Diabetes: medicamentos orales vs insulinas

Por Jeannette Pérez Pierantoni, PharmD

¿Alguna vez te has preguntado la razón por la cual algunos pacientes diabéticos se inyectan insulina mientras otros toman medicamentos orales? Quiero explicarte un poco sobre estas diferencias en tratamiento.

Si leíste la columna de la semana pasada, recordarás que existen distintos tipos de diabetes. La diabetes tipo 1 es la que se presenta cuando el cuerpo no produce suficiente insulina y en el tipo 2, el cuerpo produce insulina, pero no la puede utilizar efectivamente. Por lo tanto, es lógico pensar que se han desarrollado distintos tratamientos para atender cada tipo.

Para pacientes con diabetes tipo 1, existen varias opciones de insulina. Su médico le hará una evaluación para determinar cuál es la más indicada según su situación.

Insulinas de acción rápida son las que actúan en menos de media hora y se pueden mantener actuando hasta 5 horas. Deben administrarse 15 minutos antes de comer.  Novolog® y Humalog® son parte de esta categoría.

Insulinas de acción corta son las que actúan en 30 a 60 minutos y mantienen su acción por hasta 8 horas. Deben ser administradas 30 minutos antes de la comida. Ejemplos de estas son Novolin® R, Humulin® R y Humulin® R U-500.

Insulinas de acción intermedia son las que actuan en 1 a 2 horas y pueden mantenerse actuando por 16 a 24 horas. Novolin® N y Humulin® N son parte de este grupo.

Insulinas de larga acción son las que comienzan a actuar en 1 a 2 horas y continúan haciéndolo por un período de 24 horas. Aquí se encuentran el Lantus® y el Levemir®.

Insulinas de acción mixta son insulinas pre mezcladas. Existen distintas combinaciones y tienen como ventaja el contener una insulina de acción rápida con una de acción intermedia. Ejemplos de estas son Humalog® 75/25, Humulin® 70/30, Humulin® 50/50, Novolin® 70/30 y Novolog® 70/30.

Para los pacientes con diabetes tipo 2 existen los medicamentos orales. Estos se dividen en grupos según su forma de acción en el cuerpo. No voy a dividirlos por los nombres de los grupos porque solo lograría confundirte.

Sin embargo, me gustaría mencionar varios de los medicamentos disponibles. Algunos ejemplos son: Glucophage® (metformin), Amaryl® (glimepiride), Glucotrol ®(glipizide), Glynase® (glyburide), Prandin®, Avandamet®, Januvia®, Onglyza®, Tradjenta®, Invokana®, Farxiga®.

Espero que con esta información hayas aprendido la diferencia principal de los tratamientos para cada tipo de diabetes. Y como siempre, tienes alguna duda, sugerencia o tema que te interese que sea discutido, puedes escribir a estureceta@gmail.com. Hasta la próxima.  

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