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DIABETES AND MEDICATION

If you have Non Insulin Dependent Diabetes and are overweight, the first steps in managing your diabetes are:

• Diet
• Exercise
• Weight loss

If your blood sugars can be controlled by diet and exercise, then tablets are not necessary.
However, if after a trial of diet and exercise, blood sugars remain high, then tablets may be prescribed by your doctor. It is very important for you to know that tablets do not replace the diabetic diet. They are taken in conjunction with the diet.

How do tablets work?

There are many types of tablets which fit into two major groups:

1. Sulphonylureas
2. Biguanides

The Sulphonylurea group includes tablets such as:

• Tolbutamide (Rastinon)
• Chlorpropramide (Diabinese)
• Glibenclamide (Diaonil, Euglucon, Glimel)
• Gliclazide (Diamicron)
• Glipizide (Minidiab, Melizide)

These tablets come in different strengths and their action is to stimulate the pancreas to produce more insulin and also to help natural insulin to work better.

Some side effects can be experienced when taking these tablets, such are:

• low blood sugar
• weight gain
• gastric upsets
• skin rash

If any of these occur, you must report it to your doctor as your tablet dose may need to be reduced.

The Biguanides group includes only one drug, that is :

• Metformin (Diaformin, Diabex, Glucophage)

Metformin works by helping the body's own insulin to work more effectively.

Side effects of Metformin include: nausea and diarrhoea. To minimise these unpleasant side effects, the tablet should be taken after meals.

What happens when tablets and diet are not enough to control your blood sugars?

In some people with Non Insulin Dependent Diabetes, the tablets and diet are not able to control the blood sugars, and insulin therapy may be required permanently.

If you have any questions about insulin therapy, contact your Doctor or the Diabetes Educator at your local Hospital or Community Health Centre.

KEY POINTS

• Tablets are necessary when your blood sugars can not be controlled by diet and exercise alone.
• Tablets are not the same as insulin. Their action is to stimulate the pancreas to produce more insulin, or to assist insulin to work more effectively.
• When tablets and diet are not sufficient to control your blood sugars, insulin is prescribed