Diabetes mellitus

Diabetes mellitus is a disease characterized by persistent hyperglycemia (high blood sugar levels), resulting either from inadequate secretion of the insulin, an inadequate response of target cells to insulin, or a combination of these factors. Diabetes is a metabolic disease that requires medical diagnosis, treatment and lifestyle changes.

There are many causes and forms of diabetes known. The three most common patterns of diabetes have been recognized over the last thirty years as type 1, type 2 and gestational diabetes. There are some patients whose diabetes cannot be easily fit into one of these types, and some who display characteristics of more than one type at the same time.

Medications for Diabetes

Many people with type 2 diabetes, especially those in the early stages, manage their blood sugar effectively through diet, weight loss, and physical activity. If this does not provide effective control for you, however, there are many medications that can help manage your condition.

If your weight is normal and your blood glucose is not manageable by diet and exercise alone, your doctor may prescribe oral diabetes medications to lower your blood glucose levels. There are five classes of medications available. Each works a bit differently and has its own side effects. If one medication is not enough, your doctor may suggest combining two of these diabetes treatment medications.

Sulfonylureas
Sulfonylureas, such as Glucotrol® and Micronase®, are commonly prescribed medications for diabetes treatment. Sulfonylureas work by helping your body make insulin. They can be used alone or with other medications. They have few side effects, but cannot be used by people allergic to sulfa medications.

Biguanides
Biguanides, such as Metformin (Glucophage®), help the body use insulin more effectively. It is often used by people who are overweight, since it also helps with weight control. It can be taken alone or with another medication, but it may cause side effects, which include nausea or diarrhea.

Alpha-glucosidase inhibitors
Alpha-glucosidase inhibitors, such as Precose® and Glyset®, work by slowing down the absorption of sugar in your digestive tract. They are often used in combination with another diabetes treatment medication, such as a sulfonylurea. This type of medication can cause stomach or bowel problems in some people.

Meglitinides
Repaglinide (Prandin®) works by controlling blood sugar after meals. It is taken with meals and adjusted according to the number of meals you eat. It can be taken alone or with other medications, and has few side effects.

Thiazolidinediones
The overall action of thiozolidinediones (TZDs) is to make cells more sensitive to insulin. Medications include Avandia® and Actos®. Rezulin® was the first thiazolidinedione, but it was recently withdrawn from the market after it was determined it causes liver toxicity. The other medications in this class are considered safe and effective.

*Note: If you still use Rezulin®, contact your primary healthcare professional immediately to get it replaced with an equally effective diabetes treatment medication that does not have Rezulin®'s side effects. Rezulin® was withdrawn from the market in March 2000, after recent test data showed that the drug was more toxic to the liver than two other similar drugs, Avandia® and Actos®.

Insulin
If oral medications do not control your blood sugar levels, insulin may be used for diabetes treatment. A person with type 2 diabetes needs insulin injections if his or her pancreas has stopped producing insulin altogether.

How to delay or prevent type 2 diabetes?

A major research study, the Diabetes Prevention Program, confirmed that the following approaches can greatly reduced the chances of developing diabetes:

1. Keep a low-fat, low-calorie diet.
2. Lost a modest amount of weight.
3. Engaging in regular physical activity (walking briskly for 30 minutes, five times a week, for example).

These strategies worked well for both men and women and were especially effective for participants aged 60 and older.