Type 2 Diabetes: Living With the Disease
Medications
Several oral medicines are available to treat type 2 diabetes. These medicines increase insulin production, decrease insulin resistance, or slow intestinal absorption of carbohydrate.
You may need more than one medicine to adequately control your diabetes. Together, two or more medicines may work more effectively than a single medicine to lower blood sugar level. Taking two medicines together may reduce side effects by allowing lower doses of each. But in some cases, taking two medicines can increase the risk of side effects, such as low blood sugar (hypoglycemia).
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 as a shot if lifestyle and pills (oral medicines) are not controlling your blood sugar, or if your pancreas stops producing insulin.
Medicines also may be needed to prevent or slow the development of complications.
Medication Choices
ASA may be recommended to prevent heart attack, stroke, or other large blood vessel disease (macrovascular disease).16 If you are age 21 or older, talk to your health professional about whether you should take a low-dose ASA daily.
Medicines that increase insulin production are:
- Sulfonylureas, such as glyburide (DiaBeta), gliclazide (Diamicron), or glimepiride (Amaryl).
- Meglitinides, such as repaglinide (Gluconorm) and nateglinide (Starlix).
Medicines that decrease insulin resistance are:
- Biguanides, such as metformin (Avandamet).
- Thiazolidinediones, such as rosiglitazone (Avandia), pioglitazone (Actos), or the combination of rosiglitazone and metformin (Avandamet).
Medicines that slow intestinal absorption of carbohydrate are:
- Alpha-glucosidase inhibitors, such as acarbose (Glucobay).
Insulin
Medications to control blood pressure and cholesterol
You may need medicines to lower your blood pressure and cholesterol, reducing your risk for heart disease and large blood vessel disease.
- Angiotensin-converting enzyme (ACE) inhibitors or thiazide diuretics may be used to lower your blood pressure to the goal of less than 130/80 millimetres of mercury (mm Hg).
- Cholesterol-lowering medicines known as statins reduce LDL levels and the risk of heart disease in people with diabetes.7 They also have been shown to reduce the risk of heart attack and stroke by one-third in people with diabetes, even those who do not have high LDL levels or existing heart disease.11
What to Think About
You will need to take ACE inhibitors or ARBs if you have protein in your urine, a sign of diabetic nephropathy. Effective control of your blood sugar also is essential to prevent progression of nephropathy.
Health Canada has announced a possible safety issue with the drug rosiglitazone (Avandia, Avandamet, and Avandaryl). A new study shows that people who take Avandia raise their chance of having a heart attack. They may also raise their chance of death from heart disease.
Manufacturers of rosiglitazone (Avandia), pioglitazone (Actos), rosiglitazone, and glimepiride (Amaryl) have added a warning that these drugs may cause or worsen heart failure in certain people.
If you take any of these medicines, do not stop taking them. Call your doctor to talk about which medicine is best for you.
More information
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| Author: | Alison Allen Caroline Rea, RN, BS, MS | Last Updated: November 14, 2007 |
| Medical Review: | Anne C. Poinier, MD - Internal Medicine Caroline S. Rhoads, MD - Internal Medicine Matthew I. Kim, MD - Endocrinology & Metabolism David C.W. Lau, MD, PhD, FRCPC - Endocrinology & Metabolism | |
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