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Is Insulin Better Than Pills For Type 2 Diabetes?

Treatment For Type 2 Diabetes

Treatment For Type 2 Diabetes

Tweet The primary aim of treating type 2 diabetes is to help control blood glucose levels, but another key aim is to help with weight loss or weight management. Keeping blood sugar levels under control is important as high sugar levels have been shown to significantly increase the risk of health problems (complications) developing later in life. Type 2 diabetes can be treated by a number of different methods, ranging from lifestyle adjustments to tablet medication and injections, through to bariatric (weight loss) surgery. Lifestyle changes are advised for everyone with type 2 diabetes; your doctor will recommend treatment alongside these changes if your blood glucose levels are too high. Your GP and health centre Your GP is an important part of your healthcare and will be able to advise you treating your diabetes, refer you to diabetes education and lifestyle courses and medical specialists, where appropriate, and prescribe medication. Your GP will also be responsible for monitoring your health and ensuring you undergo a number of important diabetes health checks each year. These will include your blood glucose control, blood pressure and cholesterol, amongst others. Diet When it comes to diet, weight loss is often a primary goal for those with type 2 diabetes. If you are overweight, losing weight can help to improve insulin sensitivity and make diabetes easier to manage. To achieve weight loss, your diet should be low-calorie, and because type 2 diabetes is a lifetime condition, it is important to have a diet you are happy to commit and stick to. In the modern world, many of us have become accustomed to eating energy-dense foods, such as bread, rice, pasta and potato-based foods. Whilst these high-energy foods are convenient they’re less good for those who aren’t Continue reading >>

Insulin Usually Better Than Oral Drugs For Type 2 Diabetes

Insulin Usually Better Than Oral Drugs For Type 2 Diabetes

According to a study published in , the combination of insulin and metformin may not benefit individuals with type 2 diabetes. Although the combination results in less weight gain, improved blood glucose control and less need for insulin, the researchers state that further research is required in order to provide solid evidence regarding the benefits and harms, as well as the risks of premature death. The study was conducted by researchers from the Copenhagen Trial Unit, Steno Hospital and the Copenhagen University Hospital. At present, guidelines recommend metformin, an oral blood glucose reducing medication, for type 2 diabetics starting insulin treatment. The researchers examined 2,217 individuals aged 18+ with type 2 diabetes. Among the trials examined, the team found insufficient reports of important patient outcomes, such as total mortality and death from heart disease. According to 20 trials, levels of HbA1c (a measure of average blood glucose levels over time) were reduced when insulin and metformin was taken together. Furthermore, the researchers found that the combination of drugs considerably reduced weight gain and body mass index (BMI) by an average of 1.6 kg. The researchers state that additional studies are required in order to research the long term benefits and harms of the combination, as it increases the risk of severe hypoglycaemic attack. In this week's BMJ podcast, Trish Groves, the deputy editor of BMJ, talks to lead author Bianca Hemmingsen about how this study was able to draw on more data than prior studies, and how the researchers examined major complications and mortality instead of surrogate outcomes, such as blood sugar levels and weight. In addition, Dr. Hemmingsen highlights the insufficient evidence for determining if the combination or Continue reading >>

Type 2 Non Insulin Therapies

Type 2 Non Insulin Therapies

Pramlintide is an injected medicine for people with diabetes. In type 1 diabetes, Pramlintide can be taken in addition to insulin to help control mealtime blood sugars. If you have type 2 diabetes, and lifestyle changes are not enough to control your blood sugar, typically, your provider will first start you on a single medicine. For people who are overweight, metformin is usually the first medicine prescribed. If the single therapy doesn’t work, additional medicines can be added. Many people require treatment with 2, 3 or more different medicines. If pill combinations don’t work, an injected medicine such as an incretin-based medicine, amylin analog or insulin may be prescribed. Medicine combinations are used because different drugs target different parts of your body’s sugar regulation system. Rarely, and usually due to other medical conditions, it may be necessary to start medical treatment of type 2 diabetes with insulin therapy. Usually, however, insulin therapy is the last treatment prescribed and is added only after the oral medications or non-insulin injections don’t work. There are six types of non-insulin medicines used to treat type 2 diabetes: Incretin based therapies: Pills and injections that reduce sugar production in the liver and slow the absorption of food In this section, you also can review: A Table of Non-Insulin Medications: A summary of all the oral medications and non insulin injected therapies including the common doses and side effects. Self-assessment Quiz Self assessment quizzes are available for topics covered in this website. To find out how much you have learned about Treatment of Type 2 Diabetes, take our self assessment quiz when you have completed this section. The quiz is multiple choice. Please choose the single best answer to Continue reading >>

