Medication therapy options for diabetes can range from insulin to amylinomimetic drugs. Medication therapy is a common technique with the primary goal being to keep the blood sugar/glucose levels as close to a normal range as possible (around 100 mg/dl) while avoiding drops in the glucose level to the degree that the patient develops symptomatic hypoglycemia.
The techniques to accomplish this center around lifestyle changes (diet, exercise, weight loss, close medical follow-up/monitoring), the use of medications, and bariatric surgery.
Learning about the disease and being an active participant in the management process is critical to long-term glycemic control. The goal of treatment is to keep the HbA1C level no more than 7-8% and preferably less than 7. You should pay attention to those medical conditions that will accelerate the long-term consequence of the disease, such as hypertension (high blood pressure), elevated cholesterol (heart disease), and excess weight.
Medication Therapy Options for Diabetes
The goal of medication therapy options for diabetes is to lower the blood glucose levels by either replacing the insulin that is lacking, improving the body’s production of insulin, or improving the absorption of glucose from the blood into the cells of our body. There are several different classes of drugs that we will below.
Insulin
Insulin is the most common type of medication therapy option for diabetes, particularly used in type 1 diabetes treatment. The goal is to replace the insulin that the body fails to produce. Several types of insulin are classified as short and long-acting. A diabetic patient will take insulin by frequent, intermittent injections or a continuous infusion through various pumps. Ultimately, the amount of insulin required is dependent on the patient’s blood sugar levels, how much natural insulin they might make (if any), and how sensitive their body is to the insulin.
Some of the common drug names for insulin are:
- Short-Acting Insulin: Regular Insulin (Humulin and Novolin), Insulin Aspart (NovoLog, FlexPen), Insulin Isophane (Humulin N, Novolin N)
- Long-acting insulin: Insulin Degludec (Tresiba), Insulin Detemir (Levemir), Insulin Glargine (Lantus), Insulin Glargine (Toujeo)
- Combination Insulins (short and long-acting): NovoLog Mix 70/30 (Insulin Aspart Protamine-Insulin Aspart), and many other combinations
Injectables
Amylinomimetic drugs are injectable medications used before meals. They are meant to delay emptying the stomach, thereby delaying the digestion and absorption of the meal. This results in a slower, more controlled rise in glucose levels, which will sometimes prevent the rapid spikes in glucose levels when a diabetic eats. The medication also seems to reduce appetite. Pramlintide (SymlinPen 120, SymlinPen 60) is one of these medications.
For type 2 diabetics, the body makes insulin, however, the cells no longer respond well to the insulin the body makes. The goal of treatment with the following medications is to help the cells respond to insulin better to improve glucose absorption.