Medications & Therapies

Clearing the Confusion Around Treatment

22. Oral Diabetes Medicines Explained

Diabetes is progressive. You might start with one tablet, but may need two or three later. This is not because the medicine is "weak," but because the body's needs change.

Common Categories

  • Metformin: The "Foundation." Improves insulin sensitivity and reduces sugar release from the liver. Safest and oldest.
  • Sulfonylureas (Glimepiride, Gliclazide): "Squeezers." They push the pancreas to release more insulin. Very effective but can cause low sugar (Hypo).
  • DPP4 Inhibitors (Teneligliptin, Vildagliptin): "Smart Boosters." They work only when sugar is high. Weight neutral and safe for elderly.
  • SGLT2 Inhibitors (Dapagliflozin, Empagliflozin): "Kidney Helpers." They remove excess sugar through urine. Bonus: They protect the heart and kidneys and aid weight loss.

Deep Dive: New Drugs in India (2025 Update)

The landscape of diabetes treatment in India has changed drastically this year:

  • Price Drop for SGLT2s: With patents expiring for key drugs like Empagliflozin in 2025, generic versions (e.g., Glempa) are now available at 90% lower cost, making heart/kidney protection affordable for millions.
  • The Rise of GLP-1 Agonists: "Weight Loss + Diabetes Control" shots like Mounjaro (Tirzepatide) and Ozempic (Semaglutide) have officially entered the Indian market. They are game-changers for obese diabetic patients.
  • Oral Semaglutide: The pill version (Rybelsus) is seeing wider adoption for those who fear needles but want the benefits of modern therapy.

23. Insulin: Friend, Not Enemy

Myth: "Insulin means the end."
Fact: Insulin is the most natural medicine; it is what your body is missing. Early insulin usage can actually "rest" the pancreas and prolong its life.

Types of Insulin

  • Basal (Long-Acting): Taken once a day to control fasting levels (background coverage).
  • Bolus (Rapid-Acting): Taken before meals to handle the food spike.
  • Premix: A combination of both (common in India for convenience).

24. Technology in Diabetes

  • CGM (Continuous Glucose Monitoring): A sensor patch on your arm that shows sugar levels on your phone in real-time. No more pricking fingers 4 times a day.
  • Insulin Pumps: Small devices that deliver insulin continuously, mimicking a healthy pancreas.