According to the Centers for Disease Control and Prevention, as of 2007, approximately 23.6 million Americans had diabetes mellitus. This is equivalent to 7.8 percent of the total population of the United States. People who have diabetes type 1 must take insulin on a regular basis. People with type 2 may need to take insulin at some point, but other remedies other remedies are available.
Lifestyle Changes
The initial remedy for people with type 2 diabetes mellitus involves lifestyle changes, writes Elizabeth Corwin, Ph.D. in "Handbook of Pathophysiology." These changes include exercise, weight loss and a change in diet. Dr. Corwin explains that studies have proven that many people with type 2 diabetes can reach normal blood glucose levels when they make these changes.
Biguanides
This group of medication is a remedy for diabetes mellitus type 2 because it lowers the blood glucose levels in several ways. Biguanides decrease the amount of glucose absorbed in the stomach and intestines. They decrease the amount of glucose that is made by the liver by interfering with glycogenolysis and gluconeogenesis. Glycogenolysis is the process in which the liver breaks down glycogen, or stored glucose. Gluconeogenesis is the process which the liver makes glucose. Biguanides also stimulate the tissues to use glucose, which decreases the glucose levels in the bloodstream. Jill Crandall, M.D., Associate Professor of Clinical Medicine at Albert Einstein College of Medicine writes in "The Merck Manual for Healthcare Professionals" that the only type of biguanide that is prescribed in America is called metformin.
Thiazolidinediones
Insulin decreases the blood glucose levels, but the tissues of people who have diabetes type 2 are not as sensitive to insulin as they should be. The thiazolidinediones make the tissues more sensitive to insulin, according to Alvin Powers, M.D., Director of the Vanderbilt Diabetes Center, writing in "Harrison's Principles of Internal Medicine." This medication makes the fat and muscle use more glucose and interferes with the gluconeogenesis of the liver. Two are in use as of June, 2010: thiazolidinediones rosiglitazone and pioglitazone.
Alpha-glucosidase Inhibitors
Alpha-glucosidase inhibitors interfere with, or inhibit, an enzyme in the small intestines called alpha-glucosidase. Enzymes are proteins within the body that speed up the time that reactions take. Dr. Powers explains in "Harrison's Principles of Internal Medicine" that because this remedy inhibits alpha-glucosidase, it takes the small intestines longer to absorb carbohydrates. Miglitol and acarbose are examples of this type of medication.
Sulfonylureas
The cells in the pancreas called the beta cells release insulin. In "The Merck Manual for Healthcare Professionals," Dr. Crandall writes that the sulfonylureas are medications that stimulate the beta cells to make them secrete. This remedy for diabetes may also help the liver and the tissues become more sensitive to insulin. The sulfonylureas include glipizide, glyburide and chlorpropamide.
Insulin
All of the cells and tissues of the body, except for the liver, brain and the red blood cells, need insulin to move glucose from the bloodstream into the cells or tissues. There are different formulas of synthetic insulin. They differ by the times that they start to work and by how long their effects last.
References
- Centers for Disease Control and Prevention: 2007 National Diabetes Fact Sheet
- "Handbook of Pathophysiology"; Elizabeth Corwin, MSN, Ph.D., FNP; 2000
- "Harrison's Principles of Internal Medicine"; Anthony Fauci, M.D., Dennis Kasper, M.D., Dan Longo, M.D. et al.; 2008
- The Merck Manual for Healthcare Professionals: Diabetes Mellitus (DM)
