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How do Diabetes Medications Work?

GLP-1 Diabetes Drug Treatment Drugs: GLP-1 (glucagon-like peptide 1 receptor agonists) are incretin mimetics which have several benefits for diabetes management. They suppress post-prandial glucagon release, delay stomach emptying, and increase insulin sensitivity. The most common side effects reported are headache, nasopharyngitis, and upper respiratory tract infection. At this time, major safety concerns with incretin-based therapies (GLP-1 receptor agonists and DPP-4 inhibitors) include pancreatitis, pancreatic cancer, and thyroid carcinoma that fall into these categories. Diabetes medications that fall into this category are Semaglutide (Ozempic, Rybelsus), Lixisenatide (Adlyxin), Liraglutide (Victoza), Extended-release exanatide (Byetta), Dulaglutide (Trulicity), Albiglutide (Tanzeum).

Biguanides are a very popular class of diabetes medication. Metformin is the most popular diabetes medication in this group, and others include Glucophage XR (metformin extended-release) and Fortamet, Glumetza, Pioglitizone, and Riomet. These work by lowering the amount of sugar (glucose) made by the liver and they help the muscle cells make better use of the body’s insulin by making these cells more sensitive to insulin. (In another article I review how insulin works). The most common adverse effect of biguanides is gastrointestinal distress, including diarrheacrampsnausea, vomiting, and increased flatulence. Long-term use of biguanides has also been associated with decreased absorption of vitamin B12. Vitamin B12 is a nutrient that helps keep the body’s nerve and blood cells healthy and helps make DNA, the genetic material in all cells. Vitamin B12 also helps prevent a type of anemia called megaloblastic anemia that makes people tired and weak. Two steps are required for the body to absorb vitamin B12 from food. To purchase B12 click here: I can’t tell you how many times I have helped people with diabetes that also have this type of anemia, and it seems by the time they have anemia, they have so many other pressing health concerns that tackling the anemia is not always taking priority. I am here to tell you that addressing anemia and most importantly your dis-ease is the most important thing in your life – it is at the TOP of your daily To-Do List, whether you know it or not. If you choose to ignore the side effects and dis-ease now, you will surely have to slow down to take care of it later when it takes over. The most important thing is to take control of diabetes dis-ease today.

Dipeptidyl peptidase-4 (DPP-4) inhibitors are another class of diabetes medication drugs commonly known as Januvia, Onglyza, Tradjenta, Nesina. These help the pancreas produce more insulin and also help lower the amount of sugar made by the liver. Side effects include gastrointestinal problems – including nausea, diarrhea, and stomach pain.
flu-like symptoms, headache, runny nose, sore throat.
skin reactions, painful skin followed by a red or purple rash.

Sulfonylureas are another class of diabetes medications that basically help the pancreas produce more insulin. Some commonly prescribed sulfonylureas include DiaBeta, Glynase, or Micronase (glyburide or glibenclamide), Amaryl (glimepiride), Diabinese (chlorpropamide), Glucotrol (glipizide), Tolinase (tolazamide), Tolbutamide. Common side effects include signs of low blood sugar, such as sweating, dizziness, confusion, or nervousness, hunger, weight gain, skin reactions, upset stomach, and dark-colored urine.

Sodium-glucose cotransporter 2 (SGLT2) inhibitors are another class of diabetes medications. SGLT2 inhibitors reduce blood glucose by blocking the action of a protein called sodium-glucose co-transporter-2 (SGLT2) in the kidney. This protein is responsible for reabsorbing sugar back into the body from urine. Blocking this protein prevents the kidney from reabsorbing glucose from urine and causes glucose to be removed from the body through urine. This lowers the level of glucose in the blood. But what harm can this be doing to your kidneys? So many people I have treated for diabetes come to me at Stage 3 of Chronic Kidney disease related to the number of medications they take for high blood pressure (again caused and related to diabetes) and for having high blood sugar for so many years and causing the kidney to have to secrete sugar in the urine as an attempt to keep your body’s sugar level normal. In the following video, I explain how certain foods turn into sugar right away. These foods that turn into sugar right away cause the largest need for insulin and diabetes medication.

This visual representation of how the colander lets the sugar thru is a representation of how fast your blood sugar rises after a very starchy or sugary meal and released into the urine. Common side effects of SGL2 inhibitors are genital yeast infections in men and women, urinary tract infections (UTIs), increased urination, kidney problems, flu-like symptoms, constipation, nasal congestion, urinary discomfort.

Alpha-glucosidase inhibitors are another class of diabetes medications that block the breakdown of starchy foods such as bread, potatoes, and pasta, and they slow down the absorption of some sugars, such as table sugar. You take an alpha-glucosidase inhibitor with the first bite of each meal. Most people take a pill three times a day. Common side effects for users are flatulence, diarrhea, and stomach pain.

I have worked with people that have had diarrhea for 25 years due to metformin, or have had gastroparesis and the only thing they have found to work for them was baby food until they came to my program. The side effects to these medications are horrifying and common at best. Many people have doctor’s that themselves believe once you have diabetes you cannot get rid of it, which does not help the diabetes lifestyle mindset to change. You have to know, people are getting rid of diabetes, why can’t it be you? In another article I go more deeply into why Western medicine treats the symptoms and not the causes of dis-ease, and chances are, your medical doctor is doing the same. Nonetheless, I work together with your doctor’s to safely lower your medication as you go through the Diabetes Recovery Program.

In the Diabetes Recovery Program, Phase I is a healing phase where you learn how to let go of the foods that have hindered your ability to get well. You teach your body to use carbohydrate energy the way it was intended to use it in the first place. You may require less medication in just 4 days! It all depends on the individual. Phase II is the Maintenance Phase of the Diabetes Recovery Program which teaches you how to reincorporate more foods into your diet without going back to the diabetic lifestyle. No matter where you are on the spectrum of diabetes management, do not believe the lie that you can never get rid of diabetes. Diabetes recovery is possible for many and what is possible for others can be possible for you! To sign-up for recovery please visit the Plans & Services page at

To learn more please call me at 708-691-2382. I would love to offer you a Free 15-minute consultation over the phone to assess your particular concerns.


Raquel Lopez RDN, LDN