Latest Diabetes Treatments
Today's medical advances make a diagnosis of diabetes less frightening than it was in the past. "Diabetes can be treated, and this can prevent a lot of the complications associated with it," says Joel Zonszein, M.D., head of the clinical diabetes program at Montefiore Medical Center in NYC.
Oral Medications
Oral agents for management of type 2 diabetes (or for those with type 1 who are also insulin resistant) work in various ways to help lower blood sugar. They can be used singly or sometimes in combination:
- Sulfonylureas (chlorpropamide, glipizide, glyburide, glimepiride) stimulate the cells of the pancreas to release more insulin.
- Meglitinides (repaglinide, nateglinide) also trigger the release of insulin by stimulating the pancreas.
- Biguanides (metformin) lower blood glucose by curbing the amount of glucose produced in the liver.
- Thiazolidinediones (rosiglitazone, pioglitazone) help insulin work better and lower glucose in the liver.
- DPP-4 inhibitors (sitagliptin) help improve a patient's A1C level—an indicator of a person's average blood glucose control for the past two to three months—without causing hypoglycemia (as can happen with sulfonylureas and meglitinides).
- Alpha-glucosidase inhibitors (acarbose, miglitol) block the breakdown of starches and some sugars in the intestine.
Injectables
- Exenatide helps people with type 2 diabetes regulate blood sugar by signaling the pancreas to make more insulin and limiting the production of sugar in the liver. It also helps reduce weight. Recently, the FDA issued a warning that there is a risk of acute pancreatitis associated with this drug.
- Pramlintide is a synthetic version of the hormone amylin, which is produced by beta cells in the pancreas (as is insulin) and helps to maintain normal blood sugar. It also seems to promote weight loss. It is for those with type 1 or type 2.
- Insulin is needed by people with type 1 diabetes because their bodies are unable to make the hormone, which is needed to keep blood sugar levels healthy. Those with type 2 diabetes may need it if other measures don't control blood sugar. There are several types of insulin, each varying in the time it takes to start to work, peak and stay in the body. "It is the best agent for lowering blood sugar," says David Erani, M.D., chief medical officer of DiabetesAmerica treatment centers, "but for type 2 it's often started later than it should be."
