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Treatment Advances in Type 2 Diabetes

By

Sarah Lewis, PharmD

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Diabetes is one of the most common chronic diseases in the United States. With type 2 diabetes being the most common form of the disease, it’s a priority to make progress in its treatment. And researchers have done just that. This is good news if you—or a loved one—have type 2 diabetes. Here are some exciting advances in the treatment of type 2 diabetes.

Insulin

Type 1 diabetes usually comes to mind with insulin. But most people with type 2 diabetes will eventually need to use it. People with type 2 diabetes account for most insulin use due to their sheer numbers. Approximately 30% of type 2 diabetes patients use insulin. So making advances in insulin treatment benefits many people with type 2 diabetes.

After you receive a diagnosis of type 2 diabetes, your doctor will work with you to determine the best method of treatment, be it medication or insulin injections. But, as Dr. Anthony Cardillo explains, the most effective treatment for type 2 diabetes? Proper diet and exercise.

Medical Reviewer: William C. Lloyd III, MD, FACS Last Review Date: Aug 13, 2015

2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

If fact, people who are newly diagnosed with type 2 diabetes and whose pancreas can still make insulin, can actually reverse their diabetes by immediately starting short-term insulin and a strict diet and exercise program.

In the last 10 years, new types of insulin have come to market. Most are variations of the usual rapid-, short- or long-acting injectable insulin. One very recent newcomer is a totally different form of insulin—Afrezza inhaled human insulin. You take this type of insulin by breathing it in. It is a rapid-acting insulin. You use it at mealtime and in combination with a long-acting injectable insulin.

Other Injectable Drugs

Injectable drugs are medicines you give with a needle and syringe. Insulin has been the only injectable medicine for diabetes until recently. But now there are new ones. They include medicines that mimic natural hormones other than insulin. These hormones have different roles in helping your body use blood sugar for energy.

The drugs in this category basically help regulate blood sugar and appetite. These medicines may also help you lose weight, which can be helpful in type 2 diabetes. Here are the two classes:

  • GLP-1 agonists are a group of drugs that are useful if you have type 2 diabetes.

  • Amylin analogs will help both type 1 and type 2 diabetes. That’s exciting because insulin was the primary treatment for type 1 diabetes until this new class.

Talk with your doctor to determine if any of these drugs are right for you. It’s important to understand the benefits and potential problems with taking these drugs.

Oral Drugs

You take oral drugs by mouth and they have been the mainstay of type 2 diabetes treatment. In the past, there were basically five classes of drugs in this category. In recent years, two more classes of oral drugs have come to market:

  • DDP-4 inhibitors help trigger insulin release. But they work differently than other drugs that stimulate insulin release. As a result, they don’t cause low blood sugar the way other drugs can.

  • SGLT inhibitors lower blood sugar by getting rid of extra sugar in the urine. This is a completely new way of working. But there is a downside to this group—they tend to cause urinary tract and yeast infections.

Talk with your doctor about the benefits and potential side effects of these drugs to determine any are right for you.

Old Drugs With New Diabetes Uses

Researchers started thinking outside the box. They looked at some existing drugs that treat other diseases to see if they could help with diabetes. Two drugs have gained FDA (Food and Drug Administration) approval for treating type 2 diabetes:

  • Bromocriptine (Parlodel). This drug has many uses including treating menstrual problems, infertility, and Parkinson’s disease. The FDA approved it in type 2 diabetes under the brand name, Cycloset. Cycloset helps people have better long-term blood sugar control. Doctors check this with a lab test called an A1c. If you have diabetes, you know how important your A1c number is. Doctors can prescribe Cycloset alone or in combination with insulin or another oral medicine.

  • Colesevelam (Welchol). Doctors usually use this drug to treat high cholesterol. It turns out that people with type 2 diabetes who took this drug in combination with their usual diabetic therapy had better A1c results than those who didn’t take it. Now, doctors can prescribe it along with other diabetes treatments.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Oct 14, 2016

© 2016 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

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Medical References

  1. Lipska KJ, Ross JS, Van Houten HK, Beran D, Yudkin JS, et al. Use and out-of-pocket costs of insulin for type 2 diabetes mellitus from 2000 through 2010. JAMA. 2014 Jun 11;311(22):2331-3.;
  2. Mayfield JA, White RD. Insulin therapy for type 2 diabetes: Rescue, augmentation, and replacement of beta-cell function. Am Fam Physician. 2004 ;70(3):489-500.;
  3. Mazzola N. Review of current and emerging therapies in type 2 diabetes mellitus. Am J Manag Care. 2012 Jan;18(1 Suppl):S17-26.;
  4. National Diabetes Statistics Report, 2014, Centers for Disease Control and Prevention, Accessed July 9, 2014 (http://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf);
  5. Insulin and Other Injectables, American Diabetes Association, Accessed July 9, 2014 (http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/);
  6. Other Injectable Medications, American Diabetes Association, Accessed July 21, 2014 (http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/insulin/other-injectable-...;
  7. What Are My Options? American Diabetes Association, Accessed July 21, 2014 (http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/oral-medications/what-are...;
  8. FDA Approves Invokana to Treat Type 2 Diabetes. U.S. Food and Drug Administration, Accessed July 9, 2014 (http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm345848.htm);
  9. FDA Approves Tanzeum to Treat Type 2 Diabetes, U.S. Food and Drug Administration, Accessed July 9, 2014 (http://www.fda.gov/newsevents/newsroom/pressannouncements/ucm393289.htm);
  10. FDA Approves Afrezza to Treat Diabetes, U.S. Food and Drug Administration, Accessed July 9, 2014 (http://www.fda.gov/newsevents/newsroom/pressannouncements/ucm403122.htm);

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