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Oral Medications and Type II Diabetes

Oral Medications and Type II Diabetes

Over 16 million people in the United States have diabetes mellitus. Five to ten percent of those have insulin-dependent (Type I or juvenile-onset) diabetes while 90 to 95 percent have non-insulin-dependent (Type II or adult-onset) diabetes.

Unlike people with Type I diabetes, whose bodies have no insulin at all, people with Type II diabetes continue to produce some insulin. However, there are two problems: 1) they may not make enough insulin, and/or 2) the body doesn't effectively use the insulin that is made. This second condition, when insulin is present but doesn't effectively control blood sugar, is called insulin resistance, and is a key factor on non-insulin-dependent diabetes.

Type II diabetes is also called adult-onset diabetes, and usually occurs in people over the age of 40. Eighty percent of people with Type II diabetes are overweight-excess weight is a cause of insulin resistance. People who are slim and have Type II diabetes usually have impaired insulin secretion.

The majority of people with Type II diabetes do not need to be treated with insulin. Approximately 25 percent are treated through diet and exercise programs alone. Fifty percent of people with Type II diabetes are treated with oral medications called oral hypoglycemic agents, to bring their blood sugar level as close to normal as possible.

What Are Oral Hypoglycemic Agents

Oral hypoglycemic agents are used to lower blood sugar, but they are not insulin pills. Insulin is a protein and can't be taken orally because it would be broken down in the digestive tract and destroyed before becoming effective.

The oral diabetes medications are called sulfonylureas and biguanides. Although experts don't know exactly how there drugs work, they have these major effects:

• They stimulate the pancreas to release more insulin.
• They make the body's tissues more sensitive to the insulin that is produced or they help the body use the insulin already produced more effectively.

In order for oral hypoglycemics to work, a person's body must produce some insulin. For many people with Type II diabetes, oral medication is extremely effective. Occasionally, the medication loses its effectiveness after years of use. At this point, insulin treatment is usually recommended.

What Are Oral Hypoglycemic Agents Are Advised

Diet and regular exercise are the cornerstones of treatment for Type II diabetes. Since most people with Type II are overweight and have the insulin resistance associated with obesity, a doctor's first treatment is a program of strict diet and regular exercise. Weight loss and exercise help the body's cells use insulin more efficiently. Even those who aren't overweight can benefit from a carefully controlled diet.

If blood sugar levels are still too high after making these "life-style" changes, the next step in treatment is either oral hypoglycemic agents or insulin. Usually doctors will try oral medication first, using Pills are not a replacement for Exercise and Weight Loss. It is essential that overweight people continue their weight loss efforts. Not only is medication more effective in people whose diet and weight are under control, but losing weight increases a person's sensitivity to insulin.

Dosages
After the right type of oral hypoglycemic has been selected, doctors start people on the lowest dose available. The dose can be increased each week until satisfactory blood sugar control is acheived. If the highest recommended dose doesn't deliver the desired response, a doctor will usually consider a more powerful type of hypoglycemic agent, or insulin. Even when good control is acheived with a particular dosage, it's wise to reassess the dosage periodically. In some cases, the doses can be reduced--possibly eliminated--and the patient can continue to maintain good control over blood sugar levels by diet alone.

Just One Part of the Program
Oral hypoglycemic agents are very effective in the treatment of Type II diabetes. However, they should not be relied on as the primary means of achieving good blood sugar control. Proper diet, weight control and exercise are the therapies of choice for people with Type II diabetes. These, together with self glucose monitoring and medication, are the keys to achieving the goal of any person with Type II diabetes--the reduction--even elimination--of long-term diabetes related complications.