Am Fam Physician. 2001;63(9):1759-1760
What is diabetes?
Your body uses sugar (glucose) from food for fuel and energy. Insulin is a hormone made by your pancreas, one of the organs in your body. Insulin helps maintain your blood sugar level in the normal range (not too high or too low). Diabetes is a disease in which your body does not properly use sugar, causing your blood sugar level to become too high. High levels of sugar in the blood for long periods of time can harm your body including your eyes, heart, kidneys and feet.
What is type 2 diabetes?
Type 2 diabetes can result when:
Your body does not make enough insulin (insulin deficiency).
Your body makes insulin, but does not use it properly (insulin resistance).
Your body makes too much sugar.
Quite often, it is a combination of these effects that causes type 2 diabetes. There is no cure for diabetes, but treatment can improve your blood sugar levels.
What are the different steps in managing my diabetes?
The first step in controlling your blood sugar is to eat healthy foods and exercise. By doing so, your body will try to fix itself. If you are overweight, losing weight will lower your blood sugar level and make you feel better. If diet and exercise do not help, there are some medicines (pills and insulin shots) that your doctor can prescribe.
Remember that treatment for type 2 diabetes is not the same for every person, and it is common for your therapy to change over time. The kind of therapy your doctor chooses will depend on how long you have had diabetes, your weight, how high your blood sugar is and other factors. The figure below reviews the different steps that can be used to treat type 2 diabetes.
| Step 1 | Start diet and exercise program. Talk with your health care team about meal planning and exercise activities. |
| Step 2 | Start therapy with diabetes pills to help control your blood sugar. Continue with diet and exercise program. |
| Step 3 | If therapy with one diabetes pill does not control your blood sugar, then two or three types of pills can be tried together. |
| Step 4 | If therapy with diabetes pills does not control your blood sugar, insulin plus a diabetes pill can be tried. |
| Step 5 | Many patients will eventually be treated with insulin alone. The amount of insulin and number of shots can be changed according to your blood sugar levels. |
What are the different types of medicines used to treat type 2 diabetes and how do they work?
There are several types of diabetes pills used for patients with type 2 diabetes. These pills work in different ways to lower high blood sugar levels. If one pill does not lower your blood sugar to the normal range, then your doctor may prescribe two or three pills for you to take together.
Unfortunately, diabetes pills do not work for everyone and some patients will eventually need to take insulin shots. Some of the brand names of diabetes medicines include Micronase, Glucotrol, Prandin, Glucophage, Avandia, Actos, Acarbose and Miglitol. Talk to your doctor about the different types of medicines and which ones are right for you.
How can I get the best results from my diabetes medicines?
It is important to take your medicine every day. Ask your doctor questions about your medicines: “How often do I take this pill?” “What if I miss a dose?” “What if I am taking other medicines?” Talk to your doctor about any side effects you may be having, especially if you are taking other medicines.
Remember that diet and exercise should always be a part of your treatment because they work together with diabetes medicines to lower your blood sugar and make you feel better.