Diabetic Medications
How is diabetes treated?
The goal of diabetes treatment is to keep your blood sugar level as close to normal as possible. The first step is to have a healthy diet and to exercise. This may mean you'll need to change your diet and exercise habits. You'll also have to watch your weight, or even lose weight, to keep your blood sugar level as normal as possible. Your doctor will talk to you about the kinds of food you should eat and how much exercise you'll need every week.
Sometimes diet and exercise alone can't keep your blood sugar levels normal. Then your doctor will talk to you about other treatments, such as medicine or insulin shots.
Many people with diabetes find it fairly easy to keep track of their own blood sugar level at home. Your doctor can use the results to see how your treatment is working.
Are there medicines I can take?
Several kinds of medicine can help you control your blood sugar level. Some medicines are pills that you take by mouth (orally). Oral medicine doesn't work for everyone, though. Some people need to take insulin. If you need insulin, you'll have to give yourself a shot. Most people with type 2 diabetes start with an oral medicine. Your doctor will tell you which kind of medicine you should take and why.
What is combination therapy?
Combination therapy uses 2 medicines to help you control your blood sugar level. It can also help with other health problems (such as having high blood pressure or high cholesterol levels, or being overweight). Each medicine works in a slightly different way. This therapy can combine 2 oral medicines, or 1 oral medicine plus insulin.
What medicines could my doctor prescribe?
Six kinds of diabetes medicine are available in pill form: sulfonylureas, metformin, thiazolidinediones, alpha-glucosidase inhibitors, repaglinide and nateglinide. Each medicine has good points and bad points. Your doctor will decide which medicine is right for you.
Sulfonylureas
Sulfonylureas (glyburide, Glucotrol, others) are the most commonly prescribed diabetes medicines. They are inexpensive and have few side effects. These medicines help your body make insulin. They can be taken alone or with metformin, an alpha-glucosidase inhibitor, pioglitazone or insulin. If you're allergic to sulfa, you can't take a sulfonylurea.
Metformin
Metformin (Glucophage) may be prescribed for people with diabetes who are overweight, because it may help with weight problems. It helps the body use insulin better. Metformin can cause problems like nausea or diarrhea in some people. It can be taken with a sulfonylurea.
Thiazolidinediones
This class of medicines includes rosiglitazone (Avandia) and pioglitazone (Actos). An older medicine, troglitazone (brand name: Rezulin) is no longer being made because of the risk of liver problems. Rosiglitazone and pioglitazone appear less likely to cause liver problems, but people taking them need periodic liver tests. These medicines help your body respond better to insulin. Rosiglitazone and pioglitazone can be used alone or in combination with other diabetes medicines.
Alpha-glucosidase inhibitors
Alpha-glucosidase inhibitors (Precose, Glyset) work in your stomach and bowels to slow down the absorption of sugar. If another medicine doesn't control your blood sugar, you might use this kind. This medicine can cause stomach or bowel problems, so it may not be a good choice if you have a history of stomach or bowel trouble. It can be taken alone or with a sulfonylurea.
Repaglinide
Repaglinide (Prandin) is taken with meals to control your blood sugar. Your doctor can tell you how to adjust the dose according to the number of meals you eat. Repaglinide can be taken alone or with metformin.
Nateglinide
Nateglinide (Starlix) is taken with meals to keep your blood sugar level from getting too high after you eat. Nateglinide can be taken alone or with metformin.
Insulin
Insulin may be prescribed, particularly when it is believed that one's insulin levels are low. This applies to all Type 1 diabetics, and many long-term Type 2 diabetics.
Organizations
American Diabetes Association (http://www.diabetes.org) 800-232-3472
Adapted from the American Academy of Physicians