelly beans fruit juice glucose pills.
One of the several artificial insulins available to diabetic patients is called Humalog (insulin lispro), produced by Eli Lilly. Humalog is referred described as a “fast-acting” insulin since it begins to function 15 minutes after injection, peaks at 1 hour, and continues to function for 2 to 4 hours. It can be used in regimens with an intermediate- or long-acting insulin for coverage throughout the day. It is commonly administered within fifteen minutes of a meal or right after one.
Children can also purchase a prefilled, disposable 3 mL Humalog Junior KwikPen (100 units per mL) with half-unit dose.
The first rapid-acting insulin approved as a “follow-on” (or biosimilar-type product) to Humalog is Admelog (insulin lispro). Admelog costs could be less than those of alternative insulin lispro medications. The second approved replacement for Humalog was Lyumjev (insulin lispro-aabc injectable) from Eli Lilly in June 2020.
Jardiance 3. (empagliflozin)
Diabetics have a 70% greater death rate from cardiac disease than non-diabetics. Therefore, preventing heart (cardiovascular) problems in people with type 2 diabetes is a key objective.
Empagliflozin, the active ingredient in Jardiance (from Boehringer Ingelheim and Eli Lilly), is a sodium glucose co-transporter-2 (SGLT2) inhibitor that was initially authorised in 2014 to help adults with type 2 diabetes better manage their blood sugar (HbA1c) together with diet and exercise. In addition to treating heart failure, Jardiance is licenced for use in adults to reduce the risk of cardiovascular death in people with type 2 diabetes and heart disease.
On the market in the United States are more SGLT-2 inhibitors such Farxiga (dapagliflozin), Invokana (canagliflozin), and Steglatro (ertugloflozin).
Possible side effects of Jardiance include:
Yeast infections, dehydration, and low blood pressure that can cause lightheadedness and fainting
Urinary tract infections are more likely when there is an elevation in LDL cholesterol caused by low blood sugar with insulin or insulin secretagogues.
Poor kidney performance.
Glyxambi (empagliflozin and linagliptin), Synjardy (empagliflozin and metformin), Synjardy XR, and Trijardy XR are further combination medications that contain empagliflozin (empagliflozin, linagliptin and metformin).
According to the most recent recommendations, you might need to take SGLT-2 inhibitors like Jardiance or GLP-1 agonists like Trulicity (dulaglutide) to control risk factors like established heart disease (risk of serious events like a heart attack or stroke), chronic kidney disease, or heart failure.
Lantus 4. (insulin glargine)
Long-acting basal insulins work to maintain stable blood sugar levels throughout the day, whereas short-acting insulins, such as Humalog, are administered during mealtimes. Adults with type 2 diabetes as well as adults and kids aged 6 and older with type 1 diabetes are treated with Lantus (insulin glargine), a medication made by Sanofi.
Between meals and overnight, Lantus helps to control blood sugar levels by releasing insulin gradually and steadily.
Lantus often starts working within one to three hours and lasts for 24 hours.
It is only injected subcutaneously (under the skin) once per day, at the same time every day, due to its prolonged duration of action.
Some individuals combine Lantus with rapid-acting human insulin or an oral diabetic medication.
Lantus is available in either 3 mL SoloStar prefilled pens or 10 mL vials with a 100 units/mL dosage.
When using the SoloStar pen, you adjust the dose as necessary and inject yourself using the push button.
Toujeo and Basaglar are two other brands of insulin glargine.
The FDA initially approved Semglee (insulin glargine) from Mylan / Viatris for the same applications in June 2020 as a less expensive replacement for Lantus. It may be prescribed for the same indications as Lantus through the 505(b)(2) NDA pathway, but it was not regarded as a biosimilar and could not be used interchangeably.
The FDA approved Semglee (insulin glargine-yfgn) in July 2021. Semglee is both biosimilar to and interchangeable with its reference medicine Lantus (insulin glargine). There is also a generic version of insulin glargine-yfgn that is interchangeable. Semglee comes in two dosage forms: a 3 mL single-use prefilled pen and a 10 mL multi-dose vial (autoinjector). The first interchangeable biosimilar insulin product to receive U.S. approval was Semglee.
Rezvoglar (insulin glargine-aglr), the second biosimilar of Lantus, received approval in December 2021. It is supplied as a prefilled 3 mL pen autoinjector with 100 units per mL. Rezvoglar is not convertible with Lantus, in contrast to Semglee, thus your pharmacist cannot just replace it with Lantus. You will require a prescription from your doctor specifically for Rezvoglar.
