The treatment of a diabetic patient is generally started by making him to indulge in increased physical exercise, restrict consumption of carbohydrate , fat and high fibre diet along with withdrawing of smoking. If these measures don’t work then it becomes imperative to institute a drug therapy to achieve desired target of blood glucose, lipid profile and body weight. Drugs from various groups like Sulfonylureas , Biguanides, meglitinide analogues , thiazolidinediones and alpha glucosidase inhibitors are used to control diabetes.
Adverse effects of Sulfonylureas
Drugs like chlorpropamide, tolbutamide, tolazamide, glibenclamide, glipizide, gliclazide and glimepiride come under the category of sulfonylureas. Diabetic Patients who take sulfonylureas are generally at the risk of being hypoglycemic which if severe may lead to coma. The elder persons with impaired liver and kidney functions who are on longer acting drugs of Sulfonylureas are more prone to suffer from hypoglycemia. These drugs are less effective in obese persons and because of insulin resistance they tend to cause weight gain due to fluid retention. These drugs cross the placental barrier and may cause fetal hypoglycemia.
Adverse effects of Biguanides
Anorexia, nausea, flatulence, diarrhea, metallic taste are some of the adverse reactions caused by drugs like phenformin and metformin. Long term use of these drugs may cause B12 deficiency. Chances of lactic acidosis is there but is more in persons suffering from heart, liver or kidney impairment with concurrent use of alcohol.
Adverse effects of Meglitinide analogues
Drugs like repaglinide and nateglinide have rapid onset of action and are at greater risk of causing hypoglycemia if meal is delayed or missed. They have less allergic reactions and cause less weight gain as compared to drugs of Sulfonylureas group.
Adverse effects of alpha glucosidase inhibitors
These drugs cause flatulence, diarrhea and abdominal pain.If used along with sulfonylureas , hypoglycemia can occur.
Adverse effects of thiazolidinediones or Glitazones
This class of anti diabetic drugs causes weight gain due to fluid retention. Haemoglobin concentration decreases and deposition of subcutaneous fat increases. Its use should be avoided in case of hepato toxicity, pregnancy, lactation period, heart failure. These drugs being enzymes inducers cause failure of oral contraceptives and oral anticoagulants.
Take medicine as per medical advice, check body weight regularly, take glucose to correct hypoglycemia and avoid to indulge in heavy exercise which is more than normal. Don’t indulge in self medication . Don’t take herbal medicine without medical advice. Dont skip your meal. Don’t ingest alcohol.