News and insights brought to you by the International Diabetes Federation

A healthy diet and body weight, and regular physical activity play a crucial role in managing type 2 diabetes. If, over time, these lifestyle changes are not enough, healthcare professionals (HCPs) can turn to oral agents to help people with type 2 diabetes manage their blood glucose levels. Oral agents increase insulin secretion from the pancreas and improve insulin sensitivity.

Why not use insulin to lower blood glucose?

Insulin effectively lowers blood glucose levels and is commonly used in the treatment of people living with type 2 diabetes. However, the International Diabetes Federation suggests using it as a last resort when other medications like metformin combined with one other glucose-lowering medicine have failed to work. Studies also show that insulin use may lead to diabetes complications more than other glucose-lowering treatments. Combining insulin with oral agents can decrease the required insulin dose and minimise side effects. 

Oral agents are often the first-line treatment for type 2 diabetes because they are effective and easy to take. They help control blood glucose levels and reduce the risk of diabetes complications. For HCPs, choosing the right oral agent depends on several factors, including the severity of diabetes, the site of action and other medical conditions.    

Typically, oral agents are prescribed to people with type 2 diabetes when diet and exercise alone are not enough to control blood glucose levels.

Fact-checking: a key starting point

Fact-checking is a key starting point when adapting treatment plans to the needs of the person with type 2 diabetes, considering their personal goals and potential obstacles. 

Typically, oral agents are prescribed to people with type 2 diabetes when diet and exercise alone are not enough to control blood glucose levels. They can be combined with two or more medications or used as a treatment alone. Sometimes they are combined with insulin therapy in people with more advanced diabetes. Since there are currently several classes of oral agents, HCPs often face the dilemma of which oral glucose-lowering agent to use to manage type 2 diabetes.  

However, women with gestational diabetes may also need to take oral agents, such as metformin, if dietary changes and exercise are not enough to keep their blood glucose levels within range. 

Unfortunately, not all oral agents are suitable for all people with diabetes, and HCPs need to customise the treatment according to the needs of their patients. This is where fact-checking comes in when you are a healthcare provider. Understanding the facts can help you choose the right oral agent. 

Considering potential side effects 

Once these facts are checked, HCPs need to consider potential side effects. Sulfonylureas, for example, may cause hypoglycaemia (low blood glucose) in some people with diabetes and may not be suitable for those with kidney or liver disease. Biguanides, on the other hand, may cause gastrointestinal side effects, such as diarrhoea and nausea.  

Choosing the best oral agent is one part of the process. HCPs also need to check how oral agents interact with diabetes complications and prioritise management to reduce the risk of complications. For example, recommend testing blood glucose levels several times daily or using a continuous glucose monitoring system to track the levels over time. 

In addition to monitoring blood glucose levels, there are several other considerations when taking oral agents for the best possible outcomes. These may include following a healthy diet, exercising regularly, and managing other medical conditions, such as high blood pressure and cholesterol.  

With the proper treatment and lifestyle modifications, people with type 2 diabetes can lead healthy and fulfilling lives. Oral glucose-lowering agents are an effective and convenient treatment option for people with the condition. They can help control blood glucose levels to delay or prevent complications associated with diabetes. However, choosing the right oral agent must be based on their needs and preferences of the person with type 2 diabetes and requires regular monitoring of blood glucose levels.  

Choosing the right oral agent must be based on the needs and preferences of the person with type 2 diabetes

Would you like to learn more?

Master oral glucose-lowering agents in type 2 diabetes with the new free accredited online course for healthcare professionals from the IDF School of Diabetes.

Type 2 Diabetes Oral Agents Fact Checking  provides a deep dive into the world of oral glucose-lowering agents and how they can help manage type 2 diabetes. It will allow healthcare professionals to gain the knowledge and skills to compare the effectiveness and discuss the risks and benefits of glucocentric and cardiocentric treatment approaches. 


Justine Evans is Content Editor at the International Diabetes Federation

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