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Diabetes Treatment Continued

Jessica Evert, MD, edited by Benjamin McDonald, MD

pills spilling from bottleMedicine. While some Type 2 diabetics find that diet and exercise alone are sufficient to help them manage their blood sugar, others require additional medical assistance. When this is the case, doctors may prescribe one or more medications to help Type 2 diabetics with blood sugar control. Different medications approach the task of sugar regulation from different angles and mechanisms. The following is a list of basic information about the most commonly prescribed medications for type 2 diabetes: 

Sulfonylureas: This group of medicines works by causing the pancreas to secrete more insulin. These drugs have been around for a few years and have proven to be very safe with minimal side effects. For this reason, the sulfonylureas are commonly used as first line therapy in people with type two diabetes.

Meglitinides: These medicines work by increasing insulin release from the pancreas much like the sulfonylureas. However, the meglitinides are much shorter acting and are thus taken multiple times a day before meals. The potential advantage is that they may more closely mimic the natural daily variation in insulin levels.

Biguanides: This class of medications works by decreasing the amount of glucose that is released from the liver. Metformin is a very popular biguanide among physicians as it has less risk of hypoglycemic episodes compared to the sulfonylureas.

Alpha-glucosidase inhibitors: These medicines work by slowing down carbohydrate absorption in the intestines. This helps ensure that a patient with diabetes will not experience abrupt spikes in their blood glucose levels. These medications have fallen largely out of favor because they cause most patients gastrointestinal distress.

Thiazoladinediones: Also known as the glitazones, this group of medications works by making a patient's tissues and cells more receptive to the effects of insulin. This allows more glucose to get into the cells more efficiently. Unfortunately, these medicines are newer and are thus rather expensive compared to the others in this list.

Hospitalization. Despite best efforts, there are times when diabetic patients are unable to keep their blood sugar under control, and severe hyperglycemia or hypoglycemia states or even unconsciousness (coma) occur. Immediate emergency medical treatment is required in such circumstances. At the hospital, doctors can re-balance body systems back towards a normal and healthy state.

Some people with diabetes may also require hospitalization when consequences of diabetes (cardiovascular disease, infection, limb and vision problems, etc.) become health crises in their own right.