Bile Acid Sequestrants

Bile acid sequestrants are a type of medication that may be prescribed for adults with type 2 diabetes to help them control their blood sugar levels more effectively. Bile acid sequestrants are drugs that were originally designed, and are most commonly used, to help treat people with high cholesterol. However, it was discovered that they can also have the effect of lowering blood sugar in people with type 2 diabetes. In type 2 diabetes, the pancreas does not produce enough insulin, or the insulin that it produces does not work in the right way. We consume glucose (sugar) in foods and drinks, and insulin transfers glucose from the bloodstream and into the cells, where it provides energy. Type 2 diabetes can cause a buildup of glucose in the bloodstream, which can cause serious health problems over time.

The bile acid sequestrant that can be used to treat type 2 diabetes is sold under the brand name:

  • WelChol (colesevelam)

What is WelChol (colesevelam) ?

WelChol is a medication that can have two different effects:

For some people who have both type 2 diabetes and high cholesterol, WelChol may help to treat both of those conditions. WelChol is an oral medication that can be taken in liquid or tablet form. It should be taken in addition to maintaining a healthy diet and regular schedule of physical exercise (lifestyle management).

The active ingredient in WelChol, colesevelam, works by attaching itself to bile acids in the intestines, instead of entering the bloodstream like other medications. Researchers are still working to understand how a bile acid sequestrants such as WelChol works to lower blood sugar levels in people with type 2 diabetes, but it is thought to lower the amount of glucose (sugar) that is produced by the liver, which helps to lower the amount of glucose in the bloodstream.

According to AACE Guidelines, WelChol is usually prescribed if a person’s blood sugar is not under control after trying treatment with lifestyle management and one or more other types of diabetes medications for a few months. WelChol should be taken in addition to any other types of diabetes medications that you have been prescribed or as directed by your health care provider. Never stop taking any of your prescribed medications without talking to your healthcare provider first. Do not take Welchol if you are allergic to it or any ingredients found in Welchol. Also, talk with your health care provider about potential drug interactions with your other medications.

Some of the most common side effects reported by people with type 2 diabetes who take WelChol are:

  • Constipation
  • Indigestion
  • Nausea
  • Increased triglycerides (a type of fat found in the blood)

These are not all the possible side effects of WelChol. Patients should talk to their doctor about what to expect with treatment with WelChol. Let your healthcare provider know if you experience any side effects that are severe or that last a long time.

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Written by: Anna Nicholson | Last reviewed: October 2021