Type 2 Diabetes Treatments – Actos and Avandia

Some of the challenges in finding adequate treatments for persons with diabetes include getting around the hurdle of the lowering of a person’s insulin production: creating treatments which do not necessarily need to rely on the person making more insulin. This means that a greater number of persons with any form of diabetes may benefit from the medication, if what the symptom being treated is simply insulin resistance, for example. A person who injects insulin, or who makes a lesser amount of insulin, may be able to use the insulin available to them more efficiently, if their tissues and red blood cells are more sensitive to it.

As we have seen in earlier blog posts, Metformin (a biguanide) is a type of medication which works in this way – it lowers insulin resistance in muscles and tissues, as well as reducing the level of glucose released by the liver. However, with time, this medication might not be enough to help manage the progression of diabetes, and other treatment alternatives might need to be added. As insulin production lessens, stronger choices may need to be added into the mix.

Thiazolidinediones

Thiazolidinediones (Actos, Avandia) are familiar medications to many persons with diabetes, as in the past, they have been controversially associated with a higher cardiovascular risk. Like metformin, these medications need to build up into the system (often taking a lot longer to accumulate), and work by decreasing insulin resistance in muscle and fat, and by reducing the amount of glucose released by the liver. These medications were first introduced into the market more than 10 years ago, at which point their first incarnations were also associated with risks of liver failure. Newer medications have shown no such association.

The medications have a high degree of effectiveness in lowering average blood glucose levels, as well as improving triglycerides and HDL levels (or good cholesterol). They are are convenient for dosing, and they pose a very low risk of hypoglycemia – a real concern for older patients with diabetes who might not be ready for insulin, or other injectables.

Like some third line of defense drugs, thiazolidinediones may be combined with other drugs, like Metformin or some sulfonylureas, into one pill form.

The most common complications and side effects for thiazolidinediones include weight gain (5-10 lbs), fluid build-up, anemia, increase of LDL cholesterol, higher risk of heart attack, and higher risk of bladder cancer.  One significant factor with this medication is its high cost.

With the rise of other types of treatments, and injectables, and the past controversies related to heart failure and liver issues, thiazolidinediones are not as popularly prescribed as they used to be. It is questionable if their mild added benefits outweigh the risks that they present, even if combination with other treatments. Every patient must discuss their overall health challenges with their medical team (preferably a specialist) in order to asses a best course of treatment, as well as the implicated costs.

What other venues might a person with type 2 diabetes have, if oral agents are no longer an option? We’ll consider injectables in our next blog post discussion.

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Type2Diabetes.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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