High blood glucose (blood sugar) levels make chronic kidney disease worse. Simple tests can tell if you have diabetes. If you do, take the diabetes medications your doctor prescribes.
Glucose-lowering pills reduce blood glucose. Each of the five types works in a different way and has different side effects.
Sulfonylureas stimulate cells in the pancreas to release more insulin. They are usually taken once or twice a day. One important side effect of sulfonylureas is low blood glucose, which can cause confusion and even coma. These medications can sometimes interact with alcohol, so speak with your doctor about drinking alcohol. Four sulfonylureas are available:
- Chlorpropamide (Diabinese)
- Glipizide (Glucotrol)
- Glyburide (Micronase, Glynase, and Diabeta)
- Glimepiride (Amaryl)
Meglitinides also stimulate cells in the pancreas to release more insulin. They are taken three times a day before meals. Just like sulfonylureas, meglitinides can cause low blood glucose, which can cause confusion and even coma. There are two meglitinides:
- Repaglinide (Prandin)
- Nateglinide (Starlix)
Biguanides decrease the amount of blood glucose made by the liver and help muscle tissue better absorb insulin. Metformin (Glucophage) is the only available biguanide. Metformin, which is usually taken twice a day, can cause diarrhea.
Thiazolidinediones work by decreasing the amount of blood glucose made by the liver and by helping muscle and fat tissue better use insulin. They are usually taken once or twice a day. They are recommended only for people who cannot control their diabetes any other way. These medications can cause heart failure, weight gain, and may increase the risk of osteoporosis. If you take a thiazolidinedione, your doctor will order blood tests to make sure your liver stays healthy. Rosiglitazone can also increase the risk of
Examples of thiazolidinediones include:
- Rosiglitazone (Avandia)
- Troglitazone (Rezulin)
- Pioglitazone (ACTOS)
Alpha-glucosidase inhibitors prevent starches, such as bread and pasta, from being digested in the intestines. This slows the increase in blood glucose after a meal. These medications should be taken at the first bite of a meal. Side effects include gas and diarrhea. There are two available alpha-glucosidase inhibitors:
- Acarbose (Precose)
- Meglitol (Glyset)
Your body needs insulin to use blood glucose (blood sugar) properly. If you have diabetes, you may need to take insulin to keep your blood glucose in a normal range. There are five basic types of insulin:
Rapid-acting insulin, such as insulin lispro or insulin aspart, start reducing blood glucose about five minutes after injection and are effective for two to four hours.
Regular or short-acting insulin—
Regular or short-acting insulin usually starts working about 30 minutes after injection. It continues to work for about three to six hours.
This type of insulin generally reaches the bloodstream about two to four hours after injection. It is effective for about 12-18 hours.
—Long-acting insulin, or ultralente, reaches the bloodstream 6-10 hours after injection. It is usually effective for 20-24 hours.
Very long-acting insulin
—Very long-acting insulin, such as glargine (pronounced GLAR-jeen) insulin, begins to lower blood glucose levels about one hour after injection. It works for 24 hours.
Insulin can lead to dangerously low blood glucose. If you are taking insulin, you need to carefully watch your diet and monitor your blood glucose at home.