 Hi everyone, if you don't already know me, my name is Leah Medwig and I am your lead course instructor here at ACT for the CCMA program. And today we're going to talk about diabetes medications. And when we begin to talk about pharmacology and medications in general, it can get very complex and complicated very quickly. So we're going to discuss these diabetes medications in this lesson today in the context of your current role as a certified medical assistant. Now if you do go on to nursing school or PA school or med school or pharmacy school, you will get a whole lot more in-depth coverage about pharmacology and medications and diabetes medications. But again, just in the context of your current role, we're just going to simplify it a little bit here today. So now of course by now we already know that there is type 1 diabetes and type 2 diabetes. Type 1 diabetes is generally an autoimmune disease that is acquired early in life in early adolescence or early adulthood when your own body or your body's immune system begins to attack its own cells or in this case the pancreas, making it difficult for your body to produce insulin. And approximately 5 to 10% of the people who have diabetes have type 1 diabetes. And sometimes these symptoms of type 1 diabetes develop very quickly. It's important to understand that if your patient has type 1 diabetes, they will be on lifelong insulin and they will use lifelong insulin to survive. Usually patients that are type 1 diabetics do not use oral medications, only insulin. Now with type 2 diabetes, this is when your body doesn't use the insulin well and can't keep the blood sugars at a normal level. And about 90 to 90% of people with diabetes have type 2 diabetes. And this usually develops in later adulthood and is usually associated with poor lifestyle changes or poor lifestyle in general. And of course there is also gestational diabetes. This develops in pregnant women who never had been diagnosed with diabetes prior to being pregnant. So diabetic medications that are used to treat type 1 diabetes, as I said, any one who has type 1 diabetes will need lifelong insulin therapy and can only use insulin as treatment. Insulin is a naturally occurring hormone secreted by your pancreas. And if your patient is prescribed insulin, it may be because their body doesn't produce it as in type 1 or their body doesn't use the insulin properly or well enough as in with type 2 diabetes. Some types of insulin include short acting or regular insulin, rapid acting insulin, intermediate acting insulin, sometimes called NPH, and then the long acting insulin. Some insulin examples here include humulin R and novalin R for the short acting or regular insulin, insulin LISPRO, which is humalog, and insulin ASPART, which is novalog for the rapid acting insulin. And then you have that insulin NPH, which is the novalin N or humulin N for the intermediate acting insulin. And then you have Lantis, TJO, Solastar, Lavamir, Tressiva, and Bezseglar for the long acting insulin. Now type 2 diabetes treatment, people with type 2 diabetes may use oral medication, they may use insulin, they may use a combination of oral and oral medications and insulin. Several classes of type 2 diabetes medications do exist. In each class of that medication, it works in a different way until lower the blood sugar. And here are some examples here that I've listed. Some work by stimulating the pancreas to produce and release more insulin. Some may inhibit the production and release of glucose from the liver. Some of those medications improve the sensitivity of cells to insulin. Some of those medications can inhibit the reabsorption of glucose in the kidneys. And some of those medications can slow how quickly food moves through the stomach. Now here is a nice graph of the type 2 diabetes oral medications. As you can see on the left hand side, the first column is the drug class, the second column over is how the drug works, the third column is the generic name, and then the last column is the brand name. Now the bigunites usually help to lower the amount of glucose produced by the liver. And you might know this medication known as Metformin or Glucophage. The Sulfurnorias help beta cells and the pancreas release more insulin. And you might know this medication called Glyphazide or Glamopyride or Amaryl. The DPP4 inhibitors slow the activation of the GLP1, which is a compound in the body that lowers blood glucose levels. And you may know this type of class of drug by the name of Tragenta or Genuvia or Genumids. Then there's the SGLT2 inhibitors and this medication works by blocking glucose from being reabsorbed by the kidneys. And then the excess glucose is then released in the urine. And you may know this medication by the name of Infocana, Barsiga, and Jardians. Now I know we're probably seeing a ton of commercials on TV with all of these medications. You're probably hearing them from these commercials. So now the mechlinunites help to help beta cells and the pancreas release more insulin. And you may know this medication by the name of Prandon and the TZDs help insulin work better and the muscle and the fat cells. So those medications we just discussed were all oral medications or by pill form. And these next type 2 diabetes medications are injectables. And again here we have in the left side column the drug class, how the drug works, the generic name, and then the brand name, the drug class amylin, food moving through the stomach. Now this medication may also, can also be prescribed for type 1 diabetics as it is an injectable. But I don't typically see this being prescribed to too many type 1 diabetics, mostly just type 2. And you can see the generic name and brand name is the simlin, the GLP1 receptor agonist helps release insulin when blood glucose rises at mealtime and it helps to slow the absorption of mealtime glucose. And again you might have heard of this medication by the brand name of TrulaCity or Victoza or Ozympic. And then the next drug class is a combination of medications, insulin plus the GLP1 receptor agonist. And this is otherwise known as saliqua. So again like I said when we start getting into all of these different types of medications for things especially like diabetes, it can become complex and sometimes complicated. But as your role as a medical assistant, the most important thing to remember is that type 1 diabetics are only treated with insulin and then the type 2 diabetics can be treated with insulin and or combination of oral medications. Please reach out to me if you have any questions or concerns about anything I'm always here to help you.