Type 2 diabetes is one of a cluster of diseases in which blood glucose levels rise to abnormal levels due to defects in insulin function and production. Diet and exercise play a pivotal role; however, over time, medication management will be necessary. Regulating blood sugar is a multi-organ process in healthy individuals. Research has lead the way for new medications that target the organ while the individual continues to target the lifestyle.
Target Organs
Diabetes medications fall into different categories based on the target organ. The pancreas produces insulin, and the liver produces glucose. The body cells require insulin not only for transport, but also for entry into the cells to be used as fuel. The stomach releases a burst of insulin in response to a burst of glucose. The stomach also releases enzymes that inhibit this response. Mimicking the natural process is now possible.
Classifications
Medications are organ specific. The mechanism of action will determine the drug's classification. Secretagogues prompt insulin secretion by the pancreas. Sensitizers can either decrease the amount of sugar released from the liver, or increase insulin sensitivity within the muscle and body cells. Starch blockers slow the digestion of glucose after a meal. Inhibitors and mimetics ensure insulin is secreted only when blood sugar levels are high. External insulin can now mimic the pancreas.
Combinations
Diabetes is a progressive disease. Insulin resistance is the initial problem with insulin insufficiency over time. Initial diagnosis may simply require lifestyle change as a means of control; however, medication management is inevitable. Several medications may be required for the control of blood sugar. Combination pills are available that combine different classes of drugs in an attempt to decrease the number of pills taken at one time.
Side Effects
Diabetes medications can have side effects. Hypoglycemia, low blood sugar, is of paramount concern. Prompt treatment is necessary for preventing insulin shock. The secretagogues and injected insulin have the highest risk of prompting low blood sugar. Other side effects are dependent upon the target organ. Sensitizers and blockers can prompt bloating, gas and diarrhea. Certain labs such as liver function may also need monitoring. Other medications can interfere with diabetes medications and cause side effects.
Expert Insight
It must be stressed that diabetes is a progressive disease. Lifestyle is the primary intervention for Type 2 diabetes; however, medication management is inevitable. Individuals must realize that the addition of one or more medications is not necessarily a sign of failure on their part. There is only so much food to be given up, and only so much physical activity to be done. If they are not working, then medication management is required.
