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 (some brand names: Glucotrol, Micronase) 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 (brand name: 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 (brand name: Avandia) and
pioglitazone (brand name: 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 (brand names: 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 (brand name: 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 (brand name: 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.
