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Is Insulin Better Than Oral Medications?

Patient Education: Diabetes Mellitus Type 2: Insulin Treatment (beyond The Basics)

Patient Education: Diabetes Mellitus Type 2: Insulin Treatment (beyond The Basics)

TYPE 2 DIABETES OVERVIEW Type 2 diabetes mellitus occurs when the pancreas (an organ in the abdomen) produces insufficient amounts of the hormone insulin and/or the body's tissues become resistant to normal or even high levels of insulin. This causes high blood glucose (sugar) levels, which can lead to a number of complications if untreated. People with type 2 diabetes require regular monitoring and ongoing treatment to maintain normal or near-normal blood sugar levels. Treatment includes lifestyle adjustments, self-care measures, and medications, which can minimize the risk of diabetes-related and cardiovascular complications (eg, heart attacks and strokes). Learning to manage diabetes is a process that continues over a lifetime. The diagnosis of diabetes can be overwhelming at the beginning; however, most people are able to lead normal lives, and many patients become experts in their own care. This topic review discusses the role of insulin in blood sugar control for patients with type 2 diabetes. Separate topic reviews about other aspects of type 2 diabetes are also available. (See "Patient education: Diabetes mellitus type 2: Overview (Beyond the Basics)" and "Patient education: Self-monitoring of blood glucose in diabetes mellitus (Beyond the Basics)" and "Patient education: Hypoglycemia (low blood sugar) in diabetes mellitus (Beyond the Basics)" and "Patient education: Diabetes mellitus type 2: Alcohol, exercise, and medical care (Beyond the Basics)" and "Patient education: Preventing complications in diabetes mellitus (Beyond the Basics)".) IMPORTANCE OF BLOOD SUGAR CONTROL IN TYPE 2 DIABETES Keeping blood sugar levels in control is one way to decrease the risk of complications related to type 2 diabetes. The most common complication of type 2 diabetes is heart d Continue reading >>

Insulin Injection

Insulin Injection

Insulin injection is used to control blood sugar in people who have type 1 diabetes (condition in which the body does not make insulin and therefore cannot control the amount of sugar in the blood) or in people who have type 2 diabetes (condition in which the blood sugar is too high because the body does not produce or use insulin normally) that cannot be controlled with oral medications alone. Insulin injection is in a class of medications called hormones. Insulin injection is used to take the place of insulin that is normally produced by the body. It works by helping move sugar from the blood into other body tissues where it is used for energy. It also stops the liver from producing more sugar. All of the types of insulin that are available work in this way. The types of insulin differ only in how quickly they begin to work and how long they continue to control blood sugar. Over time, people who have diabetes and high blood sugar can develop serious or life-threatening complications, including heart disease, stroke, kidney problems, nerve damage, and eye problems. Using medication(s), making lifestyle changes (e.g., diet, exercise, quitting smoking), and regularly checking your blood sugar may help to manage your diabetes and improve your health. This therapy may also decrease your chances of having a heart attack, stroke, or other diabetes-related complications such as kidney failure, nerve damage (numb, cold legs or feet; decreased sexual ability in men and women), eye problems, including changes or loss of vision, or gum disease. Your doctor and other healthcare providers will talk to you about the best way to manage your diabetes. Insulin comes as a solution (liquid) and a suspension (liquid with particles that will settle on standing) to be injected subcutaneousl Continue reading >>

Diabetic Medications And Exercise, Part 1: Oral Medications

Diabetic Medications And Exercise, Part 1: Oral Medications

Sheri Colberg, Ph.D., FACSM, has been helping patients with diabetes successfully increase physical activity for many years and has written numerous books that patients and clinicians use. Most of her work recently has been about insulin and exercise, but many of you have written me to ask, “What about oral medications?” This week Dr. Colberg begins explaining oral medications in Diabetic Medications and Exercise, Part 1: Oral Medications. Diabetic Medications and Exercise, Part 1: Oral Medications By Sheri Colberg, Ph.D., FACSM If you use any of the oral diabetes medications, knowing their potential glucose-lowering effects is important. In general, oral medications for diabetes target one or more of three metabolic disorders found in diabetes; decreased insulin production by the beta cells of the pancreas, elevations in the production of glucose by the liver, or increased insulin resistance in muscle and fat tissues. Their many classes, differing actions, and names are listed in table 3.3. If you ever experience a change in your exercise routine, you may need to consult with your doctor about adjusting the doses of oral medications that you take, particularly if you begin to engage regularly in more physical activity than you did before. Key Point: An increase in your activity level may require you to lower your doses, even of oral diabetes medications that do not usually cause exercise-related low blood sugars. Sulfonylureas A class of drugs called sulfonylureas was the only one available to treat Type 2 diabetes for many years. They work by stimulating insulin release from the pancreas and decreasing insulin resistance. The only first-generation one still on the market is Diabinese (generic name: chloropropamide), which can last for up to 72 hours. Its long dura Continue reading >>

