Key Tools & Medications

I explained a few tools that diabetics would use, along with some of the kinds of medications or treatments they might have to use to keep their health in check. I also added a simple logbook for everyone to download to help them keep track of their results to show their doctor and learn more on how diabetes is affecting you.

Click here to download the Glucose and BP Log Gucose and BP Log.

Tools & Medicines/Treatments

Blood Glucose Testers 

To manage diabetes successfully, one has to have on-hand several testing tools.  Frequent testing of sugar levels may be necessary.  Consult with your doctor to be sure that the test frequency is adequate.  Currently I am doing two to three time per day.

There are many testers in the market.  While most meter manufacturers compete with each other on several fronts such as the amount of blood needed for the test, no coding needed or the speed of the test results, the new generation of testers recently released use wireless technology to connect test results to a Smart Phone.  The OneTouch Verio® Sync Meter from Johnson and Johnson's LifeScan Company is one of them.  You would need their free app, OneTouch Reveal®, as well. This is available from the Apple AppStore. (http://www.onetouch.com/support/products/veriosync)

Another high tech tester competing with OneTouch Verio® Sync is the BG5 by iHealth Labs from Mountain View, California. (http://ihealthlabs.com/glucometer/wireless-smart-gluco-monitoring-system/).

There is close to 100 different types of glucose meters in the market.  Many of the meters provide connectivity to a computer to download test results.  Most meters in this category require a USB cable to connect the meter to the computer.  Another recent development in meters is one that looks like a USB drive.  To download the data, you just plug the meter into the USB port of your computer.

Without any of this connectivity to a computer, one is left with a manual logbook.  This means that you have to write down your test results on piece of paper.  Of course, one could always maintain such a list using Microsoft Excel or similar software.

To a consumer like myself, one is faced with the decision:  Which one to buy?  Just visit any pharmacy such as CVS or Walgreens and you will see a wide array of products displayed.  What is interesting is that these stores have their store brand as well. Some of the more notable brands include   Bayer Contour, Accu-Chek, OneTouch, etc.

Consult with the pharmacist to help you decide.  Most likely many considerations are needed to assess the meter suited for your needs.  These include meter cost, insurance payments, supply costs (tests trips and lancets), connectivity to a computer, ease of use, size, etc.

Blood Pressure Monitor

Another important tool to help manage your diabetes is a reliable blood pressure monitor.  There are many available in the market.  Keeping track of your blood pressure is very important to properly monitor your health.  For diabetics with elevated blood pressure (hypertension), maintaining healthy blood pressure levels is essential.  Diabetes adds additional stress to your body and if one is to avoid advanced coronary disease and heart attacks, it is important to monitor blood pressure in additional to tracking blood sugar levels.

Companies such as Omron are well known for their blood pressure monitor products and there are a variety of choices available.  All of them are equipped with sophisticated electronics similar to the ones found in the machines at the doctors' offices.

I use a monitor made by Omron their BP742 blood pressure monitor.  I have been using this unit for over 5 years and the results are consistent with the ones from my doctor's office.  In fact, I have taken the unit to the doctor's office to calibrate the results and they are the same.  Thus, when I am home taking my blood pressure, I know that the results are accurate.

Medicines

COMMON TYPE II DIABETES MEDICATIONS:

There are several classes of diabetes medication in the market today as shown in the list compiled from the American Diabetes Association (diabetes.org), healthline.com, and joslin.org. Each one of them performs a specific function. Consult with your doctor for more specific instructions on how these medicines can help you. Be sure that your doctor is aware of your full medical history and lab work. The brand names are shown in parenthesis

This list is by no means comprehensive. Check if the medication you are taking is in this list. Let me know.

Scientists continue to work on various medications to treat diabetes. Because diabetes has many related complications, several classes of medications were developed not only to control diabetes but also to manage its related complications. I will update this site from time to time as new products are introduced.

With more products being developed physicians can try various classes of medications to see which works best for their patients. Understanding that the effectiveness of the medications is often reduced over time, doctors mix and match medications that work on various aspects of the disease to see if it improves blood sugar control.

Remember that most if not all medications has some side effects and when taking them, one has to consider the positive and negative effects. All sites recommend that alcohol consumption should be curtailed or eliminated in order to prevent contra-indications with the medicines.

