Oral medications
There are options to take medications to lower your blood sugar and to buy several types of non-insulin medications, which treat type 2 diabetes in different ways. Because these medications can be used in combination, your doctor may prescribe more than one medication.
These medications include:
- Metformin, which works in the liver.
- Thiazolidinediones (or glitazones), which lower glucose in the blood.
- Insulinotropic agents, which promote the pancreas to produce more insulin.
- Amylase inhibitors, which slow down the rate at which the body absorbs sugar from food.
- Enterotropin, which inhibits sugar isomerization in the liver. This therapy also slows the rate at which the body absorbs sugar from food. The drug can be taken orally or injected.
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In addition, a combination of two drug ingredients, known as combination therapy, can be taken.
Injectable drugs
This refers to non-insulin medications that require injections, rather than the oral medications described above. These medications include the following two types:
- Glucagon-like peptide-1 (GLP-1) receptor agonists, which promote insulin secretion and also inhibit gluconeogenesis in the liver. There are several GLP-1 agonists on the market, and you can discuss with your doctor which one is better for you. Some drugs need to be injected daily, while others only need to be injected once a week.
- Glucagon analogs, which have digestive inhibitory effects, lower blood glucose levels, and inhibit hepatic gluconeogenesis, need to be given before a meal.
Insulin
If you have type 2 diabetes, you don’t always need insulin, but you may only need it in certain situations. The type of insulin needed depends on the patient’s condition and includes the following types:
- Quick-acting insulin, which works within 30 minutes of injection and is effective in controlling blood sugar after meals and eating. There is also a more rapid-acting insulin that starts to work in about half the time of the above drugs, but has a shorter duration of action.
- Medium-acting insulins, which take longer for the body to absorb the drug than rapid-acting insulins but also have a longer duration of action, are good at controlling blood sugar at night and between meals.
- Long-acting insulin, a type of insulin that keeps blood sugar stable over the course of the day, can be used at night, between meals, and when fasting is needed. In some cases, the duration of action can exceed 24 hours.
- There is also a mixture of insulins that contains both long-acting and fast-acting insulin components, also called “premixed insulin.
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Talk to your doctor.
Talk to your doctor to find out which type is best for you.
You also need to choose which insulin injection is best for you. Of course, insurance coverage may also be an important factor in the decision.
The following injection options are available:
- Syringe, which allows you to choose a syringe to inject insulin, with a choice of abdomen, thigh, hip, or upper arm injection sites.
- Insulin pens, which have an injection needle at the tip, are much the same as syringe injections, but may feel easier to use. An insulin auto-injector pump, a machine that fits in a garment bag or waist pouch and pumps the drug subcutaneously through a guide needle at the tip of a thin tube, so that a steady dose of insulin can be injected consistently.
Surgery
You may have heard of bariatric surgery (gastric bypass surgery), which is not a procedure developed specifically for the treatment of type 2 diabetes. It may be considered if your doctor advises that your body mass index (BMI) is higher than 35. It is important to note that the long-term effects of this procedure on type 2 diabetes are not known. Please consult your physician if planning to undergo this procedure.
While researchers are still studying the effects of this procedure on patients, some patients who have undergone the procedure have been observed to lose significant weight and return to normal blood glucose.
Artificial pancreas
The idea behind this is to develop a separate system to monitor blood sugar levels around the clock and automatically inject insulin or other medications when needed.
That’s how an “artificial pancreas” called the Hybrid Closed-Loop Insulin Infusion System was approved by the US Food and Drug Administration (FDA) in 2016. It checks blood sugar levels every 5 minutes and injects insulin when needed.
Research on the artificial pancreas has focused on type 1 diabetes, but the artificial pancreas may also be effective for type 2 diabetes.