Many people with type 2 diabetes can manage blood sugar levels effectively on oral diabetes medications and lifestyle changes alone. Others will need to combine oral diabetes medications with injectable diabetes drugs in order to bring their blood glucose levels into a healthy range. Finding the right combination is the key to managing diabetes successfully.
For years, insulin was the only injectable diabetes medication available to help control blood sugar. Today, several newly approved injectable diabetes drugs are available. A growing number of medication options are also available, so doctors can individualize diabetes treatment with greater precision than ever before.
If you have diabetes, a healthy diet does more than keep your blood sugar under better control. A good diabetes diet can also help prevent or delay the onset of complications such as nerve pain or heart disease.
Although some people talk about a "diabetes diet," there's really no such thing, experts say. The same healthy diet recommended for those without diabetes will help you if you have diabetes, too. You may need to then tailor the meal plan to your specific needs, such as lowering your cholesterol...
How will your doctor decide the best diabetes drug regimen for you? “The first principle is to make life as easy and therapy as effective as possible,” says Daniel Einhorn, MD, president of the American Association of Clinical Endocrinologists and medical director of the Scripps Whittier Diabetes Institute in La Jolla, Calif. “Type 2 diabetes is a lifelong problem. We want to choose therapies that people can easily live with.”
One factor is how comfortable people feel giving themselves injections. “Some patients are fine with injectable medications. Others will do anything not to have to give themselves injections,” says Eleftheria Maratos-Flier, MD, professor of medicine at Beth Israel Deaconess Medical Center in Boston.
The second principle of combination diabetes drug therapy, according to Einhorn, is choosing medication therapies that work in complementary ways. “Today we have a variety of drugs that work in very different ways, so combinations can be especially effective,” says Einhorn.
One of the most commonly used oral drugs, metformin (sold under the brand names Blumetza, Fortamet, Glucophage, and Riomet), is considered the cornerstone of most combination therapy. It works by decreasing the amount of glucose produced by the liver. Metformin can be paired with insulin or with a GLP-1 agonist, which stimulates insulin production.
Doctors may also combine insulin with a GLP-1 agonist and a thiazolidinedione oral medication (Actos and Avandia), which sensitizes the body to insulin. For people comfortable with using injectable drugs, doctors may recommend one of the two new GLP-1 agonists, Byetta and Victoza. For people who don’t want an injectable drug, the alternative is a DPP-4 inhibitor (Januvia, Nesina, Tradjenta, and Onglyza), which is taken orally.
Weighing the Pros and Cons of Drug Combinations
Minimizing adverse effects is also important. Some diabetes medications can cause blood sugar levels to drop too low, causing hypoglycemia. The oral medication sulfonylurea (DiaBeta, Glynase, Micronase), which has long been used for type 2 diabetes, poses a moderate risk of causing hypoglycemia. Many doctors prefer to prescribe metformin, which is much less likely to cause hypoglycemia. Metformin is often paired with a GLP-1 agonist because these new injectable drugs work only when blood sugar levels are high, further avoiding hypoglycemia.
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People who experience hypoglycemia several times in a week should call their health care provider. It's important to monitor your levels each day so you can make sure your numbers are within the range. If you are pregnant always consult with your health care provider.
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However, it's important to continue to track your numbers so that you can make lifestyle changes if needed. If you are pregnant always consult with your physician.
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Even if your number is high, it's not too late for you to take control of your health and lower your blood sugar.
One of the first steps is to monitor your levels each day. If you are pregnant always consult with your physician.
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