Oral Medication For The Treatment Of Women With Gestational Diabetes

Oral Medication For The Treatment Of Women With Gestational Diabetes

What is the issue? Globally the number of women being diagnosed with gestational diabetes mellitus (GDM) is increasing. GDM is an intolerance to glucose leading to high blood sugars, first recognised during pregnancy and usually resolving after birth. Standard care involves lifestyle advice on diet and exercise. Treatment for some women includes oral anti-diabetic medications, such as metformin and glibenclamide, which are an alternative to, or can be used alongside, insulin to control the blood sugar. This review aimed to investigate benefits of taking oral medication to treat GDM in pregnant women. Another Cochrane Review compares the effects of insulin with oral anti-diabetic pharmacological therapies ( Brown 2016). Why is this important? Women diagnosed with GDM are at a greater risk of experiencing complications such as high blood pressure during pregnancy and at birth. They have an increased risk of developing diabetes later in life. The babies of women who have been diagnosed with GDM can be larger than normal and this can cause injuries to the mother and the baby at birth. The birth is more likely to be induced or the baby born by caesarean section. These babies are at risk of developing diabetes as children or young adults. Finding the best medications to treat the women and prevent the complications that are linked to GDM is therefore important. What evidence did we find? We searched for studies on 14 May 2016. We included 11 randomised controlled trials involving 1487 mothers and their babies (but only eight trials contributed data to our analyses). The evidence was limited by the quality and number of studies and we advise caution when looking at the results. The criteria for diagnosis of GDM and treatment targets varied between studies, and each outcome is Continue reading >>

Insulin And Type 2 Diabetes: What You Should Know

Insulin And Type 2 Diabetes: What You Should Know

Insulin and Type 2 Diabetes If your health care provider offered you a medication to help you feel better and get your blood sugar under control, would you try it? If so, you might be ready to start taking insulin. Does insulin immediately make you think of type 1 diabetes? Think again. Between 30 and 40 percent of people with type 2 diabetes take insulin. In fact, there are more people with type 2 diabetes who take insulin than type 1 because of the much larger number of people with type 2. Experts believe even more people with type 2 should be taking insulin to control blood sugar -- and the earlier, the better. With an increase in people developing type 2 at a younger age and living longer, more and more people with type 2 will likely be taking insulin. "If you live long enough with type 2 diabetes, odds are good you'll eventually need insulin," says William Polonsky, Ph.D., CDE, associate clinical professor of psychiatry at the University of California, San Diego; founder and president of the Behavioral Diabetes Institute; and author of Diabetes Burnout: What to Do When You Can't Take It Anymore (American Diabetes Association, 1999). Producing Less Insulin Naturally Over Time Research has shown that type 2 diabetes progresses as the ability of the body’s pancreatic beta cells to produce insulin dwindles over time. Your beta cells -- the cells in the pancreas that produce insulin -- slowly lose function. Experts believe that by the time you're diagnosed with type 2 diabetes, you've already lost 50-80 percent of your beta cell function and perhaps the number of beta cells you had. And the loss continues over the years. "About six years after being diagnosed, most people have about a quarter of their beta cell function left," says Anthony McCall, M.D., Ph.D., endocri Continue reading >>

