Type 2 Diabetes: Recently Diagnosed
Medications
Oral medications to treat type 2 diabetes increase insulin production, decrease insulin resistance, or slow intestinal absorption of carbohydrate, the nutrient that most affects blood sugar.
Two or more medications may lower your blood sugar level more effectively than a single medication; also, taking two or more medications may reduce side effects by allowing lower doses of each medication.
You may need to take insulin temporarily if you have surgery or are severely ill, pregnant, or breast-feeding. You also may need to take insulin daily by injection if your health professional believes that you would benefit from it or if your pancreas stops producing insulin.
Medications also may be used to reduce your risk of complications. A daily low-dose ASA may help prevent a heart attack, stroke, or other large blood vessel disease (macrovascular disease). If you are 21 or older, talk to your health professional about taking ASA as part of your treatment.5 You can reduce your risk further by lowering high blood pressure and high cholesterol.
Medication Choices
Medications that increase insulin production
- Sulfonylureas, such as gliclazide (Diamicron), glyburide (for example, DiaBeta or Euglucon), and glimepiride (Amaryl).
- Meglitinides, such as repaglinide (GlucoNorm) and nateglinide (Starlix)
Medications that decrease insulin resistance
- Biguanides, such as metformin (Glucophage) and the combination medication of rosiglitazone and metformin (Avandamet)
- Thiazolidinediones, such as rosiglitazone (Avandia), pioglitazone (Actos), and the combination of rosiglitazone and metformin (Avandamet)
Medications that slow intestinal absorption of carbohydrates
- Alpha-glucosidase inhibitors, such as acarbose (Prandase).
A new type of medicine that lowers both fasting blood sugar and blood sugar after eating
Incretin mimetics, such as exenatide (Byetta). Exenatide (Byetta) recently was approved by the U.S. Food and Drug Administration (FDA) for people with type 2 diabetes. Exenatide (Byetta) is not yet approved for use in Canada. Your doctor may recommend Byetta if you have not been able to control your blood sugar with oral medicines such as metformin or a sulfonylurea. Byetta may be taken by itself or with other oral medicines. It is given as a shot 2 times a day, before morning and evening meals.
Insulin
A new medicine called Symlin was approved by the FDA to be used with insulin. It is not approved for use in Canada. It may be used in people with type 1 or type 2 diabetes who take insulin. Symlin is a man-made form of the hormone amylin. Amylin is made in the pancreas. It works with insulin and glucagon to help control blood sugar. Symlin is given as a shot before meals.
What to Think About
You may also need to take:
- Medications that control blood pressure, if you have high blood pressure.
- Medications that control cholesterol, if you have high cholesterol.
- An angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB), if you have protein in your urine, an indication of diabetic nephropathy. If you become pregnant, your doctor will prescribe other medications, because ACE inhibitors and ARBs cannot be taken during pregnancy.
A new study shows that people who take rosiglitazone (Avandia) raise their chance of having a heart attack. They may also raise their chance of death from heart disease. If you take Avandia, do not stop taking the medicine. Call your doctor to talk about which medicine is best for you.
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| Author: | Merrill Hayden Carrie Henley | Last Updated: November 27, 2006 |
| Medical Review: | Adam Husney, MD - Family Medicine Caroline S. Rhoads, MD - Internal Medicine Hanan Bassyouni, MD - Endocrinology and Metabolism Matthew I. Kim, MD - Endocrinology & Metabolism | |
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