Diabetes is a condition that results from an inability of the body to control sugar levels. Type 1 diabetes is less common and occurs when the body does not make insulin, a hormone made in the pancreas that helps the body break down and use sugars from food. Type 2 diabetes is more common and may occur when the body resists the effect of insulin release or when the body releases the wrong amounts of insulin in response to sugar levels. Treatment options for Type 2 diabetes, which have expanded greatly in the 21st century, range from insulin injections to oral medicines that can keep blood sugar at daytime goal levels of 80 to 120 mg/dL.
Insulin
Insulin injections are a standard treatment of diabetes, because they directly replace what the body lacks in quantity or response. Myriad schedules and formulations are available, including short-acting insulin to provide an immediate processing of sugar and long-acting insulin to provide coverage across a time span. Formulations may be combined. New advances in insulin therapy include a zinc-bound insulin protein administration that may reduce possible risks of cancer associated with insulin use and with diabetes-related obesity. These zinc insulin hexamers, discovered in early 2010 by researchers at Case Western Reserve University, bind less often to cancer receptors and instead release insulin slowly from within the body.
Oral Combination Therapy
Oral medications for diabetes target three goals: increasing insulin release, increasing the body's response to existing insulin levels, and blocking the absorption of glucose into the body. A combination of these options is usually necessary for full sugar control. Sulfonylureas, like glyburide and glipizide, heighten insulin release from the pancreas. These drugs are among the oldest oral treatments for diabetes and have been used since the 1950s, but they are associated with frequent occurrences of low blood sugar. Thiazolidinediones, such as Actos and Avandia, are newer drugs that improve the body's insulin response. The full effects of thiazolidinediones are still unclear as of early 2010. Alpha-glucosidase inhibitors, like Precose, block the absorption of sugars from food in the gastric system, especially starchy sources of sugar, so they must be taken at the start of a meal. Because of their gastric activity, the main side effects are diarrhea and gas.
Byetta
Exenatide (Byetta) is an injection that entered the market in the early 21st century. Byetta increases insulin secretion when glucose levels in the blood are high, so it is given at mealtimes. Nausea is possible but mild. Other noted effects include feelings of fullness, weight loss, and--very rarely--pancreatitis. A main benefit of Byetta injection is that reflexive drops in blood sugar are less likely. Because injections are typically less preferable to patients than oral medications, Byetta is used most often as a supplement when oral drugs alone do not control a patient's glucose levels.