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 >>

Type 2 Diabetes

Type 2 Diabetes

Print Diagnosis To diagnose type 2 diabetes, you'll be given a: Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. Normal levels are below 5.7 percent. If the A1C test isn't available, or if you have certain conditions — such as if you're pregnant or have an uncommon form of hemoglobin (known as a hemoglobin variant) — that can make the A1C test inaccurate, your doctor may use the following tests to diagnose diabetes: Random blood sugar test. A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood s Continue reading >>

Pro’s And Con’s Of The Early Use Of Insulin In The Management Of Type 2 Diabetes: A Clinical Evaluation

Pro’s And Con’s Of The Early Use Of Insulin In The Management Of Type 2 Diabetes: A Clinical Evaluation

Go to: Abstract Recently, there have been increasing calls for insulin to be used as the initial treatment of type 2 diabetes, and if not then, soon after its onset. The underlying reason given is that insulin will slow apoptosis of pancreatic β-cells which is increased in type 2 diabetes. This review will examine the clinical evidence supporting this recommendation. Several observational studies in which newly diagnosed type 2 diabetic patients are intensively treated for a short time with insulin which is then stopped have shown that approximately half of these patients retain good control without pharmacological therapy for up to a year. However, Hb A1c levels in patients who have to be started on oral anti-diabetic drugs (OAD) are similar to the values in those who do not. Hb A1c levels are similar in patients randomized to initial therapy with insulin or OAD. There is no clinical evidence yet for an effect of insulin on β-cell apoptosis. The primary goal is to achieve and maintain Hb A1c levels of <7.0%. Given the extra demands on both patients and physicians when starting insulin compared to OAD and the many subsequent years in which patients have diabetes, the arguments for using insulin initially, or in patients who have achieved the target Hb A1c level, are not convincing. However, as soon as OAD therapy cannot meet this goal, insulin must be introduced. Keywords: Initial insulin therapy, early insulin therapy Go to: INTRODUCTION There is an increasing chorus of people recommending insulin as “early” treatment of type 2 diabetes in both print [1] and at national meetings [2]. A subtext of this recommendation is to use insulin as the initial treatment for newly diagnosed patients with type 2 diabetes. The hope (in the absence of firm evidence) is that this Continue reading >>

This New Treatment Could Provide Weeks Of Glucose Control For Type 2 Diabetes Patients

This New Treatment Could Provide Weeks Of Glucose Control For Type 2 Diabetes Patients

To control their blood sugar levels, people with type 2 diabetes constantly need to rely on medication, but it's a tricky condition to manage, especially if you need daily insulin shots. Researchers have been working on a new method for delivering diabetes drugs to make them last longer in the body. Now a recent study using both mice and monkeys has shown potential for treatments that would only require a couple of injections a month. Some of the latest-generation type 2 diabetes drugs contain a molecule called GLP1 (glucagon-like peptide-1), which stimulates insulin production in the body only when it needs more glucose. That sounds ideal, but unfortunately, GLP1 has a really short half-life - it breaks down in the body quickly, making it an impractical long-term treatment on its own. By combining it with other molecules, it's possible to extend the half-life of GLP1. But that method still only gets us to about 3-7 days. Right now, patients in the US already have some options that can be injected weekly, but scientists are looking for a way to slow down the release of the drug itself. Now a team from Duke University has managed to combine GLP1 with a biopolymer molecule that starts out as a liquid in colder temperatures, but thickens into a gel-like substance in reaction to body heat. This means the solution can be administered with a simple injection, but once it gets into the body, the drug is released very slowly, so it can control blood glucose levels for longer with just one dose. To test how their new solution would work for actual diabetes treatment, the researchers tried the drug in both mice and in rhesus monkeys - two species with well-established diabetes models. They got exciting results in both: in mice, the new GLP1 solution controlled glucose levels for 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 >>

