Diabetes is synonym with a seriously debilitating disease state in which the body is unable to maintain a stable blood sugar level, either because of a malfunctioning pancreas that produces the insulin or some faulty cellular utilization of sugars, which are the main energy source for our body.
However, with the advent of breakthroughs in the field of pharmacology, numerous medical aids are available that help to keep the blood sugars at optimal. These medicines work wonders in conjunction with lifestyle changes, which include healthy eating choices and incorporation of physical activity, thereby enabling an individual to lead a normal life as possible.
The medical management for type 2 diabetes is always undertaken in consultation with your general practitioner and follows the following principles
- Regular monitoring of the blood sugar levels
- Regular taking of prescribed medicine
- Adjusting the dose when required
- A better understanding of complications and how to avoid them
The medicinal approach to treating diabetes aims to achieve either of the following targets
- Increase the insulin production
- Reduce the sugar production from liver
- Enhance the insulin sensitivity
- Reduce the blood absorption of sugar
- Accelerate the flushing of sugar via the kidneys
There are two categories of medicines prescribed for managing blood sugar levels in type 2 diabetes
- Pills and non-insulin preparation
- Insulin therapy
Pills and non-insulin options
The oral options are sometimes used as a single choice or a combination of two or more medicines. The combinations work better because they target different parts of the body that handle the sugar levels with a different strategy.
- Metformin: acts by reducing the sugar production from the liver.
- Thiazolidinediones (Glitazones): acts via an enhanced sugar removal from the blood.
- Insulin-releasing pills (Secretagogues, Sulfonylureas): increases the insulin production from the pancreas.
- Starch blockers: reduces the absorption of sugar from the intestines.
- Incretin-based therapies: works in duo; by reducing the sugar production from liver and its absorption from the gut. They combine the pills and injectable medicine.
- Amylin analogs: is injectable options that are non-insulin in nature and they work in similar fashion to Incretin.
Insulin therapy is usually initiated in combination with oral medication or as an independent choice. The insulin therapy may be the first option in cases of a complicated case of diabetes or it may be started at a later stage when the sugar levels are not maintained with the sole help of oral medications.
There are two main categories of insulin, the human and the analog types. The human insulin has a limited use because of when injected into the subcutaneous fat; it clumps and delivers an unpredictable result. The analog varieties do not have such issues.
There are different types of insulin therapies according to
- Their onset of action
- Time is taken to reach maximum levels
- Total duration of action
- Insulin concentration
- Route of administration
The specific types of insulin are
- Fast acting
The fast acting insulin is quick to get absorbed into the blood and help control sugar between meal timings. Your doctor would prescribe you rapid-acting insulin analog or regular human insulin.
The intermediate-acting insulin is absorbed more slowly but the effects last longer. It controls the blood sugar levels between meals, fasting, and overnight. The insulin included in this category is NPH human insulin and pre-mixed insulin.
The long-acting insulin is the analog variety, the Insulin Glargine and Insulin Detemir with an action that stays for 24-hours and 12-24-hours respectively.
The different medications for type 2 diabetes are not equally effective for everyone and a single kind may not be effective for an individual either. The final adjustment for the type and dose should be a collaborative effort between a doctor and the patient, with regular inputs from the latter in order to avoid any side effects.