Diabetes Forecast

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The Healthy Living Magazine

Medications for Type 2

If you have type 2 diabetes, you may be managing your condition with diet and exercise alone, or combined with one or more oral medications or injected drugs


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Here's how things worked before you developed type 2 diabetes: When you ate, the level of glucose (the type of sugar used by the body for energy) in your blood rose, which caused the insulin producing cells in your pancreas to make insulin. That insulin then told your muscle cells to let glucose in. This caused a fall in your blood glucose level toward normal.

The insulin also told your liver--which, before you ate, had been busy releasing glucose from its stores, like gas from gas tank--to stop dispensing that glucose. It was the insulin, stimulated by the presence of glucose in the bloodstream, that told your body when it was time to stop releasing its fuel--glucose--and to start storing it.

As you developed type 2 diabetes, your muscle and liver developed insulin resistance, which means that they no longer responded to insulin normally. When you ate, your pancreas had to work harder to make enough insulin to overcome the insulin resistance, which it was able to do for a time. But one day, it stopped being able to keep up with the high demand for insulin. Then, when you ate, your muscle cells were unable to take up enough glucose, your liver did not fully shut off its release of glucose, and, as time went on, the levels of glucose in your blood rose higher and higher after meals.

Eventually, your liver released too much glucose 24 hours a day, and you developed high blood glucose levels even when you weren't eating.

To put it another way, in most people with type 2, blood glucose runs high because:

  • The pancreas doesn't make enough insulin to overcome your body's insulin resistance and control your blood glucose.
  • Muscle cells don't easily take in glucose because they resist insulin's action.
  • The liver doesn't store and release glucose at the right times due to insulin resistance.

Type 2 diabetes presents several challenges, for which there are a number of potential pharmaceutical approaches. Today, there are six classes of diabetes pills and two injected drugs, in addition to insulin (click here for information about insulin and the injectables Byetta and Symlin). Each acts in a different way. Many people benefit from taking two or more diabetes drugs, each of which addresses a different problem.