Insulin For Type 2 Diabetes: When, Why, And How

Insulin For Type 2 Diabetes: When, Why, And How

Blood sugar control is one of the most important parts of type 2 diabetes management. Although you may be able to treat the condition at first with oral medication and lifestyle changes, such as exercise and weight loss, most people with type 2 diabetes eventually need to take insulin by injection. "There are several scenarios in which insulin treatment should start, including in patients with significant hyperglycemia who are symptomatic," explained Alaleh Mazhari, DO, an associate professor of endocrinology at Loyola Medicine in Maywood, Illinois. "In these cases, the need for insulin may be short-term. Other situations include patients who are on multiple diabetic medications with uncontrolled diabetes, and uncontrolled diabetes in pregnancy, to name a few." Here's what you need to know about taking insulin in the short term and the long term. Insulin for Short-Term Blood Sugar Control Doctors use a blood test called a hemoglobin A1C test to measure average blood sugar control over a two- to three-month period. The treatment target for most people with diabetes is an A1C of 7 percent or less; those with higher levels may need a more intensive medication plan. "The American Association of Clinical Endocrinologists recommends starting a person with type 2 diabetes on insulin if their A1C is above 9 percent and they have symptoms," said Mazhari. Symptoms of type 2 diabetes include thirst, hunger, frequent urination, and weight loss. Research published in February 2013 in the journal The Lancet Diabetes & Endocrinology reviewed several studies that focused on the temporary use of insulin to restore sugar control in people with type 2 diabetes. The results showed that a two- to five-week course of short-term intensive insulin therapy (IIT) can induce remission in patients Continue reading >>

Diabetes Type 2

Diabetes Type 2

Many people with type 2 diabetes are prescribed tablets to help control their blood glucose levels. Metformin is the first-line medication for diabetes in the UK but there are many more types of medication for type 2 diabetes discussed below. Most people had tried initially to control their blood glucose with a regimen of diet and exercise before being given oral medication. Many people took metformin alone to control blood glucose, and some were taking metformin and gliclazide. Both medications help to reduce blood glucose but work differently. Metformin reduces the amount of glucose produced in the liver, and also makes muscle tissue absorb more glucose; gliclazide increases the amount of insulin produced by the pancreas. While people found that the medication they took had helped reduce and control their blood glucose, many had experienced side effects. Metformin can cause diarrhoea and other digestive problems and many people went back to their GPs for advice. Some people felt concerned about the risks they might face from certain drugs after reading negative reports in the media (see 'Misunderstandings about diabetes'). Rosiglitazone has been linked to an increased risk of heart attack and stroke. Since these interviews were conducted in 2008, there has been growing concern about the potential harmful effects of rosiglitazone (Avandia, but also contained in Avandamet and Avaglim) and from September 2010 in the UK and Europe, new prescribing of this drug has stopped, and most people who were taking the drug have been changed to alternative medication. Most people we interviewed had been prescribed higher dosages of medication to control their blood glucose as their diabetes got worse over time. Some people had transferred to insulin while continuing on metformin (se Continue reading >>

7 Differences Between Metformin And Insulin

7 Differences Between Metformin And Insulin

Metformin and insulin are very popular in the treatment of either type 1 or type 2 diabetes depending on which type you have. Although both of these drugs are used in treatment for diabetes they are very different from one another and are used for entirely different reasons. Some of the key differences between metformin and insulin include: Metformin is only used in the treatment of type 2 diabetes whereas insulin can be used for both Metformin is taken orally where insulin can only be taken by injection Insulin is used to lower glucose levels where metformin lowers the production of glucose in the liver You can develop hypoglycemia when taking insulin but not when taking metformin Insulin is a hormone that is naturally produced in the body where metformin does not Metformin makes muscle cells more sensitive to insulin uptake where insulin injections have no effect on muscle or cellular sensitivity Recent studies suggest that metformin yields better results than insulin in the treatment of gestational diabetes For someone with diabetes, it is always good to understand the difference between the different treatment options available to you Note: The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek medical advice for any questions regarding a medical condition or changes in your treatment. Diabetes is not a barrier for people in the workplace. A person with diabetes can still work and... Diabetic Nephropathy is nothing other than the kidney damage that occurs as the result of diabetes... Tweets by @diabetv Continue reading >>

Type 2 Diabetes And Insulin

Type 2 Diabetes And Insulin

People with type 2 diabetes do not always have to take insulin right away; that is more common in people with type 1 diabetes. The longer someone has type 2 diabetes, the more likely they will require insulin. Just as in type 1 diabetes, insulin is a way to control your blood glucose level. With type 2 diabetes, though, dietary changes, increasing physical activity, and some oral medications are usually enough to bring your blood glucose to a normal level. To learn about how the hormone insulin works, we have an article that explains the role of insulin. There are several reasons people with type 2 diabetes may want to use insulin: It can quickly bring your blood glucose level down to a healthier range. If your blood glucose level is excessively high when you are diagnosed with type 2 diabetes, the doctor may have you use insulin to lower your blood glucose level—in a way that’s much faster than diet and exercise. Insulin will give your body a respite; it (and especially the beta cells that produce insulin) has been working overtime to try to bring down your blood glucose level. In this scenario, you’d also watch what you eat and exercise, but having your blood glucose under better control may make it easier to adjust to those lifestyle changes. It has fewer side effects than some of the medications: Insulin is a synthetic version of a hormone our bodies produce. Therefore, it interacts with your body in a more natural way than medications do, leading to fewer side effects. The one side effect is hypoglycemia. It can be cheaper. Diabetes medications can be expensive, although there is an array of options that try to cater to people of all economic levels. However, insulin is generally cheaper than medications (on a monthly basis), especially if the doctor wants yo Continue reading >>

Should I Use Diabetes Pills Or Insulin?