1. Sulfonylureas stimulates the pancreas to release more insulin, both right after a meal and then over several hours. These drugs have been in use since the 1950s. Several generations of these drugs are in use today. They all have the same effect in lowering blood sugar butdiffer mostly on its the side effects. Some side effects include low blood glucose, occasional skin rash, irritability, and upset stomach. Care must also be taken because one may suffer from low blood sugar (hypoglycemia) if too much insulin is released by these medicines.

• Glimepiride (Amaryl)
• Glyburide  (Diabeta, Micronase)
• Glipizide (Glucotrol, Glucotrol XL)
• Micronized glyburide (Glynase)

2. Biguanides reduces the amount of glucose released from the liver. It also helps muscle tissue more sensitive to insulin, thus reducing sugar glucose. . The medicine has been around since the late 50’s. The medicine has herbal origins. The web site, news-medical.net, traces the drug’s origins to the early 20^th century. The early pioneers in this research
   discovered that the herb, Galega officinalis has an active ingredient that has a glucose lowering effects on the body. After years of experimentation on the dosage, clinical trials were conducted to determine the safe levels of the drug. Metformin (Glucophage)

• Metformin liquid ( Riomet)
• Metformin extended release  (Glucophage XR, Fortamet, Glumetza)

3. Meglitinides works by making the pancreas produce more insulin after a meal. However, the effects of the medicine could diminish quickly. For some people, the medicine could cause low blood sugar (hypoglycemia).

• Repaglinide (Prandin)
• Nateglinide (Starlix)

4. Thiazolidinediones increases the amount of glucose taken up by muscle cells and keeps the liver from overproducing glucose as well as improve blood fat levels. Some of the side effects could be severe, and could include nausea, vomiting, fatigue, loss of appetite, shortness of breath, severe edema or dark urine. It may also increase the risk of congestive heart failure for those at risk.

• Pioglitazone (Actos)
• troglitazone (Rezulin) this medicine was the first generation but was removed because of its severe effect on the liver function for a small number of patients.

5. DPP-4 (Dipeptidyl peptidase-4) inhibitors is a new class of that works by preventing the breakdown of naturally occurring compound in the body called GLP-1 (Glucagon-like peptide-1). This compound controls the level of glucose in the body, but unfortunately, it breaks down quickly. The DPP-4 inhibitors prevents this compound from breakdown quickly, allowing it to work for a longer period. The product also shows some positive effects inlowering cholesterol levels. The medicine is often used in conjunction with Metformin, and there are several that combines Metformin in the tablet. Some of the side effects include stomach discomfort, diarrhea, sore throat, stuffy nose, upper respiratory infection.

• Sitagliptin (Januvia)
• Saxagliptin (Onglyza; and Kombiglyze/Metformin
• Linagliptin ( Tradjenta; and Jentadueto/Metformin)

6. SGLT2 (Sodium Glucose Transporter -2) Inhibitors is another class of medication that works by preventing the reabsorption of glucose in the kidneys. Under normal conditions some of the glucose in the blood stream is filtered in the kidney and reabsorbed in the blood stream. SGL-2 medications inhibits this process, and the excess glucose is passed off as urine. Unfortunately, with more glucose in the urine, there is a potential for urinary tract and yeast infections.

• Canagliflozin (Invokana)
• Dapagliflozin (Farxiga)

7. Alpha-glucosidase inhibitors blocks the breakdown of carbohydrates such as pasta, bread, potatoes, table sugar, etc. in the intestine. Some side effect include bloating, gas, and abdominal pain.

• Acarbose (Precose)
• Miglitol (Glyset)

8. Bile Acid Sequestrants are cholesterol lowering drugs that also reduces glucose levels for patients with diabetes. The medication helps lower LDL levels. Since this medicine is not absorbed in the blood stream they are considered safe for patients with liver issues. Some of the side effects include flatulence and constipation.

• Colesevelam (Welchol)

9. Insulin drugs can be grouped generally based on how fast they work and how long their effects last. They are applied by injection. There are also pumps used for insulin.

• Short-acting: (Humulan, Novolin, etc.)
• Rapid-acting: (NovoLog, FlexPen, Apidra, Humalog)
• Intermediate-acting: (Humulin, Novolin, Iletin)
• Long-acting: (Levemir, Lantus)