Diabetes mellitus is a disease characterized by the absence or resistance to the hormone insulin. According to the American Diabetes Association, more than 23 million Americans are living with diabetes. Medicinal treatment is an important component of diabetes management to help prevent comorbidities such as cardiovascular and renal diseases.
Type I Diabetes
Type I diabetes is often diagnosed in children and young adults. In type I diabetes, the pancreas is unable to produce adequate quantities of insulin. The exact cause of type I diabetes is not known, however according to experts at the Mayo Clinic, type I diabetes is associated with an autoimmune response in which the body's immune system damages the pancreas.
Insulin for Type I Diabetes
Individuals with type I diabetes require insulin shots. There are several types of insulin that are categorized by their peak effect and duration of action. Examples include the rapid acting insulin Humalog NPH, an intermediate acting insulin; and Lantus, a long-acting insulin. According to the American Dietetic Association Nutrition Care Manual, rapid acting insulins are usually given with each meal, whereas the longer acting insulins are injected once per day. Individualized combinations of the different types of insulin can be used depending on the patient's lifestyle and eating habits.
Type II Diabetes
According to a review published in the January 2002 edition of the Journal of the American Medical Association, type II diabetes is characterized by a decreased insulin output by the pancreas and resistance to insulin function in organs such as the liver, muscle and adipose tissue. The causes of type II diabetes are multifactorial and include genetics and obesity.
Traditional Medications for Type II Diabetes
Several types of medications have traditionally been prescribed for treatment of type II diabetes. These medications are referred to as oral hypoglycemic agents and all have the common goal of maintaining low blood glucose. According to a review published in the Journal of the American Medical Association, there are several mechanisms by which these medications work. For example, alpha-glucosidase inhibitors such as Acarbose, slow the digestion of dietary carbohydrates by inhibiting enzymes in the intestine. Sulfonylureas, such as Glipizide, work on the pancreas to help increase insulin production. Thiazolidinediones, such as Actos, bind to receptors on muscle and adipose cells that help regulate genes involved in glucose metabolism. Metformin, a medication classified as a Biguanide, helps to maintain low blood glucose by reducing the production of glucose by the liver. Combination therapy with two different classes of oral hypoglycemic agents is common.
New Medications for Type II Diabetes
Insulin secretion is enhanced by proteins produced in the intestines called incretins. According to a 2006 article in the Journal of the American Board of Family Medicine, drugs that target incretin metabolism are the latest class of medications for the treatment of type II diabetes. These medications work by either mimicking the action or inhibiting the breakdown of incretins. Byetta and Januvia are examples of type II diabetic medications that target the incretin system.
