Administration of insulin or other medications for diabetes is a common form of managing the disease. Aside from selecting nutritious eats and drinks, engaging in exercise, getting an adequate amount of rest, and controlling stress, medications can assist in the management of the illness. Some other treatment options are also available.
What medicines might I take for diabetes?
The decision of which medicine to take is based on the diagnosis of diabetes and its effectiveness in regulating blood glucose levels. Other considerations that could influence the type of diabetes medication you require can include any existing medical conditions, expense for medications, insurance policy details and co-pays, access to medical care, and your lifestyle.
What type of diabetes do I have?
Type 1 diabetes
If you suffer from type 1 diabetes, it is necessary to take insulin as your pancreas is unable to produce it. You will have to administer insulin at different points throughout the day, such as when you are consuming food and drinks, in order to regulate your blood sugar level.
There are different ways to take insulin . You can administer insulin via a needle and syringe, an insulin pen, or an insulin pump. Some individuals may be able to use a device known as an automated insulin delivery system or artificial pancreas to manage their condition.
Type 2 diabetes
Certain people with type 2 diabetes are able to manage their blood sugar through alterations in their everyday lifestyle. Eating healthy foods and drinks, cutting down on calories if one is overweight or obese, and getting exercise are all part of modifying one’s lifestyle.
Some individuals with type 2 diabetes necessitate the use of diabetes medications. These medications might consist of diabetes medications that are swallowed or injected such as insulin. Eventually, you may require more than a single diabetes medication to regulate your blood sugar level. Even if you are not normally prescribed insulin, there may be times when you will require it, for example, during pregnancy or if you are staying in the hospital for medical care.
Gestational diabetes
If you are suffering from gestational diabetes, you can keep your blood sugar level in check by adhering to a nutritious diet and doing at least 150 minutes of moderate exercise, like brisk walking, every week. If you are unable to maintain your target blood glucose level through healthy nutrition and exercise, your doctor may suggest you take insulin as well. They can help you develop a plan to control your glucose levels. Insulin is safe to take while you are pregnant.
No matter what kind of diabetes you are faced with, taking the required medications on a daily basis can be a struggle. Recent advancements in drug treatments and delivery methods can facilitate the maintenance of blood sugar levels. Discuss with your doctor to determine which medications and delivery methods are ideal for you and match your routine.
What are the different types of insulin?
Several types of insulin are available. Every kind of insulin has different levels of speed in beginning to work, referred to as “onset,” and the effects last for a varying amount of time, known as “duration”. Generally, all types of insulin reach their most powerful effect at some point, called a “peak”. Following the period of highest activity, the impact of the insulin gradually dissipates over the course of several hours. Table 1 details the various kinds of insulin, its swiftness in beginning to function, the time it reaches its highest concentration, and the duration of its effectiveness.
Table 1. Types of insulin and how they work 1,2
| Insulin Type | How Fast It Starts to Work (onset) | When It Peaks | How Long It Lasts (duration) |
| rapid-acting/
ultra rapid-acting |
15 minutes | 1 hour | 2 to 4 hours (rapid)
5 to 7 hours (ultra) |
| rapid-acting, inhaled | 10 to 15 minutes | 30 minutes | 3 hours |
| regular, also called short-acting | 30 minutes | 2 to 3 hours | 3 to 6 hours |
| intermediate-acting | 2 to 4 hours | 4 to 12 hours | 12 to 18 hours |
| long-acting | 2 hours | does not peak | 24 hours |
| ultra long-acting | 6 hours | does not peak | 36 hours or longer |
A different type of insulin, referred to as premixed insulin, is a combination of different types of insulin, as outlined in Table 1. It may take anywhere from 15-60 minutes for premixed insulin to take effect, and its effects can last 10-16 hours. The time at which the effects of the insulin will be at their most potent can differ depending on the combination that is being used.
What are the different ways to take insulin?
