While making lifestyle changes can go a long way in managing diabetes, as well as related conditions such as high blood pressure and high cholesterol, your doctor may prescribe medications depending on your health needs.
Your diabetes treatment plan may include insulin, oral diabetes medication or a combination approach, as determined by your doctor. In some cases, patients may require multiple-drug therapy if they have additional cardiovascular risk factors with diabetes. Adherence to your medication plan is very important.
The pancreas normally secretes a hormone called insulin, which helps the body's cells take in glucose from the blood to use it for energy.
When functioning as it should, the pancreas produces the ideal amount of insulin. In people with type 1 diabetes, the pancreas doesn't produce insulin. People with type 2 diabetes produce insulin, but their bodies do not use it properly. Over time people with type 2 diabetes may produce less insulin as well. Insulin may be prescribed for both types of diabetes to help regulate blood glucose so the body can work properly.
There are many types of insulin on the market, all of which must be injected into the fat under the skin in order for it to reach the bloodstream. (Insulin is not currently available in pill form because it would be broken down during the digestive process.) Injections can be done using a:
- Syringe: A needle connected to a hollow tube that holds the insulin and a plunger that pushes the insulin down into and through the needle
- Insulin pen: A device that looks like a pen and holds insulin but has a needle for its tip
- Insulin pump: A small machine (worn on a belt or kept in a pocket) that holds insulin, pumps it through a small plastic tube and through a tiny needle inserted under the skin where it stays for several days
Insulin types differ by how they are made, how quickly they work, when they peak, how long they last, and how much they cost. They include:
- Rapid-acting insulin, begins to work about 15 minutes after injection, peaks in about 1 hour, and continues to work for 2 to 4 hours.
- Regular or short-acting insulin, which usually gets into the bloodstream within 30 minutes of injection, peaks two to three hours after injection, and is effective for about three to six hours
- Intermediate-acting insulin, which typically gets into the bloodstream two to four hours after injection, peaks four to 12 hours later, and works for around 12 to 18 hours
- Long-acting insulin, reaches the bloodstream several hours after injection and tends to lower glucose levels fairly evenly over a 24-hour period.
Your doctor will work with you to determine the best type and dosage to manage your diabetes and fit your lifestyle. Some patients take insulin one or more times a day to regulate their blood glucose levels. Your health care team will educate you about how and when to give yourself insulin.
Possible side effects of insulin include low blood glucose and weight gain.
Oral Diabetes Medication
For people with type 2 diabetes, pills may be prescribed as a means of regulating blood glucose levels. There are ten classes of oral diabetes medications that lower blood glucose. They can be used with insulin or in combination with one another. Your healthcare provider will prescribe the type of medication or combination of medications that you will need to control your blood glucose levels.
Your health care provider will tell you how and when to take pills and/or insulin, including instructions on whether to take them with food.
Medications for Associated Conditions
In addition to medications to control blood glucose, your doctor may also prescribe:
High Blood Pressure Medication
Although high blood pressure is symptomless, left untreated, it can damage blood vessels, the heart and other organs, ultimately causing death. Doctors may prescribe one or more types of medication to bring blood pressure to the target range. Follow the medication regimen as prescribed, notifying your doctor immediately if you experience any side effects.
While many patients must take medications indefinitely to control this condition, doctors may be able to reduce your drug dosages once you reach and maintain normal blood pressure for a year or more. (Typically, you can't stop treatment entirely.) Coping with the inconvenience of medication is still much better than suffering a stroke or heart attack.
Your doctor may determine that, in addition to eating a heart-healthy diet, achieving or maintaining a healthy body weight and engaging in regular physical activity, you also need medication such as a statin to lower your cholesterol levels and reduce your risk of CVD. This treatment is generally long-term, and it's important to follow your doctor's instructions.
There are a number of medications to lower blood cholesterol levels Your doctor will determine if you can benefit from such treatment and select the medication or combination of medications for you.
Learn more about the types of cholesterol-lowering medications.
Diabetes is a major risk factor for cardiovascular disease and stroke.
If your doctor determines you are at a high risk for CVD, he or she may recommend a low-dose aspirin regimen to help reduce your risk for heart attack and strokes. Aspirin "thins" the blood and helps prevent blood clots from forming—clots that can block blood flow through arteries, especially when those arteries are already narrowed by a buildup of plaque.
Do not begin aspirin therapy on your own. The best way to know if you are a candidate for it is to ask your health care provider.
To help you and your doctor keep up with the various types of medications you are taking, use this handy medicine chart.
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