How Type 2 Diabetes Medication Works

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Historically, the goal of treatment for patients with type 2 diabetes is getting the A1C, which is a marker of your average blood sugar on a laboratory test below 7%. And it can be challenging to achieve this, so many patients will require multiple medications as well as multiple lifestyle interventions to achieve that target. Some medications make your body more sensitive to the insulin that you're making. Some medicines actually help your body produce and secrete more insulin, and then there are some medications that not only will help improve your blood sugar but may also help patients lose weight.

Now, historically, again, we focused on glucose levels. We wanted to get them under control. However, there's new evidence out there that some medications for type 2 diabetes not only improve the blood sugar but can also reduce your risk of having cardiovascular events, such as a heart attack or stroke, and then there are other medications which have been shown to help reduce the progression of chronic kidney disease and therefore help to delay complications related to the kidney as a result of the state of high blood sugars in patients with type 2 diabetes.

So it's not all just about blood sugar control, it's also about using the right medications that can help not only to the lower blood sugar, but also to provide those ancillary benefits. But what happens over time with type 2 diabetes is your body's ability to make and secrete insulin will decline. So as you go from 50% to 30% to 20% and less insulin production and your body is less responsive to the insulin, some patients will require insulin replacement therapy, but many patients can continue to be maintained with oral or non-insulin-injectable therapies for a very long time.

When patients are diagnosed, that is the time to really be aggressive, and that is where you need to make sure that your patients see a diabetes educator to really understand what type 2 diabetes is all about, the management, their expectations, and the requirements that they're going to need to follow in order to manage their blood sugar. Incorporating a nutrition expert to really guide the patients on portion sizes and the amount of sugar that they should take at each meal is very important and should augment any medication that is initiated for patients with type 2 diabetes.