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Managing Diabetes: Treatment with Oral/Injectable Medications

 
 
Treatment with Oral Medications

For some people with type 2 diabetes, oral medications (pills), along with a healthy meal plan and exercise, can help keep blood glucose levels within healthy ranges. There are several different kinds of oral medications. These pills are taken alone or in combination with each other or with insulin to lower blood glucose levels.

Oral medications include:
• Insulin secretors to help your pancreas make more insulin
• Insulin sensitizers to help your body become more sensitive to insulin
• Medications that decrease the liver’s production of glucose and help your body become more insulin sensitive
• Combination medications which combine an insulin secretor with an insulin sensitizer
• Medications which delay the absorption of glucose from food

Since everyone with diabetes is different, there is no single “ideal” dose or combination of medications. Your doctor or nurse practitioner will prescribe the best medication or combination of medications for you. If you have any questions about when or how to take your medications, be sure to discussthem with your diabetes care team. Diabetes can change over time. When it does, your treatment plan will need to change with it. As a result, don’t be alarmed if your medications change from time to time.

Treatment with Insulin
As you’ve already learned, your body needs a hormone called insulin to let it use the glucose in your blood for energy. Insulin can’t be taken orally (swallowed in pill form) because the digestive process would make it useless. For this reason, insulin is taken by injection.

In type 1 diabetes, the body stops producing insulin entirely. People with type 1 diabetes need daily insulin injections to stay alive.

In type 2 diabetes, the body still produces some insulin, but not as much as it needs. If your meal plan, exercise and oral diabetes medications can’t bring blood glucose to healthy ranges, then you’ll also need to take insulin injections.

Types of Insulin
Insulin comes in several types. They are classified based on three timing factors:

1. How fast they work (known as “onset”)
2. When they work best (known as “peak time”)
3. How long they keep working (known as “duration”)

Different types of insulin are often used in combination, to give people with diabetes the best possible control over blood glucose levels. Each person with diabetes is a unique person with unique needs. For this reason, there is no “ideal” combination of insulin types, or injection schedule.

Let’s take a closer look at the different types of insulin:

INSULIN
(Name)
ONSET
(how fast it works
after injection)
PEAK TIME
(when it works best)
EFFECTIVE
DURATION

(how long it works)
Rapid-acting
(Lispro or Aspart)
(Glulisine)
10-15 minutes
30-90 minutes 2-4 hours
Short-acting
(regular)
1/2 - 1 hour 2-3 hours 3-6 hours
Intermediate-acting
(NPH)
2-4 hours 6-10 hours 10-16 hours
Long-acting
(Glargine)
(Levemir)
1 hour
1.5 hours
None
6-8 hours
24+ hours
6-24 hours
Combinations
(70/30; 50/50;
75/25)
15 minutes
1 hour*
Dual* 10-16 hours

* If you use a “combination insulin,” check with your doctor or diabetes care team regarding the onset and peak times for your particular prescription.


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