Deciding on how you will take insulin could be determined by your daily routine, your insurance coverage, and what you prefer. Discuss with your physician about the different choices available and which one is the most advantageous for you. Many individuals who suffer from diabetes inject themselves with insulin by means of either a syringe and needle, an insulin pen, or an insulin pump. Inhalers and insulin jet injectors are not typical methods of administering insulin. Artificial pancreas systems are now approved by the U.S. Food and Drug Administration (FDA). Consult with your physician to determine if an artificial pancreas would be a viable solution for you.
Needle and syringe
You can administer insulin to yourself with a needle and a syringe. You extract a measured amount of insulin from the vial or bottle via the needle and into the syringe. Injecting insulin in your belly will provide the fastest results, although your doctor may suggest changing up which area you use for administering it.
Pen
A device that resembles a pen but has a needle as its tip is an insulin pen. Some insulin pens are designed to be single-use and pre-filled with insulin. Some have enough space to accommodate an insulin supply container which can be replaced after it has been used. Insulin pens are considered simpler to operate by a lot of people, however they are pricier compared to using needles and syringes.
Pump
A tiny device referred to as an insulin pump dispenses regular amounts of insulin to be taken over the course of the day. You carry an external pump attached to your waist, pocket, or in a pouch. The insulin pump links to a slim plastic tube and a minute needle. You stick the plastic tube containing a syringe needle beneath your skin, and then remove the needle.
Inhaler
Using an inhaler device, powdered insulin can be inhaled into the mouth from it. The insulin is inhaled into the lungs and is transported quickly into the bloodstream. It may be beneficial to use an insulin inhaler instead of having to inject insulin with a needle. Inhaled insulin is intended to be used solely by adults dealing with either type 1 diabetes or type 2 diabetes. Inhaling insulin is not as frequently employed as the use of a needle and syringe.
Jet injector
A jet injector is an apparatus that administers insulin into the dermis with a highly concentrated mist rather than using a hypodermic needle. It is less popular than a needle and syringe or a pen.
Artificial pancreas
An artificial pancreas is a device set consisting of three components, which together imitate how a functioning pancreas modulates blood glucose levels in a person’s body. A CGM is a device which monitors blood sugar levels every few minutes and has a tiny sensor placed underneath the skin and fastened with an adhesive patch.
Medication to reduce the blood glucose level
The vast majority of type 2 diabetes medications come in the form of pills. In spite of this, injections of insulin are required for people who suffer from type 2 diabetes to help manage the blood sugar (glucose) levels adequately. Many individuals find great advantages in taking insulin injections. Insulin shots can be taken in conjunction with other medications to further enhance blood sugar levels.
Using medication should not be viewed as a substitute for the lifestyle changes that have been mentioned; it should be viewed as an additional measure.
Metformin as a type 2 diabetes treatment
Metformin is a biguanide medicine. The primary way it reduces blood sugar is by reducing the amount of glucose that the liver puts into the circulation. Your body’s cells become more reactive to insulin when you do this. This indicates that cells will receive an increased quantity of glucose with the same amount of insulin present in the bloodstream. Studies have demonstrated that Metformin reduces the possibility of other diabetes-related difficulties (e.g. heart attack and stroke).
Typically, Metformin is prescribed as the initial form of medication if your blood sugar cannot be controlled through lifestyle changes alone. This medication is especially helpful if you are obese, as it has a lesser chance of causing weight increase than some other sugar-controlling tablets.
Metformin also has the benefit of not typically leading to low blood sugar levels. This could be an issue with some other types of glucose-reducing medications such as sulfonylureas, yet these drugs are not as regularly used in current medical practice. Metformin can be taken together with other medications for glucose regulation if one pill is not enough for controlling blood sugar levels.
SGLT-2 (sodium-glucose co-transporter-2) inhibitors – canagliflozin, dapagliflozin, ertugliflozin and empagliflozin
These four drugs – canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin – block the sodium-glucose co-transporter-2 (SGLT-2) receptor. The results of these are that the level of glucose in your urine increases, thus causing the amount of glucose in your blood to decrease. These medications can be utilized independently or combined with other medications to help regulate blood sugar levels in individuals with type 2 diabetes.
