Exclusive: Anti-Diabetic Drugs: How They Work & Side Effects

Sunday 2 June 2019

Many of us obediently swallow whatever medications that doctors prescribe - some do it out of ignorance and some out of great faith in their doctors. Most times, doctors do not explain the mechanisms behind the drugs they prescribe nor give solutions on how to prevent the side effects that always come with long-term consumption of medication.

In this post, we learn about drugs taken to treat high blood sugar problem. We learn how the drugs work, what are the categories, what are the mechanisms and what are the side effects.

The red blood cells in our body carry oxygen and nutrients to the whole body, including glucose, which is a source of energy. Carbohydrates are converted into glucose, which then flow in the bloodstream. Glucose needs to enter the RBC first before it can be utilised. For glucose to enter body cells, it needs a key, which is the insulin hormone produced by pancreas.

If the pancreas cannot produce sufficient insulin, there will be excessive glucose flowing in the bloodstream, resulting in high blood sugar reading. When the cells cannot receive glucose, they will starve.

Another reason for high blood sugar is the RBC receptor is not functioning well; it cannot recognise the insulin to open the door to welcome glucose to enter.

The normal fasting blood glucose level should not exceed 5.6 mmol/L.
Pre-diabetes level is in the range of 5.6 - 6.9 mmol/L.
A person is confirmed to be a diabetic if he has a reading in excess of 7 mmol/L.

Diabetes Complications

Diabetes itself is not life-threatening. It's the complications of high blood sugar that can be fatal.

1) Blindness
High blood sugar damages the retina and in the long run, can lead to blindness.

2) Dialysis / Kidney Failure
Excessive sugar in the blood over burdens the kidney.
Diabetics need the help of a machine to cleanse their blood because their kidney can no longer perform this function. When your eGFR reading is less than 15 mL/min/1.73m2, it means your kidney function has deteriorated substantially and doctors will advise you to do dialysis.

3) Liver Failure
Excessive sugar attracts a lot of bad bacteria. The liver has to work harder to perform the detox function and in the long-term, it becomes damaged.

4) Heart failure
When your blood is full of glucose, it would be very sticky and muddy. Your heart has to work extra hard to pump such blood and will lose its strength and ability in the long term.

5) Gangrene / Amputation
You can tell a lot about how healthy you are by looking at the condition of your legs. If your legs are strong, you can walk at a fast pace, there is no pain, your feet feel warm (good blood circulation) and you are able to stand for long periods without feeling tired - you are healthy and your kidney is healthy.

The blood of diabetic patients is very dirty. The feet are the furthest points from the heart. It is harder for the heart to pump blood to such a distance. As blood cannot reach there, their feet always feel cold. Less blood also means there are less RBCs and WBCs circulating there. When the virus / bacteria attack the cells and tissues in your feet, there would be fewer soldiers to fight them. As such, the infections are harder to heal. The wounds grow bigger when there are more and more virus / bacteria accumulating in the area, resulting in gangrene and eventually amputation.

How Anti-Diabetic Drugs Work

The 5 common anti-diabetic drugs carry these brand names and in brackets, the class of medication they fall under:

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