Should I Use Diabetes Pills Or Insulin?

Diabetes affects the way your body breaks down food. Treatment depends on which type of diabetes you have. In type 1 diabetes, your pancreas stops producing insulin. Insulin is a hormone that helps regulate glucose, or sugar, in your blood. Type 2 diabetes starts with insulin resistance. Your pancreas no longer produces enough insulin or doesn’t use it efficiently. Every cell in your body uses glucose for energy. If insulin isn’t doing its job, glucose builds up in your blood. This causes a condition called hyperglycemia. Low blood glucose is called hypoglycemia. Both can lead to serious complications. A variety of pills are available to treat diabetes, but they can’t help everyone. They only work if your pancreas still produces some insulin. They can’t treat type 1 diabetes. They aren’t effective in people with type 2 diabetes when the pancreas has stopped making insulin. Some people with type 2 diabetes can benefit from using both pills and insulin. Some pills to treat diabetes include: Biguanides Metformin (Glucophage, Fortamet, Riomet, Glumetza) is a biguanide. It lowers the amount of glucose in your liver and boosts insulin sensitivity. It may also improve cholesterol levels and might help you lose a little weight. People normally take it twice per day with meals. You can take the extended-release version once per day. Potential side effects include: upset stomach nausea bloating gas diarrhea a temporary loss of appetite It may also cause lactic acidosis in people with kidney failure, but this is rare. Sulfonylureas Sulfonylureas are fast-acting medications that help the pancreas release insulin after meals. They include: People usually take these medications once per day with a meal. Potential side effects include: irritability low blood glucose upset st Continue reading >>

Studies: Diabetes Pills Better Than Insulin At Reducing Death Risk

Studies: Diabetes Pills Better Than Insulin At Reducing Death Risk

For most people with diabetes, insulin is the most reliable way to lower blood sugar. But is insulin the best way to prevent death and heart disease in Type 2 diabetes? Recent studies seem to show that people with Type 2 treated with certain oral medications had less risk of dying than did people taking insulin. The insulin-users also had higher rates of cardiovascular disease (CVD). CVD is disease of the heart and blood vessels. A study from Sweden followed over 20,000 adults diagnosed with Type 2. Half were starting insulin therapy; the other half started one of the newer oral drugs, either a DPP-4 inhibitor or an SGLT2 inhibitor. DPP-4 inhibitors help raise the body’s level of incretin hormones, such as GLP-1. GLP-1 decreases insulin resistance and promotes insulin production in response to glucose. SGLT2 inhibitors cause glucose to be eliminated in the urine, lowering blood levels. Subjects were followed for a year and a half. People using the oral drugs had a 44% decreased risk for all-cause mortality, and 15% less risk of CVD. The oral drugs also were linked with a 74% lower risk of severe low sugars (hypoglycemia). The SGLT2 inhibitor used in the study (dapagliflozin, brand name Farxiga) lowered the risk for death more than the DPP-4 inhibitors did, but the DPP-4 drugs were associated with a lower risk of severe hypoglycemia. Risk of hypoglycemia might be important, because hypos might themselves cause physical stress that could lead to earlier death. (By the way, you might be wondering what is meant by death rate or mortality rate. Isn’t everybody’s death rate the same: one to a person? It is, but the statistic “death rate” refers to the number of deaths in a given period, like five years, or whatever the study’s timeframe is.) A study from Wales las Continue reading >>

