Diabetes Drug Classes

What are different types of diabetes drugs classes?

Using diabetes drugs to help treat diabetes is extremely common. There is a wide range of drug types that have a range of different functions. Every single anti-diabetic drug works in a unique way to help people manage their condition. Some drug types act in similar ways to others. Drugs that display similarities are often put in the same class of drugs. Knowing drug classes and how they work can allow a better understanding of the different anti-diabetic medications. Below is a comprehensive list of different drug classes, how they work, who they work for and what medications fall into these classes.

Insulin

Insulin is a hormone that is naturally released in the body to regulate blood glucose levels. People with diabetes are unable to do so, therefore insulin is prescribed to help keep blood sugar at a normal level.

People with either type 1 or type 2 diabetes are prescribed insulin injections, if they haven’t responded well to oral medications. There are many different types of insulin available. Some forms can act for as long as day whereas others can only work for a few hours.

Insulin isn’t generally part of the different drug classes, but as an extremely important medication for diabetes treatment, it is always worth mentioning.

Biguanides / Metformin

In the biguanide class of anti-diabetic drugs, Metformin is the only medicine that is available. It works by preventing the liver from producing glucose and helps to improve the body’s sensitivity to insulin. Metformin can be prescribed to people with type 1 diabetes along with their insulin treatment. For people with type 2 diabetes, Metformin will be a common first line of treatment.

Sulphonylureas

Medicines that end in “ide” tend to be included in this class of drugs. The purpose of anti-diabetic medications in this class is to increase the amount of insulin the pancreas produces and increase the working effectiveness of insulin.

Sulphonylureas medications are for people with type 2 diabetes. However, hypogylcaemia and weight gain are fairly common side effects.

The following is a list of drugs that come within the Sulphonylureas drugs class:

  • Glibenclamide – also known as Glyburide (Daonil);
  • Glipizide (Glucotrol);
  • Gliquidone (Glurenorm);
  • Glyclopyramide (Deamelin-S);
  • Glimepiride (Amaryl);
  • Gliclazide (Diamicron)

Meglitinides / Prandial Glucose Regulator / Glinides

Anti-diabetic medications in this class have a very similar response to those in the sulphonylureas class. They are still prescribed to people with type two diabetes, but the main difference is that anti-diabetic drugs in the meglitinides class act for a shorter time.

People will take meglitinide medications within half an hour before eating a meal. Although the drugs act for a shorter period of time, it does mean that hypoglycaemia and weight gain are much less likely side effects.

The follow are examples of prandial glucose regulators (brand names in brackets):

  • Repaglinide (Prandin)
  • Nateglinide (Starlix)

Alpha–Glucosidase Inhibitors

People with type 2 diabetes are usually prescribed Alpha-Glucosidase Inhibitors. The purpose is to reduce post-meal blood glucose levels by slowing down the digestion of carbohydrates in the small intestine.

The following are examples of drugs in this class, brand names in brackets:

  • Acarbose (Precose or Glucobay)
  • Miglitol (Glyset)

Thiazolidinedione / Glitazones

Improving insulin sensitivity is the purpose of anti-diabetic drugs in this class and are prescribed to people with type 2 diabetes. Additionally, medications in the thiazolidinedione category have been found to help decrease triglyceride levels.

There have been certain concerns over the long-term safety of Glitazone medications. Actos (Pioglitazone) has been connected to instances of bladder cancer. The danger of this has not bee presented as sufficient enough for a UK ban. However, Avandia (Rosiglitazone) has been banned by the European Medicines Agency amid concerns that the drug is linked to an increase risk of heart attacks.

DPP-4 Inhibitors / Gliptins

When people with type 2 diabetes haven’t responded well to medicines like Metformin and Sulphonylureas, DPP-4 Inhibitors are prescribed. Their purpose is to stimulate the production of insulin and reduce the production of glucagon; particularly during digestion.

DPP-4 Inhibitors also prevent the protein Dipeptidyl Peptidase-4 from destroying the incretin hormones.

The following medications are drugs in this drug class with brand names in brackets:

  • Linagliptin (Tradjenta)
  • Saxagliptin (Onglyza)
  • Sitagliptin (Januvia)
  • Vildagliptin (Galvus)

Incretin Mimetics / GLP-1 Analogues

Anti-diabetic medications in this class of drugs are for people with type 2 diabetes. Incretin Mimetics are an injectable treatment that mimics the effect of incretins, which are a group of hormones. These hormones increase the production of insulin and decrease the release of glucagon. This is relatively similar to the way DPP-4 Inhibitors function.

Incretin Mimetics are quite effective in helping to improve blood glucose levels and assisting with weight loss.

The following are available in the UK in this drug class with the brand names in brakcets:

  • Dulaglutide (Trulicity)
  • Exenatide (Byetta)
  • Liraglutide (Victoza)
  • Lixisenatide (Lyxumia)

Amylin Analogues

People who have been diagnose with either type 1 or type 2 diabetes can be prescribed Amylin Analogues. Amylin is a hormone that is produced by the pancreas and released at the same time as insulin, just in much smaller quantities. They help to supress glucagon release, thus reducing post meal blood glucose levels. There is an increased risk of hypoglycaemia that people taking the medication need to be aware of.

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