Oral Medications

Many people with type 2 diabetes still make 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 type 2 diabetes on a therapy of diet and exercise. If this is not enough, the healthcare professional may prescribe oral medications. If oral medication still does not help control blood glucose levels, insulin may be added to the 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 prescribe a variety of medications for better results. While on oral medication for diabetes, frequently checking your blood glucose level helps you know if the treatment is working.

Insulin Treatment

Insulin is a natural hormone made in your pancreas. Insulin is responsible for moving sugar (blood glucose) from your bloodstream into your cells. If your body cannot generate its own insulin, it will be necessary to take insulin in order to maintain healthy blood glucose 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 tablet 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 glucose. 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 glucose levels, you may gain a better understanding of your therapy. 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 glucose 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:

• Injections are the most common way people with diabetes deliver insulin to their bodies. It involves drawing insulin from a vial into a syringe and injecting it into the subcutaneous tissue of the body.
• Insulin pens offer a different method of injection. They look like writing pens and are prefilled with insulin. The person dials a dose of insulin from a cartridge in the pen.
• The insulin pump is attached to the body at all times, delivering insulin to the body 24 hours a day. However the pump can be temporarily taken off for showers, swimming etc.

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 glucose when it is out of range. Your healthcare professional will help you determine your rates and dosages.

Under the care of a healthcare professional, the person using the insulin pump 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 a pillow.

People with insulin pumps 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 glucose 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 medications are now available. These injectable medications 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