What Are Insulin Sensitivity Drugs?
Insulin sensitivity refers to how sensitive your body is to the hormone insulin. Impaired insulin sensitivity, also called insulin resistance, is when cells in your muscles, fat, and liver don’t respond to insulin the way they should. Insulin helps glucose in your blood, or blood sugar, enter these cells, and then it’s used for energy. If you have insulin resistance, these cells have trouble taking up glucose, and then your pancreas makes more insulin.
Insulin resistance leads to prediabetes and type 2 diabetes. If you have type 2 diabetes, you may take medicine to help manage it, along with lifestyle habits such as following your doctor’s recommendations on nutrition and physical activity. Many diabetes drugs lower blood sugar in different ways. Some help your body make better use of insulin.
Types of Insulin Sensitivity Drugs
To improve insulin sensitivity, lifestyle habits such as exercising regularly, eating a nutritious diet, and losing excess weight can help. No medications are specifically approved to treat impaired insulin sensitivity, but some drugs used to treat diabetes can make your cells more open or sensitive to insulin. They’re sometimes called insulin sensitizers.
Two types, or classes, of diabetes drugs can improve insulin sensitivity, or help your body use insulin better. These medications are biguanides and thiazolidinediones (TZDs). Your doctor may combine insulin sensitivity drugs with healthy lifestyle changes.
Biguanides
Biguanides are a class of drugs used to treat type 2 diabetes. They help manage diabetes by lowering blood sugar levels.
The only drug in this class is called metformin, and the FDA approved it in 1994 to treat type 2 diabetes. Doctors also prescribe it off label to manage prediabetes, type 1 diabetes, and other conditions.
Metformin for insulin resistance
Metformin is the only biguanide, and its brand-name versions include Glucophage, Glucophage XR, Glumetza, Fortamet, and Riomet. It’s the main drug used to treat type 2 diabetes.
Metformin lowers elevated blood sugar (glucose) in people with diabetes in two ways. It lowers the amount of glucose your liver makes, so there’s less in your bloodstream. And it makes your muscle tissue more sensitive to insulin, so it absorbs glucose and your body can use it for energy. This reduces insulin resistance.
While metformin is used to treat type 2 diabetes, studies show that it also may delay the development of type 2 diabetes in people at high risk, as well as help prevent heart attacks.
Metformin dosage
Metformin comes in three forms: immediate-release pills, extended-release pills, and a liquid. How much you take and how often you take it depends on the strength of the medication and other things, so it’s important to follow your doctor’s prescription.
For example, if you’re taking 500 milligrams of immediate-release pills, you typically take them twice a day, with breakfast and dinner. And you may take extended-release pills once a day. Your doctor may start with a low dose and increase it slowly, based on how well you respond to taking metformin.
You shouldn’t take metformin if you have severe kidney disease. As with any new treatment, talk about the benefits and risks with your doctor before you start taking it.
Metformin side effects
Metformin can cause diarrhea, nausea, vomiting, and belly pain. These symptoms usually get better as your body adjusts to the medicine, but they can last longer. It’s important to take your meds with meals. Switching to extended-release tablets may help, too.
It’s rare, but metformin can also cause a life-threatening problem called lactic acidosis. Symptoms include cramps, nausea, weakness, and fast breathing. If you think you have lactic acidosis, get emergency care right away.
While some diabetes drugs cause weight gain as a side effect, it’s not a typical side effect of metformin. Instead, metformin may cause weight loss.
Thiazolidinediones (TZDs)
Thiazolidinediones are another class of drugs used to treat type 2 diabetes. There are two drugs in this class: pioglitazone (Actos) and rosiglitazone (Avandia), and both were approved by the FDA in 1999. A third drug in this class, troglitazone (Rezulin), was approved in 1997 but withdrawn in 2000 because it increased the risk of liver failure.
