Even if you can manage your diabetes now by just eating well and being active, you may need medication someday.
We've come far since the 1920s, when insulin was first used to treat diabetes. There's no magic pill yet, but you have more options than ever before to help control your blood sugar. And more are coming.
How can you get your daily chocolate fix -- and eat less sugar or calories, too? That's a million-dollar question that several companies are banking on people asking. Over the past few years, the sugar-free and portion-controlled chocolate market has exploded. There are all sorts of sugar-free versions of favorite chocolate bars. And you can now buy individually wrapped chocolate bars or sticks in 60- to 100-calorie portions, along with the ever-popular kisses.
To help you decide among all the options...
Most type 2 diabetes drugs work by helping your body make insulin or use it better. SGLT2 inhibitors are different because they don't have anything to do with insulin.
Your kidneys try to keep glucose, a kind of sugar your cells use for energy, out of your pee. Proteins called SGLTs make sure the glucose goes back into your body.
But with type 2 diabetes, if your blood sugar level is already creeping up, you don't need the glucose in your body. These pills turn off one of those proteins so that you pee it out instead.
Canagliflozin (Invokamet, Invokana)
Dapagliflozin (Farxiga, Xigduo)
SGLT2 inhibitors have some extra benefits, says John B. Buse, MD, PhD, director of the Diabetes Care Center at the University of North Carolina at Chapel Hill. "You're losing calories through urine, so there is weight loss -- usually about 5 to 10 pounds in 6 to 12 months."
When you take SGLT2 inhibitors, you lose a little bit of salt, too, which can help with your blood pressure.
These drugs aren't perfect, he says. "The downside is that, because there is sugar in your nether regions, women have a higher risk of yeast infections, and uncircumcised men can get foreskin infections."
To avoid the risk of dehydration, Buse says that elderly people with kidney disease and people who are taking diuretics, pills that make you pee out extra water, shouldn't take SGLT2 inhibitors.
The only inhaled insulin on the market is Afrezza. It's a fast-acting insulin, so you only take it at mealtimes. It comes in 4-unit and 8-unit cartridges that you pop into a small gadget, like the ones people with asthma use.