Oral Medications

Many people with type 2 diabetes still create insulin, but their bodies either do not make enough or do not use it as effectively as they should.

Often, healthcare professionals start people with diabetes on a therapy of diet and exercise. If these are not enough, the healthcare professional may prescribe oral medications. If medication still does help control blood sugar levels, insulin may be added to a person’s therapy.

Today’s oral drugs offer more options for the treatment of type 2 diabetes. Because various medications work in different ways, healthcare professionals may be able to add drugs together for better results. While on oral medication for diabetes, frequently checking your blood sugar helps you know if the medicine is working.

Insulin Treatment

Insulin is a natural hormone made in your pancreas. It moves sugar (blood glucose) from your blood into your cells. If your body cannot generate its own insulin, it may be necessary to take insulin in order to maintain healthy blood sugar levels. In these cases, insulin must be placed into the bloodstream. Insulin can be injected by a syringe or a pen, or through an insulin pump. Insulin cannot be taken in pill form because the acids in the stomach break it down.

There are a variety of insulin types, brands and sources. Healthcare professionals often prescribe 2 types of insulin: mealtime insulin and background insulin. Mealtime insulin (bolus) is used to control after-meal blood sugar. Background insulin (basal) is used to meet your needs throughout the day and night.

Insulin Characteristics

By observing how the insulin you use affects your blood sugar levels, you may better monitor your blood sugar levels. Each type of insulin has 3 characteristics:¹

• Start, or onset—how long it usually takes for insulin to start working.
• Peak—the time when the insulin is working hardest.
• Duration—how long the insulin usually stays in your body.

Make a point of knowing the characteristics of the insulin(s) you use and understand how they affect your blood sugar levels.

Insulin Delivery Methods

Because people with type 1 diabetes do not produce their own insulin, they need to supply their bodies with insulin from an outside source. There are currently 3 main insulin delivery methods:

• Shots, or injections, are the most common way people with diabetes deliver insulin to their bodies. It involves drawing insulin from a bottle into a syringe and injecting it into the body.
• Insulin pens offer a different method of injection. They look like writing pens and are prefilled with insulin. The user dials a dose of insulin from a cartridge in the pen.
• The insulin pump is attached to the user at all times, delivering insulin to the body 24 hours a day.

Insulin Pumps

Insulin pumps provide insulin to your body 24 hours a day. A basal, or background, rate is delivered automatically based on your total daily insulin requirements. You can also give yourself a bolus insulin dose to cover the food you eat, as well as supplemental doses to correct your blood sugar when it is out of range. Your healthcare professional will help you determine your rates and dosages.

Under the care of a healthcare professional, insulin pump users can go to school or work, sleep and even play sports with the pump. At night, it can be clipped to sleepwear, a blanket or tucked under your pillow.

Insulin pump users can take their pumps off to swim, bathe or shower or to participate in physical activity. If the pump is off the body for less than an hour, simply test your blood sugar when you reconnect and take the necessary steps outlined by your healthcare team. Check with your healthcare professional if you must be disconnected for more than an hour.

Other Treatment Options

Other Injections

In addition to insulin and oral medications, other types of injectable medicines are now available. These injectable medicines are designed to keep your blood sugar from going too high after you eat. These therapies work with insulin in the body and are not substitutes for insulin.

Pancreatic Islet Transplantation

The pancreas, an organ about the size of a hand, sits behind the lower part of the stomach. It makes insulin and enzymes that help the body digest and use food. Throughout the pancreas are clusters of cells called the islets of Langerhans. Islets are made up of several types of cells, including beta cells that make insulin.

Pancreatic islet transplantation is an experimental procedure in which these islets are taken from the pancreas of a deceased organ donor. The islets are purified, processed and transferred into another person. Once implanted, the beta cells in these islets begin to make and release insulin. Researchers hope that islet transplantation will help people with type 1 diabetes live without daily injections of insulin.¹