Yes, thanks to current technology and the Internet, there are many tools that a person with diabetes can use to manage diabetes.
For example, there are websites that help keep track of blood glucose readings, which is important for the patient and the health care professionals who are helping their patient to stay healthy.
There are also websites that offer diabetes-management assistance, and some clinics and health care providers can send your lab results directly to a patient’s account.
The Internet also offers many personal health-management or electronic health record websites, some for free (but such sites may have online advertising) and some for a price.
It is up to the individual to decide how much information he or she is willing to provide when signing up for an account.
For security purposes, a person with diabetes interested in such a service should do some research on the company before choosing. (For more about the websites, see the “Resources, Websites, and Apps” section of this book.)
DIABETES AND MEDICATION
What types of medicines are used to treat diabetes?
Two main types of medications are used.
The first are oral medications, or those that are taken by mouth; these are most often associated with type 2 diabetes.
The second type is insulin that is injected or administered using an insulin pump or pen and is most associated with type 1 diabetes. (Insulin cannot be taken as a pill because the acid and digestive enzymes in a person’s stomach destroy the hormone.) According to the Centers for Disease Control and Prevention, the medicines used by adults with diabetes (both type 1 and 2) can be broken down by how they are taken.
Among adults, 57 percent take oral medications only, 14 percent take only insulin, 14 percent take a combination of insulin and oral medication, and 15 percent take no medication (mostly people with prediabetes).
How long will it take before someone with diabetes can see an improvement in blood glucose levels, after taking medications and/or making lifestyle changes?
Everyone differs when it comes to how long it takes to see an improvement (or a worsening) in blood glucose levels.
And, of course, everyone is different when it comes to taking medications and making lifestyle changes after being diagnosed with diabetes.
But, on the average, most people with diabetes will see an improvement in three to four months.
Therefore, a follow-up blood glucose test is usually administered three to four months after a diagnosis.
There is one caveat: according to the American Diabetes Association, if a person has had uncontrolled diabetes for a long time and has just been diagnosed, most doctors will test the person’s blood glucose levels after two to three weeks to make sure there is an improvement.
Does a person with diabetes always have to take some type of medication?
Unfortunately, if a person has type 1 or type 2 diabetes, then he or she will probably have to take some medication for the rest of his or her life.
Diabetes is a progressive disease, and the longer a person has it, the more likely the person will need pharmaceutical help to manage it.
Most people with prediabetes, people who have blood glucose levels above the normal range but not high enough to be called diabetes, will not need to take diabetes medication or will take medication only for a short time (until their blood glucose levels are lower and/or stable).
And if a person who has prediabetes can maintain normal blood glucose levels and not develop diabetes, then he or she will never need any diabetic medication.
Insulin is only one medication diabetics can take to control blood sugar. For example, metformin works for those with less pronounced cases.
What diabetes medications have recently been approved by the U.S. Food and Drug Administration?
For the past few decades, the U.S. Food and Drug Administration (FDA) has approved many different types of diabetes medications. These include medicines that are taken orally, injected, or inhaled. The following chart lists the diabetes medications that were approved between 2013 and 2016:
Recently Approved Diabetes Medications
Brand Name
Generic Name
Approval Date
Basaglar
insulin glargine injection
December 16, 2015
Tresiba
insulin degludec injection
September 25, 2015
Ryzodeg
insulin aspart: insulin degludec
September 25, 2015
Toujeo
insulin glargine injection
February 25, 2015
Lucentis
ranibizumab
February 6, 2015
Glyxambi
empagliflozin and linagliptin
January 2015
Trulicity
duglaglutide
September 18, 2014
Invokamet
canagliflozin and metformin hydrochloride
August 8, 2014
Jardiance
empagliflozin
August 1, 2014
Afrezza Inhalation Powder
insulin human
June 27, 2014
Tanzeum
abliglutide
May 2014
Farxiga
dapaglifozin
January 2014
Invokana
canagliflozin
March 29, 2016
Nesina
alogliptin benzoate
January 25, 2016
Duetact
pioglitazone hydrochloride and glimepiride
January 2013
Source: FDA website. All FDA-approved medicines used in the treatment of diabetes are either taken orally, injected, or inhaled and can be found listed at what is called Drugs@FDA ( http://www.accessdata.fda.gov/cder/drug-satfda/ ). For drug-labeling information, go to the National Library of Medicine database of current drug information called DailyMed ( http://dailymed.nim.nih.gov/dailymed/about.cfm ).
What is the common procedure if a person is diagnosed with type 2 diabetes?
According to Harvard Medical School, people who have been newly diagnosed with type 2 diabetes should start by concentrating on lowering their blood glucose levels.
The two most frequent steps are making lifestyle choices, mainly eating better and exercising more, and to start taking a medication called metformin.