This class of insulin sensitivity drugs helps your cells use insulin better and lowers the amount of glucose your liver makes. Doctors usually consider prescribing metformin before considering TZDs.
If you have a history of congestive heart failure, you shouldn’t take this kind of medication because it could worsen that condition.
Pioglitazone
Pioglitazone is the main TZD used to treat type 2 diabetes. It works by increasing your body’s sensitivity to insulin. Your doctor may prescribe it alone or along with metformin or other medications.
The risks of pioglitazone and rosiglitazone differ somewhat. Pioglitazone may cause liver problems, and studies have shown that it may increase the risk of bladder cancer and fractures.
Rosiglitazone
Like pioglitazone, rosiglitazone increases your body’s sensitivity to insulin, and it may be used alone or along with metformin or other medications.
Some studies have shown that rosiglitazone is linked to a higher risk of congestive heart failure, heart attack, and death than pioglitazone is. Because of the heart attack risk, in 2011 the FDA restricted the use of rosiglitazone, but it removed the restrictions in 2013 after a long-term clinical trial did not show increased risk.
Thiazolidinediones dosage
Your dose of TZDs will depend on your specific situation. With pioglitazone, your doctor may prescribe a low daily dose at first, around 15 milligrams. Then they may raise the dose slowly to 30 or 45 milligrams a day. You may take tests to see how well your liver is working before and during treatment.
If your doctor prescribes rosiglitazone, your prescription may be for 4-milligram tablets once a day or divided and taken twice a day. Then your doctor may increase the dose to 8 milligrams per day.
It’s important to follow your doctor’s dosage instructions carefully.
Thiazolidinediones side effects
Both types of TZDs may cause side effects that include chest pain, swelling, trouble breathing, and decreased urine output. If you’re taking pioglitazone, side effects may also include weight gain, extreme fatigue, and dilated neck veins. If you’re taking rosiglitazone, other side effects may be stomach pain and blurred vision.
TZDs can have serious side effects, including a greater chance of liver problems, fractures, and heart failure. Talk with your doctor about the risks and benefits of taking these drugs.
Insulin Sensitivity vs. Insulin Resistance Medications
If you have insulin resistance, your body has built up a tolerance to insulin, or it resists insulin. Insulin resistance is the same thing as impaired insulin sensitivity, or low insulin sensitivity. Your body isn’t as sensitive to insulin as it should be.
Insulin resistance medications and insulin sensitivity medications are the same. They make your body more sensitive to insulin, helping it use insulin the way it should.
How to Choose the Right Insulin Sensitivity Drugs
Doctors take into account many things, including whether you have type 2 diabetes and other medical conditions you may have, when choosing the right insulin sensitivity drug. They’ll also consider your medical history and your lifestyle habits.
Your doctor may prescribe multiple insulin resistance or insulin sensitivity drugs, and they are likely to also prescribe changes to your diet and exercise.
Takeaways
Insulin resistance, or impaired insulin sensitivity, is when your body doesn’t respond to insulin the way it should. If you have type 2 diabetes, two classes of diabetes drugs can help improve your insulin sensitivity: biguanides and thiazolidinediones (TZDs). Along with medication, your doctor may prescribe changes to your diet and exercise habits to help improve your insulin sensitivity.
Insulin Sensitivity Drug FAQs
What drugs increase insulin sensitivity?
Two classes of drugs that are used to treat diabetes can improve, or increase, your insulin sensitivity. They are called biguanides and thiazolidinediones (TZDs).
What does metformin do for insulin resistance?
Metformin can reduce insulin resistance, helping your body use insulin better.
Does metformin lower insulin levels?
If you have type 2 diabetes, metformin doesn’t exactly lower insulin levels, but it lowers your blood sugar levels. It also improves your insulin sensitivity.
What is the best insulin-sensitizing medication?
The best insulin sensitizer depends on your condition and other things, like your age. If your doctor is prescribing an insulin-sensitizing medication, they will consider several things to decide which one is best for you.
