Do we need drugs for all patients with diabetes?

In some patients, particularly in the initial phase of diabetes with mild elevated blood sugar, one could manage with proper diet and exercise. In most of these cases, after variable period of time, some drug will be needed.

Do we need specific medication for obese diabetics?

A drug called metformin (Glucopahge, glyciphage, glycomet) is the best drug for obese diabetics. Not only does it brings down the blood sugar and corrects metabolism, it also helps in losing weight.

I am a diabetic on oral drugs and I frequently get abdominal problems. What are the medications that should be avoided?

The mostly likely culprit is metformin, and if abdominal upsets are severe or prolonged, this drug should be avoided. Another group of drugs (acarbose, voglibose) sometimes used in diabetes could also cause diarrhea.

I have diabetes and hypertension. Could any of the medications cause weight gain and swelling of the feet?

Thiazolidinediones (rosiglitazone, pioglitazone) can cause weight gain and swelling feet. While use of rosiglitazone is restricted because it could cause cardiac side-effects, pioglitazone is popularly prescribed. Use of insulin could also cause similar effects. Anti-hypertensive drugs calcium channel blockers like amlodepine commonly cause swelling of the feet.

Could any of the medication lead to deterioration of kidney function in diabetes?

One important complication of prolonged uncontrolled diabetes is kidney dysfunction. Medications do not cause kidney disease. Metformin, however, should be stopped, pioglitazone should be avoided, and dose of new medications (galvus, januvia) should be lowered when the blood creatinine level (indicative of kidney damage) is high. In case of markedly high creatinine, insulin therapy would be the best option.

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