Oral Medication

Oral Medication

Because caregivers are often reluctant to begin insulin injections on their pets, vets will often offer an oral-medication alternative such as Glucotrol, Glipizide, Metaformin, or Acarbose. These oral medications either reduce insulin resistance or stimulate the pancreas to produce more insulin (assuming it still can). Unfortunately for cats, diabetes is a condition with many vicious circles, and these medications, in the ~80% of feline cases where they don't work, tend to make diabetes worse instead. Worse, vet literature often says that 6 to 8 weeks of oral med treatment should be tried before giving up, and it's quite possible for an untreated diabetic (or one on an ineffective treatment) to die of starvation, dehydration, or ketoacidosis within that time. The odds of oral medication leading to a successful regulation of your cat are poor, and the odds of things getting much worse during the treatment are more likely. Recent studies in cats (including those below) are now pointing toward a deterioration cycle of in cats. (Type II diabetes -> (hyperglycemia <-> amyloidosis) -> Insulin dependence) Since Glucotrol/Glipizide are shown[1] to promote amyloidosis in the presence of hyperglycemia (hardly an unusual condition in a diabetic), there is every reason to believe that these meds can only make things worse.[2] (Though Dr. Galloway disagrees[3]. ) Possible reasons why veterinarians keep trying this course on cats: Most caregivers are (or the vets believe they will be) unwilling or unable to give regular insulin shots Diabetic cases that are well-treated are rare enough for many vets that they don't have a chance to track successful versus unsuccessful treatments Nobody is financially motivated to show negative results of a drug therapy. In dogs, results of oral insul Continue reading >>

Top 6 Breakthrough Diabetes Treatments You May Have Missed

Top 6 Breakthrough Diabetes Treatments You May Have Missed

Are you concerned you might be diagnosed with diabetes one day? You are not alone. Diabetes and prediabetes are two of the top pressing health issues in the nation. The number of Americans who are at risk for diabetes is astounding: it is reported that close to 86 million people in the U.S. have prediabetes, meaning their blood sugar levels are higher than normal but not yet high enough to be classified as type 2 diabetes. The American Diabetes Association (ADA) estimates a person diagnosed at age 50 dies six years earlier than a person without diabetes. One in three American adults will have diabetes in the year 2050 if current trends continue. Close to 29 million Americans, or 9% of the population, currently have diabetes. The vast majority of people, about 90 to 95 percent of those diagnosed with diabetes, have type 2 diabetes, according to the ADA. Insulin is a hormone the body needs to utilize the glucose (sugar) from food to provide energy for the body. In type 2 diabetes, the pancreas either doesn't make enough insulin, there is resistance to the effects of insulin, or both. Treatment typically begins with oral metformin, a veteran drug that is the backbone of many diabetes treatment regimens. From there, different drug classes may be added to metformin, and for some patients, the use of insulin may become necessary. However, the latest diabetes news is encouraging. New drugs, improved monitoring devices and an understanding of how diet and exercise can impact diabetes is adding up to positive outcomes for patients. As reported in August 2014 from research in The Lancet Diabetes & Endocrinology, the vast majority of people with type 2 diabetes are living longer lives due to better medications and treatments for both the disease and the numerous complications that Continue reading >>

Differences Between Oral Medication And Injectables For Diabetes

Differences Between Oral Medication And Injectables For Diabetes

More people in the United States have been diagnosed with type 2 diabetes than ever before. Until recently, most people with the disease took oral medications to control their blood glucose (sugar) levels, and eventually they would need insulin injections. In the last few years, though, non-insulin injectable medications have become available in the U.S. and now people with type 2 diabetes have another treatment option before going on insulin. It may seem on the surface that oral medications and injectables work similarly, but there’s enough of a difference to make injectables for diabetes an increasingly popular choice for blood glucose management. Advances in diabetes treatment have recently brought us non-insulin injectable medications, which can be a great option to help you control your diabetes and stay healthy. 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement. Oral Medications: How They Work Oral medications act in several ways to help you manage your diabetes, such as: Reducing glucose formation: Metformin is the most common oral medication for type 2 diabetes and it’s often the first treatment prescribed for diabetics. This drug works by reducing the amount of glucose produced by your liver. Metformin can be taken alone or combined with another glucose-lowering drug. Brand names of metformin include Glucophage and Formeta. Producing more insulin: Other oral medications called sulfonylureas stimulate your pancreas to produce more insulin. While your body still may not use the insulin effectively, having more of it in your system allows your body access to more of it in order to re Continue reading >>

Which One Is The Best For A Diabetic, Oral Medicine Or Insulin Injections?

Which One Is The Best For A Diabetic, Oral Medicine Or Insulin Injections?

Type 1 diabetic needs insulin, not oral meds. Type 2 start with exercise and losing weight, then metformin (which at this moment is being trialed in non diabetics to prolong healthy lifespan), if needed other tablets can be added on, although the very cheap and old sulfonylureas use is correlated with more deaths so I would avoid using them on their own if tablets only won’t regulate your diabetes you should add insulin to your metformin tablets, don’t stop the metformin because the combination leads to better survival/lifespan Continue reading >>

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