Body makes insulin but may be insufficiently (impaired insulin secretion) or insulin resistance (impaired biological response to insulin in the tissue). Insulin resistance and lack of insulin secretion are considering being the cause of type 2 diabetes.
Is it possible to manage diabetes without medication?
During diagnosis, if you are asymptomatic with A1C level of less than 7% or fasting blood glucose less than 130mg/dl or 7.22mmol/l, you can manage your diabetes without medication, however, with lifestyle changes (diet and exercise) and by losing some weight.
Diet, exercise and weight reduction should be the cornerstone of diabetes management. You can manage your diabetes by losing some weight, increased physical activity (or regular exercise) and with proper diet. Losing 10 or 15 pounds or 4.5 to 6.8 Kg can sometimes help you reach your target. Always check with your doctor before you stop taking your diabetes pills or start your treatment by lifestyle change alone (without medication).
Classes of Diabetes Drugs
Different diabetes pills available in the market are members of six classes of diabetes drugs that work differently in lowering blood-glucose levels.
- Alpha-glucosidase inhibitors
- DPP-4 inhibitors
Oral medication for diabetes are come under three major categories, they are:
- Insulin Sensitizers are working to lower your blood glucose level by increasing insulin sensitivity of your muscle, fat and liver. Some of the insulin sensitizers are Biguanides, TZDs or glitazones
- Insulin Secretagogues (insulin secreting medications) are diabetes drugs that work by making the pancreas to release (or secrete) more insulin to help lower your blood glucose level. Some insulin secretagogues are Sulfonylureas, Meglitinides or glinides, GLP-1 agonists, DPP-4 inhibitors
- Others - Alpha-glucosidase inhibitors, Amylin analog, SGLT2 inhibitors
How is a diabetes oral medication works?
Diabetes medication helps to control your blood-glucose level in people whose body still produces insulin (in case of type 2 diabetes). Several kinds of diabetes medication are available in the market, which works differently such as:
- It stimulates your body to increase insulin secretion by the pancreas.
- It makes your liver to limit or stop producing & dumping glucose into the blood stream.
- It makes your body cells to better utilizing the glucose in the blood stream.
- It inhibits your small intestine from absorbing glucose in the food.
At the beginning, your doctor may try one and two medications or its combination to assess, which one best suitable for your body system. Be in a close coordination with your doctor to get an individualized diabetes treatment.
When do you need diabetes medication?
You need diabetes medication treatment along with lifestyle changes, when your A1C is more than 7% or FBG level more than 130 mg/dl or 7.223 mmol/l.
Derive maximum benefits from your diabetes medications
Your daily routine such as eating habits, physical activities and other health conditions can have an influence over your medication effectiveness. Your medication works best when it is combining with proper meal planning, consistent regular exercise, getting enough sleep, and effective stress management. You should take the diabetes medication at the same time every day, if you are a forgetful person like me, then you can set reminder on your phone to alert you. Store the medication as directed by your doctor or as instructed by the manufacturer. Closely monitor your medicine’s effectiveness and any side effects it produces; discuss with your doctor regarding this so that he may change the medication or dosage that best suits you.
What should be your diabetes target?
Every diabetes type 2 should try to achieve a target:
- A1C of less than 7.0 % (4 to 6 % non-diabetic normal range),
- Pre-prandial glucose level of 90 to 130 mg/dl or 5 to 7.223 mmol/l,
- Postprandial glucose level of less than 180 mg/dl or 10 mmol/l, and
- Bedtime glucose level 110 to 150 mg/dl or 6.111 to 8.334 mmol/l.
What should be your target of metabolic control?
- HbA1c should be 7.0 to 7.5%.
- Total Cholesterol should be less than equal to 90 mg/dl or 5 mmol/l.
- LDL Cholesterol should be less than equal to 54 mg/dl or 3 mmol/l.
- Triglyceride should be less than equal to 43.2 mg/dl or 2.4mmol/l.
- Self-monitoring blood glucose should be 72 to 126 mg/dl or 4 to 7 mmol/l, 144 to 216 mg/dl or 8 to 12 mmol/l in elderly.
- Self-monitoring blood ketones should be less than 0.6.
- Urine albumin: creatinine ratio (ACR) should be less than 2.5mg/mmol in men and 3.5mg/mmol in women.
- Urine protein: creatinine ratio (PCR) should be less than 45 mg/mmol.
- Blood Pressure should be less than equal to 130/80mmHg.
- Waist circumference should be less than 94cm (37 inch) in men and 80cm (31.5 inch) in women.
Is it possible to adjust diabetes medication to cover whatever ate?
No, the diabetes medication works as intended, and you cannot adjust it with respect to the food you ate. However, if you are in insulin treatment, then it is possible for you to learn and adjust the dosage with respect to the food intake and the physical activity you had. Still it is not advisable for you to eat you want, and take extra drugs to normalize your blood-glucose levels.
Do I take insulin (pills) orally for diabetes treatment?
You cannot take insulin in pills form, because your stomach would break down insulin (a protein molecule) and make it ineffective. However, there are various researches are going on to find a method to take insulin orally, hope for a positive result at the earliest so that no more injection pains.