Diabetes drug treatment
type 2 diabetes

There are two types of diabetes, namely type 1 and type 2.

General treatment of type 1 diabetes requires lifestyle changes, such as eating a healthy diet and exercising. People with type 1 diabetes need insulin injections and regular monitoring of blood glucose levels using a fingerstick meter.

General treatment of type 2 diabetes also requires lifestyle changes, including losing weight, eating a healthy diet, and exercising. A small number of people with type 2 diabetes can control blood glucose levels through diet and exercise alone. However, most people need to take drugs to lower blood glucose levels, including sometimes insulin. People who take drugs to treat type 2 diabetes often need to monitor their glucose with a fingerstick several times a day.

Doctors must be careful when using drugs to treat diabetes mellitus, because insulin and many drugs taken by mouth can make blood glucose levels too low (hypoglycemia).

Insulin replacement therapy

People with type 1 diabetes need insulin treatment all the time, and their condition will get much worse without it. Many people with type 2 diabetes also need insulin. Insulin is usually injected under the skin. In some patients, it is not a common treatment.

Oral insulin cannot be taken at present because insulin is destroyed in the stomach. New pharmaceutical forms of insulin that can be taken by mouth are being tested. Insulin is injected into the layer of fat under the skin of the arm, thigh, or abdomen.

Small, thin-tipped syringes make the injection almost painless.An insulin pen containing an insulin cartridge is a convenient method for many people who carry and use insulin, especially people who take several daily injections outside the home.

Another device can be used, which is an insulin pump that pumps insulin continuously from a reservoir through a small needle left in the skin.

The rate of insulin administration can be adjusted depending on the time of day, whether the person is exercising or other activities, as additional doses of insulin can be released. Insulin with meals when necessary, or to correct high blood glucose levels.

The way the pump works is very similar to the way the body normally produces insulin. Pump therapy is considered in some people who need injections more than 3 times per day.

Some people have the pump an extra degree of control, while others find that using the pump does not work for them or they get sores where the needle entered.

 

 

Choose the type and dose of insulin

Choosing the type of insulin is complex. Doctors consider the following factors when choosing the best type of insulin and the dose to use:

1.How well the body responds to the insulin it makes

2.The amount of increase in the level of glucose in the blood after eating meals

3.Possibility of using other hypoglycemic agents instead of insulin

4.The extent to which people are willing and able to monitor their blood glucose levels and adjust the dose of insulin that should be used 5.How often patients want to use insulin injections

6.The extent of daily activity varies 7.How likely a person is to develop symptoms of hypoglycemia (low blood sugar levels) Some people can take a combination of two types of insulin – rapid-acting and intermediate-acting insulin – in one morning dose.

A second dose of either or both types of insulin may be given at dinnertime or before bed. Some people use the same amount of insulin every day, while other people, especially those with type 1 diabetes, need to adjust the dose of insulin, especially when they eat, as it varies with diet, exercise, and blood glucose level, as well as the person’s need may change of insulin according to weight gain or loss, stress or illness, especially infection. One modifiable treatment includes injections of long-acting insulin in the morning or evening, plus a number of additional injections of rapid-acting insulin during the day with meals.

Adjustments are made as insulin needs change. Measuring blood glucose levels at different times of the day helps determine Determine the necessary modification. This treatment regimen requires people to have a lot of knowledge about their diabetes to pay proper attention to the details of their treatment.

lack of blood sugar

The most common complication of insulin therapy is low blood glucose levels (hypoglycemia).

Hypoglycemia occurs most often when people try to finely control blood glucose levels. Symptoms of mild or moderate hypoglycemia include headache, sweating, palpitations, light-headedness, blurred vision, irritability, and confusion.

More severe hypoglycemia symptoms include seizures and loss of consciousness. In older people, hypoglycemia may cause stroke-like symptoms. However, people who have frequent hypoglycemia may not feel symptoms because they do not have symptoms (hypoglycemia unawareness).

Doctors teach people how to recognize the symptoms of hypoglycemia and how to treat the symptoms. Usually, the person can eat something sweet, such as hard candy or juice, to quickly raise the blood glucose level.

People may also carry glucose tablets to use when hypoglycemia occurs. Because people with hypoglycemia may be so confused that they are not aware of hypoglycemia, it is important that other family members learn the signs of hypoglycemia.

 

 

Oral blood sugar-lowering medications

Oral hypoglycemic drugs often can sufficiently lower blood glucose levels in people with type 2
diabetes, but they are not effective in managing type 1 diabetes. There are several types, but oral hypoglycemic drugs work. Through 4 main methods: 1.Insulin-releasing stimuli cause the pancreas to produce more insulin

2.Insulin sensitizers do not affect insulin secretion, but they do increase the body’s response to it. 3.Some medications delay the absorption of glucose into the intestine

4.Some medications increase the excretion of glucose in the urine    Inducers of insulin release include sulfonylurea drugs (such as glyburide) and meglitinides (such as repaglinide). Insulin sensitizers include biguanides (such as metformin) and thiazolidinedione’s (such as pioglitazone). Drugs that delay the absorption of glucose into the intestine include alpha-glucosidase inhibitors (such as acarbose and miglitol).

Drugs that increase urinary glucose excretion include sodium-glucose cotransporter-2 inhibitors (such as canagliflozin, dapagliflozin, and empagliflozin). Dipeptidyl peptidase-

4 inhibitors (such as sitagliptin, saxagliptin, linagliptin, and alogliptin) stimulate the pancreas to produce more insulin and delay the absorption of glucose into the intestine. These drugs work by increasing glucagon-like peptide-1. People with type 2 diabetes are often treated with oral hypoglycemic agents when diet and exercise fail to lower blood glucose levels adequately. Sometimes the drugs are given only once in the morning, although some people need two or three doses. More than one type of oral drug may be used, or an oral drug may be used in addition to insulin or an injectable glucagon-like peptide-1 drug when one drug is not sufficient.

Injectable blood sugar-lowering drugs

Insulin is the most common injectable hypoglycemic drug. Its use was discussed above.

There are two other types of injectable hypoglycemic drugs:

1.Glucagon-like peptide-1 drugs

2.Amylin-like drugs

Injectable antihyperglycemic drugs are used in combination with other antihyperglycemic agents.

Glucagon-like peptide drugs work primarily by increasing the release of insulin by the pancreas. These drugs also slow the passage of food from the stomach (which slows the increase in blood glucose), reduce appetite, and promote weight loss. They are given by injection. The most common side effect is nausea. and vomiting. These drugs can increase the risk of pancreatitis (painful inflammation of the pancreas), although the evidence for this is not clear. People with a personal or family history of medullary thyroid cancer should not use these drugs. This is because studies in animals have shown an increased risk of some types of thyroid tumors. So far, no increase in the incidence of these types of cancer has been shown in humans.

The use of amylin–like drugs, whose effect is similar to that of amylin, a pancreatic hormone that helps regulate blood glucose levels after eating. Pramlintide is the only amylin-like drug currently available. It works by inhibiting the production of the hormone glucagon. Since glucagon increases the level of glucose In the blood, pramlintide helps lower the level of glucose in the blood. It also slows the passage of food from the stomach, and helps people feel full. It is given by injection and used in combination with insulin that is given at the same time as a meal in patients with type 1 or 2. from diabetes