I’m on rosiglitazone and gliclazide and my doctor wants to put me on metformin as well. Is this OK?

This combination of tablets is known as triple oral therapy. It is known to be effective and is sanctioned by NICE, the official government watchdog. In July 2010, another government body warned doctors against prescribing rosiglitazone, so you should probably use the alternative pioglitazone, which is believed to be safer. It is available as a combination tablet with metformin called Competact.

Treatment diabetes with Tablets with Canadian Health Care Mall

Treatment diabetes with Tablets

The downside of using triple therapy is the increased risk of side effects. Gliclazide rarely causes problems, apart from the risk of hypoglycaemia. Glitazones may lead to weight increase and fluid retention. Metformin is notorious for causing gastric side effects, such as nausea, diarrhoea and wind. Provided you are not troubled by these unwanted effects, you have a 50% chance of delaying the need for insulin. We do not want to give the impression that insulin treatment is a last ditch option, since many people with Type 2 diabetes do very well when treated early with insulin. However, some people are determined to stay off insulin as long as possible, either for psychological reasons or because they risk losing their job.

My doctor says my diabetes is not as well controlled as it should be and he wants to try a new tablet, sitagliptin, which he says will not make me gain weight.

Sitagliptin (Januvia) is one of a class of new drugs called DPP4 inhibitors (or gliptins), which have been developed to prolong the action of a hormone called GLP-1. This hormone is produced by the intestines when food is taken into the stomach and one of its effects is to stimulate the pancreas to produce more insulin. GLP-1 is normally destroyed very rapidly by an enzyme known as DPP4 and if the action of DPP4 is blocked (by a DPP4 inhibitor) the effect of GLP-1 is prolonged for many hours. This enhances the blood glucose lowering effect of GLP-1. Unlike most tablets used to treat diabetes, the DPP4 inhibitors (gliptins) do not cause weight gain. Gliptins can be used in combination with any other blood glucose lowering tablet.

I have just started taking Clucobay tablets for my diabetes. Could you explain how Clucobay works?

Glucobay, the trade name for acarbose, acts by slowing down the digestion of starch and related foodstuffs. Acarbose slows the breakdown and absorption of many dietary carbohydrates, reducing the high peak of blood glucose which can occur after eating a meal containing carbohydrate. It was launched in the UK in 1993, having been used very extensively in other European countries. It is an addition to diet treatment and has been shown to be effective in many people with diabetes who do not require insulin treatment.