For type 2 diabetes it is possible that no medication is required if changes to diet, exercise regimes and lifestyle allow the body to become self-regulating once again. However, if this is not the case, medication will need to be taken.
There are five different types of drug available that all work in slightly different ways to help the type 2 diabetes sufferer.
The alpha-glucosidase inhibitors work by affecting the way the body digests carbohydrates. These drugs are taken with every meal and actually slow down the digestion process of carbohydrates to prevent high levels of glucose entering the bloodstream. They have caused diarrhea in some patients.
Thiazolidinediones support the work of insulin at a cellular level. They also inhibit the release of glucose from the liver and so control glucose levels in the blood. These drugs are taken with food, although they are not required to be taken with every meal. Because these drugs alter the way the liver works it is important that they are taken under medical supervision and that regular liver function checks are made.
The Biguanide drugs also act on the liver and work to control glucose levels in the blood stream by decreasing the amount of glucose released by the liver. Once again, it is important that liver function is monitored whilst these drugs are being taken.
Meglitinides stimulate the insulin producing cells of the pancreas to release insulin. These drugs are usually taken immediately before every meal. There is an increased risk of hypoglycemia when these drugs are being taken as the pancreas may be stimulated into producing too much insulin which may cause blood sugar levels to fall too low.
Sulphonylureas also stimulate the pancreas to produce and release more insulin, so once again hypoglycemia can become a problem.
These drugs are only available to those with type 2 diabetes and it should be noted that pill treatment does not always work for everyone. This type of drug therapy seems to have the best chance of success with those who have just developed type 2 diabetes or with those who have only ever needed very small amounts of insulin to keep their glucose levels within acceptable limits. Oral medication is not prescribed to pregnant women and in these cases the diabetic mum-to-be must control her condition either through changes in diet or by taking insulin.
It should be noted that taking diabetes medication does not give the diabetic license to abandon all dietary controls. It is important to continue to test glucose levels and to eat a sensible, diabetic friendly, diet.
Sometimes the drugs are offered in combinations to enhance their effects e.g. a pancreas stimulant with a glucose inhibitor. This can be beneficial provided the side effects do not make the treatment unbearable.
These drugs can only work if the pancreas is still able to produce insulin. For those who have type 1 diabetes where their bodies produce no insulin at all, insulin replacement is required. In addition, insulin replacement or supplementation becomes necessary when drug therapy can no longer maintain glucose levels.