In a recent prospective study conducted in the United Kingdom, it was shown less than twenty-five percent of people with Type 2 diabetes who rely on diet and exercise are able to maintain their blood sugar level within normal limits, according to APC Diabetes Care Guide.
Furthermore, less than ten percent of these diabetics achieve their blood sugar goal after nine years. As a result of this rather poor blood sugar control, diabetologists around the world agreed that the use of drugs to help fight the disease is an integral part of management of Type 2 diabetes. The hope is more diabetics can control their blood sugar levels. The more this blood parameter is controlled, the more chance there will be of preventing long-term complications.
Although many people find they can bring their blood sugar back to a normal range by limiting their carbohydrate intake, not everyone is prepared to follow such a restrictive plan for the rest of their lives.
What are the different types of anti-diabetic medications?
1. Insulin: Insulin is a special hormone synthesized within the body to facilitate the transport of glucose across the cell membranes to provide energy which is required both for cell function and survival. In diabetics, the pancreas which is the producer of insulin, becomes exhausted resulting in lesser amounts of insulin circulating in the blood. Decreased amounts of insulin leads to less energy being transported to the cells and this, in turn, results in an array of complications that may have been prevented with the normal level of insulin.
So, with the administration of insulin via injection, immediate and long-term complications may be prevented. And with the regular use of insulin, glucose utilization within the cells can be normalized and, of course, blood sugar level will be better controlled.
2. Oral anti-diabetic medications: Oral anti-diabetic medications are more frequently used in people with Type 2 diabetes compared to insulin. It is usually started when a Type 2 diabetic is unable to achieve normal blood sugar levels despite lifestyle modifications. There are different kinds of oral anti-diabetic medications and these can be classified according to their particular method of action in achieving better blood sugar control:
- Insulin secretagogues stimulate the pancreas to secrete more insulin. The best known include sulfunylureas: glyburide (Micronase, DiaBeta, Glynase), and glipizide (Glucotrol), and non-sulfunylureas secretagogues which include repaglinide (Prandin) and nateglinide (Starlix)
- Insulin sensitizers enhance the sensitivity of muscles and fat to the stimulation of insulin. With better insulin sensitivity, the transport of glucose across the cell membranes of muscles and fat is more efficient. The types of insulin sensitizers biguanides, includes metformin (Glucophage). The ADA recommends metformin should be the first drug prescribed for a person with Type 2 Diabetes. Unlike so many other drugs metformin does not cause weight gain. Metformin is also used in combination with insulin or other oral anti-diabetic medications.
The natural course of Type 2 diabetes results in progressive insulin secretion failure from the pancreas and worsening of insulin resistance, or a decreased response of cells and tissues to the action of insulin. But with appropriate and timely administration of these medications, problems can be prevented. Later stage complications of uncontrolled Type 2 diabetes and blood sugar such as:
- cardiovascular diseases
- renal complications
- nerve complications, and
- eye complications
can also be avoided or, at least, delayed.
It should also be stated that oral anti-diabetic medications have limited power… alone they cannot bring your blood sugar levels back into the normal range… they are an add-on to dietary control.
Anupam Ghose, a physician by training, was diagnosed with Type 2 Diabetes Mellitus (T2DM) in 2017. After the diagnosis of T2DM, he followed a low carbohydrate high fat diet and reversed his T2DM within a year. Now he has one main goal in life. Yes, it is to make people understand that the conventional method of treating T2DM is not beneficial. The best way to reverse T2DM is through diet and lifestyle modification. He decided to help people suffering from T2DM in their new journey by offering consultations and working together with them in order to achieve a T2DM free life.