Oral Medication And Insuliin

Oral Medication (Hypoglyemic Drugs)

Many people are prescribed pills for diabetes apart from the life style modifications and dietary changes to bring their blood level sugar near target levels.

Oral medication for diabetes works only for people with diabetes type 2.
In Type 1 diabetes, there is destruction of the insulin producing cells by its own immune system leading to complete lack of insulin. In this case oral medication does not work and the patient has to take insulin for therapy.

In type 2 diabetics, the sugar levels can be controlled with one or more pills. The available types of oral medication for diabetes usually either improve the body’s ability to make insulin or make the body tissues more sensitive to it. Often, patients take a combination of medicines that do both. Thus, by taking a combination of oral antidiabetic medicines, it is possible for people with type 2 diabetes to remain off insulin for many years.

Diabetes pills belong to different groups and they work in different ways to bring about lowering of sugar levels.

Oral medication for diabetes works best when you

Eat healthy, maintaining the right balance in your daily consumption of carbs, fats and proteins.
Are physically active
Avoid stress Some commonly used medicines are

Some commonly used medicines are:
Metformin
It is indicated for most patients when diet modifications and exercise routines fail to maintain target blood glucose levels. Usually, patients require continuous treatment for a number of years in order to maintain blood glucose levels.

Glipizide
Glycated hemoglobin (A1C) levels are tested every three months and if A1C <7 mg/dl with metformin plus lifestyle intervention is not achieved within three months then a second oral antidiabetic agent is initiated.
The second line of therapy is a short duration sulfonylurea such as Glipizide .

Alternate Drugs
For patients who are intolerant of or are not candidates for metformin or sulfonylureas, Repaglinide is a reasonable alternative.

The following medicines are prescribed keeping a few factors listed below in mind:

Factors	First choice of drug
BMI > 25 kg/m2	Metformin
Waist hip ratio Male > 0.9 Female > 0.85	Metformin
Presence of stomach troubles	Sulfonylurea
Kidney Dysfunction	Glipizide
Economic constraints	Glibenclamide
Complications of diabetes	Insulin therapy

Insulin

What is insulin?
It is a hormone produced by pancreas to regulate the levels of glucose in our blood. In absence of insulin our body cells cannot use glucose as a source of energy.

In Type 1 diabetes there is complete deficiency of insulin in the body and therefore, currently it is necessary for all patients with Type 1 diabetes to take insulin either by injection or by pump.

In Type 2 diabetes, insulin is started only when the target blood sugar levels are not maintained with oral antidiabetic medicines, diet and exercise.

Are there different types of insulin?

Yes. All types of insulin can control blood sugar levels. But some types of insulin start working faster or last longer than other types. Many people use 2 different types of insulin each day so that their body has insulin all day and night.

How do I Give Myself an Insulin Shot?
Your doctor or nurse will teach you how to give yourself an insulin shot.
Here's what you do:

Choose a part of the body - People can use different parts of the body for an insulin shot
Pinch up some skin and quickly insert the needle
Push the plunger down all the way and count to 5
Let go of the skin and remove the needle
Throw out the needle in a container that is made for used needles

You should never use another person's insulin needles or let another person use yours.
How many times and much insulin should I use?
Your doctor will work with you to make a treatment plan that tells you the frequency and dosage of insulin for you.

Do I Need to Keep Checking My Blood Sugar Level?
Checking your blood sugar level is important because it can tell you:

If your blood sugar level gets too low or too high – If you use too much insulin, your blood sugar level can get too low. If you do not use enough insulin, your blood sugar level can get too high. Levels that are too low or too high can lead to serious problems. Talk with your doctor or nurse about what to do if your blood sugar level gets too low or too high.
What changes to make in your next insulin dose – Knowing your blood sugar level will help you choose your next insulin dose.
How well your treatment is working – One goal of diabetes treatment is to keep your blood sugar at or near a normal level. This can prevent health problems later in life.

How do I store insulin?
Insulin preparations are stable at room temperature. However, due to loss of potency at high temperatures, in India it is recommended that insulin be stored in a refrigerator. Insulin can be stored in earthen vessels if a refrigerator is not available.

How can I store insulin during travel?
Insulin vials should be wrapped in a polythene cover and submerged in cold water in a thermos container during travel.

What is an insulin pump?
An insulin pump is a small device about the size of a small cell phone that is worn externally and can be discreetly clipped to your belt, slipped into a pocket, or hidden under your clothes It delivers precise doses of rapid-acting insulin to closely match your body’s needs:
• Basal rate: Small amounts of insulin delivered continuously (24/7) for normal functions of the body. The programmed rate is determined by your healthcare professional.
• Bolus dose: Additional insulin you can deliver “on demand” to match the food you are going to eat or to correct a high blood sugar.

Treatment Flow