Chapter05 Diabetes medications

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These audio videos have been created using artificial intelligence (AI) tools, based on the original content from the book “”माझा मधुमेह, माझे नियंत्रण“ i.e. My Diabetes, My Control.

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Doctors choose medicines for diabetes based on treatment targets (fasting and post‑meal sugar, HbA1c), age, weight, daily routine, and comorbidities. Major classes include: –

(i) agents that reduce absorption of carbohydrates/fats (acarbose/voglibose, orlistat),

(ii) agents that reduce insulin resistance and hepatic glucose production (metformin, thiazolidinediones),

(iii) agents that increase the body’s own insulin (secretagogues), and

(iv) insulin injections. In addition, SGLT2 inhibitors and DPP‑4 inhibitors (gliptins) are used.

Metformin and thiazolidinediones improve receptor efficiency. They are not strictly tied to mealtimes. Secretagogues must be taken before meals, and meals should not be skipped.

Insulin types—rapid (~2 hours), intermediate (~12 hours), long‑acting (~24 hours), and premix—guide the schedule: basal, bolus, basal‑plus‑bolus, or twice‑daily premix.

If control is not achieved with tablets, or during severe infections, surgery, or cardiac events, starting insulin is appropriate. In some cases, the dose can later be reduced or stopped. Sustained control requires self‑monitoring—check sugar often with a glucometer to decide doses and carbohydrate intake.

For safety, use proper pens and needles. Rotate injection sites. Store insulin in a cool place, but not the freezer. Eat immediately after rapid insulin. Remember, diabetes is not only a sugar disorder—targets for blood pressure, lipids, BMI, and waist‑to‑hip ratio are equally important. Do annual tests: HbA1c, lipid profile, UMA, and eye/foot/dental/ECG checkups.

Ultimately, a lifestyle disease needs lifestyle change. Without discipline around diet, exercise, and medication timing, true and durable control is not possible.