With or without insurance, Semglee and Rezvoglar ought to be less expensive for you than Lantus. To find out about price, coverage, and copay, contact your pharmacy or insurance provider.
Fifth, Soliqua 100/33 (insulin glargine and lixisenatide)
Insulin glargine 100 Units/mL and lixisenatide 33 mcg/mL are combined in Sanofi’s Soliqua 100/33 injection, which is a glucagon-like peptide-1 (GLP-1) agonist. Combining the two medications results in the patient with type 2 diabetes just needing one injection as opposed to two. It’s a significant improvement.
To assist regulate blood sugar and reduce HbA1c, Soliqua 100/33 combines a long-acting, basal insulin with a GLP-1 (glucagon-like peptide-1) receptor agonist. It is used to regulate blood sugar in persons with type 2 diabetes who are not well controlled on lixisenatide or basal insulin (less than 60 units per day). Patients who are uncontrolled on oral anti-diabetic medications may also be prescribed it. It is administered as a once-daily injection and comes in a single dose, pre-filled pen.
Insulin glargine (Lantus), a long-acting basal insulin, delivers a continuous release of insulin to control blood sugar levels before and after meals.
A GLP-1 agonist called lixisenatide (Adlyxin) helps the pancreas generate more insulin in response to a rise in blood sugar and regulates the liver’s ability to create glucose.
Studies have shown that Soliqua 100/33 lowers HbA1c (average blood sugar over time) more effectively than Lantus; 55% of patients achieve a target of less than 7% at 30 weeks versus 30% with Lantus alone. Similar amounts of hypoglycemia occurred in both groups.
Low blood sugar, nausea, stuffy or runny nose, sore throat, diarrhoea, respiratory tract infections, and headache are some of the side effects of Soliqua that are most frequently reported.
When metformin and/or a second oral antidiabetic medicine failed to control type 2 diabetes in patients, the FDA expanded the uses for Soliqua 100/33 in 2019.
Toujeo 6. (insulin glargine)
Injections of long-acting insulin aid diabetic patients in managing their blood sugar levels throughout a 24-hour period. The active component in Lantus is the same as that in Sanofi’s Toujeo (insulin glargine). For anyone with type 1 or type 2 diabetes, including adults and children older than 6 years old, Toujeo is a once-daily, long-acting basal insulin.
All of the primary research outcomes in the clinical studies evaluating Toujeo were achieved by showing comparable blood sugar management with Toujeo compared to Lantus. Toujeo begins acting within six hours, can last up to 36 hours, and stabilises in the blood by roughly day five.
Hypoglycemia (low blood sugar), allergic responses, injection site reactions, lipodystrophy (abnormal distribution of body fat), pruritus (itching), rash, edoema (fluid retention), and weight gain are the most often reported Toujeo side effects.
There are two disposable prefilled pens (autoinjectors) for Toujeo available:
Toujeo SoloStar (450 units/mL) contains 300 units of Toujeo U-300. It can provide up to 80 units in a single injection and doses are delivered in units of 1.
The March 2018-approved Toujeo Max SoloStar has 900 Toujeo U-300 units. In one injection, it can give as many as 160 units. Patients who require at least 20 units per day are advised to use it.
The best pen for you will be recommended by your doctor.
7. Falsehood (dulaglutide)
A glucagon-like peptide-1 (GLP-1) receptor agonist called Trulicity (dulaglutide) is used to treat type 2 diabetes. It belongs to the same drug class as, among others, Saxenda, Bydureon, Victoza, Rybelsus, and Ozempic.
Along with diet and exercise, the once-weekly subcutaneous (under the skin) injectable Trulicity from Eli Lilly is approved for lowering blood sugar levels in persons with type 2 diabetes.
Its use has also been increased to help adults with type 2 diabetes who have established cardiovascular disease or multiple cardiovascular risk factors (such as smoking, obesity, high blood pressure, elevated cholesterol (LDL), and family history) reduce their risk of serious heart issues like heart attacks or stroke.
Trulicity is an automatic injector pen that is available in a variety of intensities. For many patients, medication once weekly may be a significant benefit. Reduced risk of low blood sugar (hypoglycemia) is another benefit of GLP-1 receptor agonists, particularly when compared to insulin or sulfonylureas.
