Diabetes

Insulin is not available in oral form. It is delivered by injections that are generally required one to four times per day. Some people use an insulin pump, which is worn at all times and delivers a steady flow of insulin throughout the day.

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Insulin preparations differ in how quickly they start to work and how long they remain active. Sometimes different types of insulin are mixed together in a single injection. The types of insulin to use, the doses required, and the number of daily injections are chosen by a health care professional trained to provide diabetes care.

People who need insulin are taught to give themselves injections by their health care providers or diabetes educators.

Unlike type 1 diabetes, type 2 diabetes may respond to treatment with exercise, diet, and/or oral medications. There are several oral hypoglycemic agents that lower blood glucose in type 2 diabetes. They fall into one of three groups:

Medications that increase insulin production by the pancreas. These include Amaryl, Glucotrol, and Glucotrol XL, Micronase, Diabeta, Glynase, Prandin, and Starlix.
Medications that increase sensitivity to insulin. These include Glucophage, Avandia, and Actos.
Medications that delay absorption of glucose from the gut. These include Precose and Glyset.

Most type 2 diabetics will require more than one medication for good blood sugar control within three years of starting their first medication. Different groups of oral medications may be combined, or insulin and oral medications may be used together.

Some people with type 2 diabetes find they no longer need medication if they lose weight and increase activity, because when their ideal weight is reached, their own insulin and a careful diet can control their blood glucose levels.

Oral hypoglycemic agents are not known to be safe for use in pregnancy; women who have type 2 diabetes and take these medications may be switched to insulin during pregnancy and while breast-feeding.

Gestational diabetes is treated with diet and insulin.

SELF-TESTING

Self-monitoring of blood glucose is done by checking the glucose content of a drop of blood. Regular testing tells you how well diet, medication, and exercise are working together to control your diabetes.

The results of the test can be used to adjust meals, activity, or medications to keep blood sugar levels in an appropriate range. Testing provides valuable information for the health care provider and identifies high and low blood sugar levels before serious problems develop.