Diabetes mellitus is a clinical condition that results from a deficiency in the functions of insulin, with resultant excessively high levels of blood glucose. There are two types of diabetes: Type 1, characterized by a deficiency in insulin production by a disease in the pancreas and an early onset in life; and Type 2, characterized by later onset and deficiency in production of and response to secreted insulin.
Diabetes mellitus predisposes to several serious complications if left untreated. All medications for diabetes are geared toward lowering blood sugar. Medications for Type 2 diabetes are numerous and are classified according to function and parent compounds.
Insulin Injections
Insulin is used to treat complicated presentations of diabetes, especially in patients who are unconscious or unable to tolerate tablets. It's also used in a small percentage of Type 2 diabetics who don't respond well to lifestyle changes and pills. There are three types of Insulin, according to the length of time they work.
Short-acting or rapid onset insulin preparations are the choice in acute situations and as adjunct to long-acting preparations. They require repeated shots during the day. Examples are Humulin R, Humalog and Novolog.
Intermediate and long-acting insulin preparations are the more popular preparations available to diabetics, because they usually require once or twice daily dosing. Examples are Humulin N, Novolin N, Levemir and Lantus.
There are also premixed preparations that combine short-acting and intermediate or long-acting forms in a single delivery in particular proportions for added advantages.
Oral Diabetic Medications
Biguanides such as Metformin (glucophage) work by stopping the liver from releasing stored glucose or producing more glucose. It's one of the few diabetic medications that don't lead to weight gain.
Sulfonylureas (Amaryl, Glucotrol, Diabeta) and Meglitinides (Prandin, Starlix) act on the pancreas to increase insulin production and secretion.
Thiazolidinediones (Avandia, Actos) act on insulin receptors to reduce insulin resistance and increase its effectiveness.
Alpha-glucosidase inhibitors (Precose, Glycet) act in the intestines to reduce and slow down the absorption of glucose.
Combinations of these oral forms are also available to combine therapeutic advantages like Avandaryl (Avandia and Amaryl) or Glucovance (Diabeta and Glucophage).
Lifestyle Changes
The mainstay of diabetes treatment remains lifestyle changes involving diet and exercise and a close monitoring of blood sugar to ensure the effectiveness of therapy. Early involvement of doctors to supervise all facets of treatment ensures successful treatment plans and prevention of complications of persistently uncontrolled diabetes, including heart disease, stroke and blindness.