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 >>

Best Treatments For Type 2 Diabetes

Best Treatments For Type 2 Diabetes

At-a-glance Six classes of oral medicines (and 12 individual drugs) are now available to help the 25.8 million people in the U.S. with type 2 diabetes control their blood sugar when diet and lifestyle changes are not enough. Our evaluation of these medicines found the following: Newer drugs are no better. Two drugs from a class called the sulfonylureas and a drug named metformin have been around for more than a decade and work just as well as newer medicines. Indeed, several of the newer drugs, such as Januvia and Onglyza, are less effective than the older medications. Newer drugs are no safer. All diabetes pills have the potential to cause adverse effects, both minor and serious. The drugs’ safety and side effect “profiles” may be the most important factor in your choice. The newer drugs are more expensive. The newer diabetes medicines cost many times more than the older drugs. Taking more than one diabetes drug is often necessary. Many people with diabetes do not get enough blood sugar control from one medicine. Two or more may be necessary. However, taking more than one diabetes drug raises the risk of adverse effects and increases costs. Taking effectiveness, safety, adverse effects, dosing, and cost into consideration, we have chosen the following as Consumer Reports Best Buy Drugs if your doctor and you have decided that you need medicine to control your diabetes: Metformin and Metformin Sustained-Release — alone or with glipizide or glimepiride Glipizide and Glipizide Sustained-Release — alone or with metformin Glimepiride — alone or with metformin These medicines are available as low-cost generics, costing from $4 to $35 a month. If you have been diagnosed with diabetes, we recommend that you try metformin first unless it's inappropriate for your hea Continue reading >>

Type 2 Diabetes Treatments

Type 2 Diabetes Treatments

You have lots of options to manage diabetes. Diet, exercise, and medication work together to bring your blood sugar under control. Your doctor will help you figure out if you need to take medicine, which kind is right for you, and how often you should take it. Over your lifetime, you'll probably handle your disease in different ways. Sometimes medications stop working, and you'll have to switch. You'll need to adjust to changes in your body as you age. And researchers are looking for new diabetes medicines and ways to treat it. Check Your Blood Sugar Your blood glucose number tells you how well your treatment is working. Your doctor will let you know how many times a day you need to check it. It depends on what diabetes medications you're taking. When you're sick, you'll have to check your ketones, too. Diet and Exercise There's no one-size-fits-all diabetes diet. You'll need to pay attention to carbs, fiber, fat, and salt to manage your blood sugar and avoid complications of diabetes. How much and when you eat are important, too. Talk to your diabetes team or a registered dietitian to help you plan your meals and snacks. Physical activity -- from working out to doing chores -- lowers your blood sugar. It helps your cells use insulin. It also helps your muscles use glucose. Make sure you check your blood sugar before and after exercise. Eating right and being active help you lose extra pounds and stay at a healthy weight. That will also help control your blood sugar. Pills Oral medications are often the first kind of medicine people with type 2 diabetes try when diet and exercise alone aren't enough to keep their blood sugar in a healthy range. There are many of them, and they work in different ways. A drug doctors often prescribe tells your liver to hang on to some of Continue reading >>

Diabetes Medication Misconceptions

Diabetes Medication Misconceptions

If you or a loved one has recently been diagnosed with type 1 or type 2 diabetes, you may have some questions about how the diseases are treated. There are many misconceptions about diabetes medications, mainly because the treatment for type 1 and type 2 diabetes can be very different. One of the most pervasive myths about diabetes--both forms of it--is that the disease can be treated by simply refining your diet or exercising more. While this is certainly an option for some people with type 2 diabetes, it is absolutely untrue for people with type 1. Type 1 diabetes is an auto-immune disease that occurs when the body’s disease fighting system, the immune system, destroys all your body's insulin-producing cells. Insulin is a vital agent that your body needs to convert food into energy. If your body is not producing insulin, you must take it by injection or a pump to live. Insulin currently cannot be taken by mouth because the digestive juices in your stomach and intestine will break down the insulin before it has a chance to get into your bloodstream to do its job. If you have type 2 diabetes, you may or may not have to take insulin injections, depending on a variety of factors. Contrary to popular belief, insulin injections are not for people with diabetes who have been "bad"—instead, taking insulin is a reflection of insulin production by the pancreas. People diagnosed with type 2 diabetes in general are still producing some insulin, although the amount they produce is not enough for their needs. Their cells may also be resistant to the effects of insulin, which makes them require more insulin than a person who does not have diabetes. Frequently when type 2 diabetes is diagnosed, weight loss, exercise, and changes in how much you eat can bring blood glucose levels Continue reading >>

