Most people with type 2 diabetes only need oral diabetes medications and lifestyle changes to control their blood glucose levels. Other patients also need injectable diabetes medications.
Which treatment is the right one?
“The first principle is that you have to take your own medication.
“The first principle is to make life as easy as possible and to make treatment effective,” said Dr. Daniel Einhorn, medical director of the Scripps Whittier Diabetes Institute in La Jolla, California, “We want to choose treatments that therapies that patients can easily cope with.”
What would doctors consider?
There are several types of diabetes medications complemented by a healthy lifestyle that can control blood sugar.
If a patient needs more than one diabetes medication, this is a combination. Doctors choose to co-administer medications appropriately, Einhorn says: “The various medications work in different ways, so co-administration can sometimes be very effective.”
The combination usually includes metformin, which suppresses the amount of glucose produced by the liver.
In addition to metformin, some patients use insulin or other medications, which may be tablets or injections. The doctor will consider whether the patient wants to self-inject, so it is important for the patient to tell the doctor how he or she feels about this.
Some patients can take injectable medications,” said Dr. Eleftheria Maratos-Flier, professor of medicine at Beth Israel Deaconess Medical Center in Boston, USA. Other patients will choose a non-injectable option,”
Doctors also consider other things, including the patient’s weight and the pros and cons of each drug, so they tailor the treatment plan to the patient’s needs.
“For patients, the optimal combination of medications continues to change,” said Marina Basina, MD, professor of endocrinology at Stanford University, “and over time, if one of the medications is no longer effective for the patient, or if the treatment regimen has side effects, it is important to make change.”
How to choose the best diabetes therapy is both an art and a science. The American Diabetes Association publishes treatment guidelines each year, and teams of skilled professionals issue therapy recommendations.
“But the field of diabetes treatment changes so quickly that some guidelines are almost obsolete by the time they are published,” Maratos-Flier said. The only way to find the best treatment is to repeat the trials because there is no way to know in advance how patients will respond to a drug or combination of drugs.
Patients need to watch their blood glucose levels with their doctors to make sure the combination therapy is working properly.
Einhorn said, “The sooner you get your blood glucose levels down to normal, the better your control of blood glucose will be and the less likely your diabetes will progress.