It has been discovered that SGLT-2 inhibitors have some additional advantages when taken by people. These include:
- Weight loss.
- Reduction in blood pressure.
- Slowing down of decline in kidney function.
- Reduction in the risk of heart failure.
- Reduction in the risk of having a further heart attack if you have already had one.
SGLT-2 inhibitors and heart disease or heart failure
Individuals who have type 2 diabetes are more prone to developing cardiovascular disease, heart attack, stroke, or even heart failure in comparison to other people without diabetes. Many studies have proven that SGLT-2 inhibitors decrease the odds of getting heart failure and lessen the difficulty for individuals who currently have it. Research has revealed that particular SGLT-2 inhibitors could potentially lower the chance of having cardiovascular disease.
When you are diagnosed with type 2 diabetes (and regularly at follow-up checks) your doctor should assess you to see if you:
- Have evidence of CVD or heart failure.
- Are at high risk of CVD or heart failure.
Your doctor should provide you with a combination of SGLT-2 inhibitor medication and metformin if you have coronary heart disease or congestive cardiac failure as your first course of treatment. If you are in danger of having cardiovascular disease or a heart attack, it is important to talk to your doctor about the pros and cons of making a SGLT-2 inhibitor in combination with metformin your initial form of treatment.
SGLT-2 inhibitors and chronic kidney disease
Those suffering from type 2 diabetes are more likely to experience CKD than people who are not. Certain SGLT-2 inhibitors have been revealed to decrease the degradation of kidney function substantially, thereby safeguarding the kidneys.
If you are diagnosed with both type 2 diabetes and chronic kidney disease, you may be given medicines such as SGLT-2 inhibitors even if your glucose levels aren’t too high. If you suffer from CKD, these medicines might not be as successful in reducing your blood sugar levels. Despite no alteration in blood sugar levels, they still shield your kidneys.
If you have been diagnosed with Chronic Kidney Disease, it is important to take either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. These medications, originally designed to manage high blood pressure, can also help protect your kidneys from damage.
DPP-4 (dipeptidyl peptidase-4) inhibitors – also known as incretin enhancers
This set includes alogliptin, linagliptin, saxagliptin, sitagliptin, and vildagliptin. DPP-4 is an enzyme that decomposes hormones referred to as incretins. Substances released by the intestine when food is present are referred to as incretins. Incretins:
- Help keep you feeling full; and
- Enhance your body’s production of insulin; and
- Reduce production of another hormone, glucagon, which raises your blood glucose.
These treatments for type 2 diabetes help to bring down the blood sugar level by making the effects of incretins more potent as they stop DPP-4 from taking effect. It may be suggested that you take something in addition to metformin or a sulfonylurea, or both of these, in the event your HbA1c amount is still high.
GLP-1 (glucagon-like peptide-1) mimetics – exenatide, dulaglutide, liraglutide, lixisenatide and semaglutide
These five drugs, exenatide, dulaglutide, lixisenatide, liraglutide and semaglutide , are used to treat type 2 diabetes and they are all synthetically-made versions of glucagon-like peptide-1 (GLP-1). They are administered as injections. They operate in a fashion comparable to that of the naturally-produced hormone glucagon-like peptide 1. These actions include:
- Stimulating insulin secretion in response to glucose; and
- Preventing glucagon release after meals (glucagon is a hormone which raises blood sugar); and
- Slowing down emptying of food from the stomach, to keep you feeling full. People receiving this treatment usually lose weight.
Evidence suggests that certain GLP-1 medications may lower the chance of experiencing further heart issues in those who have already had a heart attack.
GLP-1 medications can be utilized as an additional therapeutic option to enhance sugar regulation when administering insulin is not a viable solution. There is a once-weekly treatment available. Treatment of type 2 diabetes in the UK is mostly only accessible to those who are significantly overweight, with a BMI of over 35.
Leave a Reply