Dr. MJ Bazos MD,
What is type 2 diabetes?
Diabetes is a disease that occurs when
your body doesn’t make enough of a hormone called insulin, or when your
body can’t use insulin the right way. Insulin helps balance the level of
glucose (sugar) in your blood. The blood sugar level is too high in people with
diabetes. Children usually get type 1 diabetes, which means their body
doesn’t make insulin at all. Adults usually get type 2 diabetes, which
means their body makes insulin, but it doesn’t make enough or they
can’t use it properly. How is
diabetes treated? The goal of diabetes
treatment is to keep your blood sugar level as close to normal as possible. The
first step is to have a healthy diet and to exercise. This may mean you’ll
need to change your diet and exercise habits. You’ll also have to watch
your weight, or even lose weight, to keep your blood sugar level as normal as
possible. Your doctor will talk to you about the kinds of food you should eat
and how much exercise you’ll need every week.
Sometimes diet and exercise alone
can’t keep your blood sugar levels normal. Then your doctor will talk to
you about other treatments, such as medicine or insulin shots.
Many people with diabetes find it
fairly easy to keep track of their own blood sugar level at home. Your doctor
can use the results to see how your treatment is working.
Are there medicines I can take?
Several kinds of medicine can help you
control your blood sugar level. Some medicines are pills that you take by mouth
(orally). Oral medicine doesn’t work for everyone, though. Some people
need to take insulin. If you need insulin, you’ll have to give yourself a
shot. Most people with type 2 diabetes start with an oral medicine. Your doctor
will tell you which kind of medicine you should take and why.
What is combination
therapy? Combination therapy uses 2
medicines to help you control your blood sugar level. It can also help with
other health problems (such as having high blood pressure or high cholesterol
levels, or being overweight). Each medicine works in a slightly different way.
This therapy can combine 2 oral medicines, or 1 oral medicine plus insulin.
What medicines could my doctor
prescribe? Six kinds of diabetes
medicine are available in pill form: sulfonylureas, metformin,
thiazolidinediones, alpha-glucosidase inhibitors, repaglinide and nateglinide.
Each medicine has good points and bad points. Your doctor will decide which
medicine is right for you.
Sulfonylureas (some brand names:
Glucotrol, Micronase) are the most commonly prescribed diabetes medicines. They
are inexpensive and have few side effects. These medicines help your body make
insulin. They can be taken alone or with metformin, an alpha-glucosidase
inhibitor, pioglitazone or insulin. If you’re allergic to sulfa, you
can’t take a sulfonylurea.
Metformin (brand name: Glucophage) may
be prescribed for people with diabetes who are overweight, because it may help
with weight problems. It helps the body use insulin better. Metformin can cause
problems like nausea or diarrhea in some people. It can be taken with a
This class of medicines includes
rosiglitazone (brand name: Avandia) and pioglitazone (brand name: Actos). An
older medicine, troglitazone (brand name: Rezulin) is no longer being made
because of the risk of liver problems. Resiglitazone and pioglitazone appear
less likely to cause liver problems, but people taking them need periodic liver
tests. These medicines help your
bodyrespond better to insulin.
Resiglitazone and pioglitazone can be used alone or in combination with other
Alpha-glucosidase inhibitors (brand
names: Precose, Glyset) work in your stomach and bowels to slow down the
absorption of sugar. If another medicine doesn’t control your blood sugar,
you might use this kind. This medicine can cause stomach or bowel problems, so
it may not be a good choice if you have a history of stomach or bowel trouble.
It can be taken alone or with a sulfonylurea.
Repaglinide (brand name: Prandin) is
taken with meals to control your blood sugar. Your doctor can tell you how to
adjust the dose according to the number of meals you eat. Repaglinide can be
taken alone or with metformin.
Nateglinide (brand name: Starlix) is
taken with meals to keep your blood sugar level from getting too high after you
eat. Nateglinide can be taken alone or with metformin.
Diabetes Association: www.diabetes.org