Initially, traditional treatment started with lifestyle changes, and if that did not work, then the person was treated with medications.
In the meantime, the disease would progress.
Now, most doctors recommend that both lifestyle changes and medication be started when a person is first diagnosed.
This is because research has shown that many times, in the early stages of the disease, the insulin-secreting cells in the pancreas that are “wearing out” may be saved.
This results in either slowing down the disease’s progression or even, for some people, mitigating the disease before it can take over.
Metformin lowers your HbA1c without causing weight gain or hypoglycemia.
What is metformin?
The type of drug most often used to treat a person who has just been diagnosed with diabetes is called by the generic name metformin (one brand name is Glucophage).
It is known to lower a person’s HbA1c by about 1.5 percent and, in most cases, does not cause weight gain or hypoglycemia.
It acts by reducing glucose secretion by the liver, lowering the organ’s resistance to insulin, and it decreases blood glucose levels without stimulating the secretion of insulin.
It is considered a biguanide (see above for other types of medications), a type of oral diabetes medication, and is most often taken twice a day (usually with breakfast and dinner) or one to two times a day if an extended-release formula is taken.
There are some side effects, such as nausea and diarrhea, and in rare cases, it may cause lactic acidosis.
In addition, there are often some restrictions to metformin that a person should discuss with his or her health care provider, especially if the person has kidney, heart, or liver disease.
Does metformin have a peculiar smell?
Yes, there is one aspect of the diabetes drug metformin that no one expected.
According to most people who take metformin, it has a distinctive smell that some describe as a “fishy” odor.
Some doctors are concerned that this characteristic may cause a person to stop taking the drug.
And since the drug works so well for most people with type 2 diabetes, stopping metformin would be detrimental to the person’s health!
There are potential solutions.
One study indicated that switching to certain extended-release versions of the drug may help (these drugs are said to have less smell, if any at all).
But the best solution if the smell is a concern, without holding one’s nose as they take the drug, is to contact a health care professional about possible alternative formulations.
Do any non-diabetic medicines affect a person with diabetes?
According to the Centers for Disease Control and Prevention, some non-diabetic medications can affect a person’s blood glucose level.
This is a concern if a person already has type 1 or type 2 diabetes.
This is also why health care professionals must know the various medications a person with diabetes is taking, including those taken without a prescription (for example, vitamins and herbal supplements).
The following are only some types of medications that can cause a problem with blood glucose levels:
• barbiturates
• thiazide diuretics (given mainly for high blood pressure)
• corticosteroids
• birth control pills and progesterone
• decongestants containing beta-adrenergic agents, such as pseudoephedrin
• vitamin B3, also called niacin (but the risk of high blood sugar from niacin decreases after it has been taken for a few months)
Is type 2 diabetes always treated with oral medications?
Most people with type 2 diabetes are commonly treated with oral medications. But if the drugs no longer work, then the person may have to turn to insulin injections. This means either insulin only or oral medications augmented with insulin injections.
What are some possible ways to get off or lower diabetic medication if a person has type 2 diabetes?
Some health care professionals suggest that there are certain specific conditions in which a person with type 2 diabetes may be able to take less diabetes medication or even stop taking medication.
One of the major problems in coping with diabetes is that the person usually has to make conscious lifestyle changes.
In fact, certain lifestyle changes may help immensely.
These include more healthful eating habits, starting or maintaining better exercise routines, and keeping excellent track of blood glucose levels.
The following lists some target glucose levels to reach in order to reduce, possibly, or even stop a person’s type 2 diabetes medication (of course, getting off medication also depends on other health conditions and what the health care provider says):
What combination drug was recently approved by the U.S. Food and Drug Administration for type 2 diabetes?
I n 2016, the U.S.
Food and Drug Administration approved a combination drug that includes metformin (a common treatment for type 2 diabetes) and empagliflozin (an SGLT2 inhibitor).
The medicine, called Synjardy, is a joint effort by Boehringer Ingelheim Pharmaceuticals and Eli Lilly and Company.
When the kidneys filter blood, they usually reabsorb all the filtered glucose and return it to the bloodstream.
One of the primary proteins responsible for reabsorption is called SGLT2.
What empagliflozin does is block this reabsorption, causing glucose to be lost in the urine and lowering a person’s blood glucose levels.
At the same time, with this combination pill, the metformin decreases the amount of glucose made by the liver.
It also improves insulin sensitivity in the liver and in muscle and fat cells.
Through trials, researchers found that this combination significantly lowered the HbA1c levels compared with the same dose of either medicine alone.
But there are some restrictions.
It cannot be used by people with type 1 diabetes or who have diabetic ketoacidosis or severe kidney disease.
126 to 140 or 150 mg/dl , This is still above the normal level, but if these readings are consistently low enough, the person may be able to eventually stop taking medication.