As Type 2 diabetes progresses, the pancreas can lose its ability to produce enough insulin. Injections are typically the next step in treatment. For those who do not like needles or the inconvenience of having to have injections, therapy with three drugs could be a viable alternative. Using a dipeptidyl peptidase (DPP-4) inhibitor along with a sulfonylurea and metformin, makes for better blood sugar control than any one drug by itself.
Researchers at HEC Science Clinic in Yokohama, Japan, investigated to determine whether triple therapy could be just as effective as insulin in people diagnosed with Type 2 diabetes and who prefer not to use insulin.
Their study, reported on in the journal Japanese Clinical Medicine in February 2012, included three women with poorly controlled Type 2 diabetes, all of whom had refused insulin...
- the first diabetic was taking metformin, glibenclamide, and miglitol. When the dose glibenclamide was lowered and sitagliptin was added, her HbA1c went from 11.1 percent to 6.1 percent.
- the second participant was being treated with metformin and glibenclamide. Her HbA1c level went from 7.9 percent to 6.0 percent with the addition of sitagliptin.
- the third diabetic was taking sitagliptin with metformin at the start of the study. When glimepiride was added her HbA1c went from 8.6 percent to 7.1 percent.
None of these women gained weight. From these results it was concluded the combination of the medications tested could be a helpful alternative to insulin therapy in Type 2 diabetes.
DPP-4 inhibitors, or gliptins, include sitagliptin, saxagliptin, linagliptin, alogliptin, anagliptin, and vildagliptin. They work by stimulating secretion of a molecule called GLP-1 from the digestive system. GLP-1 works by lowering glucagon, a hormone that increases blood sugar levels, from the liver. GLP-1 also causes the pancreas to secrete more insulin.
Metformin works mainly by lowering the amount of sugar released by the liver, and improving insulin sensitivity. Combining metformin and a gliptin, creates a greater blood sugar-lowering effect than treating with either one alone. When the two are used together the liver and muscles likely become more sensitive to the increased amount of insulin released by the pancreas.
Sulfonylureas Tolbutamide, Glipimide, Diabenese, and several others, also work by increasing the amount of insulin released by the pancreas. This increased amount of insulin is probably able to do its job better in the presence of metformin because the cells are less resistant to the insulin in the presence of metformin.
Triple therapy could become an alternative to insulin injections when metformin or metformin with only one other drug is not enough. Of course, the combination of diet, weight management, and exercise are still the mainstay of treatment for Type 2 diabetes.
Type 2 diabetes is not a condition you must just live with. By making easy changes to your daily routine, its possible to protect your heart, kidneys, eyes and limbs from the damage often caused by diabetes, and eliminate some of the complications you may already experience.
For nearly 25 years Beverleigh Piepers has searched for and found a number of secrets to help you build a healthy body. Go to http://DrugFreeType2Diabetes.com to learn about some of those secrets.
The answer isn't in the endless volumes of available information but in yourself.
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