Insulin sensitiser improves the sensitivity of tissues to insulin, i.e. it improves the efficiency of body's own and injected insulin. They also reduce fattyness of liver.
Insulin sensitisers i.e. glitazones are used to treat type 2 diabetes in adults as a phase two or three medicine together with metformin or other blood sugar-lowering medicines or basal insulin. They can also be used on their own, if metformin or other diabetes medicines are not suitable.
People with an acute insulin resistance and fatty liver are the essential user group of insulin sensitisers.
With new pharmaceutical products becoming available, the use of insulin sensitisers in treatment of type 2 diabetes has become less common compared to previous years. In Finland (7/2023), there is one insulin sensitiser for sale: pioglitazone. It is also available as tablets combined with other diabetes medicines, with the tablet including two different pharmaceutical products.
Insulin sensitisers or glitazones bond with the cell’s nucleus receptor and affect the cell’s metabolism in several different ways. They make the body more sensitive to both the insulin produced by the body as well as injected insulin by modifying the fatty cells in such a way that the subcutaneous fatty tissue is better able to store fat. At the same time, they reduce fat in the abdominal cavity and liver.
The pharmaceutical product is taken once a day at any time of the day. The therapy starts with a smaller initial dose, which is increased within two to three months, if necessary. Unlike other pharmaceutical diabetes products, insulin sensitisers take several weeks to achieve their full effect.
In itself, the insulin sensitiser does not cause your blood sugar to drop too low. After starting the drug food quantities should not be increased, rather the quantity should be reduced, if there is overweight. The product dose does not need to be adjusted according to alternating eating habits or exercise. If the insulin sensitiser is added to an existing basal insulin therapy, the need for insulin usually reduces within few weeks. The insulin dose is reduced on the basis of blood sugar self-measurements and the doctor’s instructions.
Insulin sensitisers are not suitable for persons with a heart failure, osteoporosis or a severe liver disease. The elderly and anyone living with kidney failure should take extra care when using the product.
Insulin sensitisers are not used during pregnancy or breastfeeding.
All pharmaceutical products involve an individual risk of side effects.
The side effects of insulin sensitisers include swelling resulting from the accumulation of liquid as well as the related weight gain and heart failure. The accumulation of liquid can also reduce haemoglobin, in other words, cause anaemia. It is important to monitor weight during the treatment.
In women, the insulin sensitiser increases the risk of osteoporosis.