Anyone with a personal or family history of specific types of thyroid cancer shouldn’t utilise GLP-1 receptor agonists. All GLP-1 receptor agonists carry a boxed warning for potential thyroid malignancies, including carcinoma.
Trulicity’s typical side effects include:
ill feeling, vomiting, diarrhoea, and stomach (abdominal) pain
Victoza 8. (liraglutide)
A GLP-1 receptor agonist (incretin mimetic) called Victoza (liraglutide) from Novo Nordisk is similarly approved to enhance glycemic control in persons with type 2 diabetes mellitus. It belongs to the same drug class as Bydureon BCise, Rybelsus, Ozempic, and Trulicity.
Heart disease, the primary cause of illness and mortality in those with type 2 diabetes, is four times more likely to strike those who have the condition.
Despite having received first approval in January 2010, Victoza now has a new designated indication: it can lower the risk of heart attack, stroke, and cardiovascular (CV) death in individuals with type 2 diabetes and existing heart (cardiovascular) disease. Victoza showed a potential for saving lives by lowering cardiovascular death by 22% and overall death by 15%.
It was authorised for the treatment of children with type 2 diabetes who are at least 10 years old in June 2019.
Victoza’s most frequent side effects, which are typical of GLP-1 receptor agonists, were gastrointestinal (stomach) problems, which led to the study’s suspension. Headache, nausea, and diarrhoea are the overall most prevalent adverse reactions.
Victoza is offered in pre-filled, multidose pens in injection doses of 0.6 mg (for initial titration), 1.2 mg, or 1.8 mg. Liraglutide is present at 6 mg/mL in each 3 mL pen. Victoza is taken once daily and can be taken with or without food at any time of the day. Your dose will be decided by your healthcare provider.
Ozempic and Rybelsus.
Glucagon-like peptide-1 (GLP-1) analogue Ozempic (semaglutide injectable) is manufactured by Novo Nordisk. In addition to diet and exercise, it is used in type 2 diabetes patients to help regulate blood sugar levels and lower the risk of events including heart attacks, strokes, and mortality in adults with existing heart disease.
Ozempic is a once-weekly subcutaneous (under the skin) injection that is administered in the form of a disposable, single-patient use, pre-filled injectable pen.
If you have multiple endocrine neoplasia type 2 (tumours in your glands), a personal or family history of medullary thyroid cancer, insulin-dependent (type 1) diabetes, or diabetic ketoacidosis, you shouldn’t use Ozempic, just like with other GLP-1 analogues.
In investigations, nausea, vomiting, diarrhoea, abdominal (stomach area) pain, and constipation were the most frequent adverse effects recorded in 5% or higher of individuals treated with Ozempic.
The first GLP-1 agonist to be administered orally in the United States was approved in September 2019 with Rybelsus (semaglutide oral tablets), again from Novo Nordisk. It is a brand-new oral medication made from semaglutide, an injectable drug (Ozempic).
Rybelsus is administered once day as an oral tablet. The Rybelsus dose should be consumed with no more than 4 ounces of plain water at least 30 minutes before the first meal, drink, or oral medication of the day. It will facilitate absorption.
Rybelsus patients who experience adverse effects at least 5% of the time typically include nausea, stomach pain, diarrhoea, decreased appetite, vomiting, and constipation.
10. Segluromet, Steglujan, and Steglatro (ertugliflozin)
As we’ve seen, managing type 2 diabetes patients’ blood sugar frequently requires a mix of drugs.
In 2017, the FDA authorised Merck’s SGLT2 inhibitor Steglatro (ertugliflozin) as well as two novel ertugliflozin-containing combination medications: Segluromet (ertugliflozin and metformin) and Steglujan (ertugliflozin and sitagliptin). These are all oral medications that help persons with type 2 diabetes mellitus better control their blood sugar levels through diet and exercise.
The kidneys are where ertugliflozin works to aid in the removal of glucose from the bloodstream.
Steglatro was examined in Phase 3 studies both on its own and in combination with metformin, sitagliptin, insulin, and a sulfonylurea. In comparison to placebo, steglatro with metformin and sitagliptin significantly reduced A1C by 0.7% and 0.8%, respectively, and caused weight loss of around 6.2 to 6.6 pounds.
This is not all the information on these or other diabetic therapies that you need to know for safe and effective use, and it does not replace the recommendations of your doctor. Examine the patient medication guide and the complete product information. With your physician or other healthcare professional, go over this information and any questions you may have.