Common Questions About Diabetes Medicines

Common Questions About Diabetes Medicines

How do I know if my diabetes pill is working? The best way to find out how well your diabetes pill is working is to test your blood sugar. Ask a member of your health care team what time of day is best for testing. You'll want to test when your diabetes medicine is expected to be most active in your body. Keep a record of your blood sugar levels (PDF) during that time to see if they're at or near your goal. If your levels are at or near your goal and you're not having any problems with the medicine, then it's probably working well. If you're still not sure, talk to your doctor or other member of your care team. Can I stop taking my diabetes medicine after my blood sugar is under control? It's reasonable to think that after a person gets good blood sugar control, it means the end of managing diabetes. But that's not the case. People with type 1 diabetes aren't able to make their own insulin, so they will always need to take insulin shots every day. For people with type 2 diabetes who are on medicine, the answer isn't as clear. Sometimes when people are first diagnosed, they start on pills or insulin right away. If the person also works hard to control diabetes with diet and exercise, he or she can lower the need for medicine and might be able to stop taking it altogether. As long as the person is able to keep blood sugar levels normal with diet and exercise, there isn't a need for medicine. However, type 2 diabetes changes over time. The change can be fast or slow, but it does change. This means that even if a person was able to stop taking medicine for a while, he or she might need to start taking it again in the future. If a person is taking medicine to keep blood sugar normal, then it's important to keep taking it to lower the chances for heart disease and other healt Continue reading >>

Insulin-based Versus Triple Oral Therapy For Newly Diagnosed Type 2 Diabetes

Insulin-based Versus Triple Oral Therapy For Newly Diagnosed Type 2 Diabetes

OBJECTIVE Early use of insulin after diagnosis of type 2 diabetes is met with resistance because of associated weight gain, hypoglycemia, and fear of decreased compliance and quality of life (QoL). RESEARCH DESIGN AND METHODS In treatment-naive patients with newly diagnosed type 2 diabetes, insulin and metformin were initiated for a 3-month lead-in period, then patients were randomly assigned to insulin and metformin (insulin group) or metformin, pioglitazone, and glyburide (oral group) for 36 months. Hypoglycemic events, compliance, A1C, weight, QoL, and treatment satisfaction were assessed. RESULTS Of 29 patients randomly assigned into each group, 83% (insulin group) and 72% (oral group) completed this 3-year study. At study completion, A1C was 6.1 ± 0.6% (insulin group) versus 6.0 ± 0.8% (oral group). Weight increased similarly in both groups (P = 0.09) by 4.47 kg (95% CI 0.89–8.04 kg) (insulin group) and 7.15 kg (95% CI 4.18–10.13 kg) (orals group). Hypoglycemic events did not differ between groups (mild 0.51 event/person-month in the insulin group vs. 0.68 event/person-month in the orals group, P = 0.18 and severe 0.04 event/person-year in the insulin group vs. 0.09 event/person-year in the orals group, P = 0.53). Compliance, QoL, and treatment satisfaction were similar between groups, with 100% of patients randomly assigned to insulin willing to continue such treatment. CONCLUSIONS When compared with a clinically equivalent treatment regimen, insulin-based therapy is effective and did not cause greater weight gain or hypoglycemia nor decrease compliance, treatment satisfaction, or QoL. Insulin is safe, well-accepted, and effective for ongoing treatment of patients with newly diagnosed type 2 diabetes. RESEARCH DESIGN AND METHODS Patients between the ages of Continue reading >>

Pills Vs. Insulin

Pills Vs. Insulin

A re you wondering whether pills or insulin will be right for you? (Editor's Note: A regimen of weight loss and exercise should be tried first before resorting to medications.) If you have type 1 diabetes, pills won’t work. You’ll have to take insulin injections. If you have type 2 diabetes, however, you may respond to pills. Many doctors try pills in patients with type 2 diabetes because they are easier to take and have other advantages. The American Diabetes Association (ADA) recommends that you tell your doctor you’d like to try the pills and, if they don’t work, you’re willing to take insulin injections. There’s no blood test to predict how you will respond to pills. The only way to know is to try them for several weeks. Increasing your level of physical activity and exercising will help you gain better glucose control with diabetes pills, says the ADA. If you have type 2 diabetes and are taking insulin, talk to your doctor. Some insulin-dependent people can switch to many medications, such as metformin, pioglitazone, repaglinide, glyburide and others. New diabetes medications are always being tested, so stay in touch with your diabetes health-care team. Reprinted from What to Expect When You Have Diabetes. Copyright by Good Books (www.GoodBooks.com). Used by permission. All rights reserved. If you spend time on social media, why not get your diabetes tips there also? Lifescript has just launched a dedicated type 2 diabetes Facebook page that will offer diabetes tips, recipes, inspiration and more. You’ll get advice, find friends, and discover solutions to everyday living. Come join us! Play Video Play Loaded: 0% Progress: 0% Remaining Time -0:00 This is a modal window. Foreground --- White Black Red Green Blue Yellow Magenta Cyan --- Opaque Semi-Opaqu Continue reading >>

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