Type 2 diabetes mellitus is an ever-present and advancing disease which is diagnosed in patients having diabetes symptoms. This type2 diabetes mainly crops up in people who are obese, have uncontainable food habits and live an inactive lifestyle.
Type 2 diabetes mellitus is also described as “insulin resistance” as body cells do not respond appropriately when insulin is present. Especially in obese or overweight patient’s type 2 is treated initially by regulating diet and exercise and by encouraging weight loss. Insulin sensitivity is restored to a certain degree by weight loss, thus improving the life of the patient. When this treatment does not seem to work then oral anti-diabetic drugs are administered. Medications of type 2 diabetes mellitus include oral drugs, Injectable peptide analogs, insulin preparations, anti-hypertensive agents, anti-diabetic drugs, hypolipidemic agents and gastric bypass surgery.
The oral drugs for type2 diabetes mellitus include, sulphonylureas, Biguanides (metformin), Thiazolidinediones, alpha-glucosidase inhibitors (acarbose, miglitol), Meglitinides (nateglinide, repaglinide and their analogues). Meglitinides which arouse insulin release (nateglinide, repaglinide, and their analogs) quickly can be taken with food, unlike sulfonylureas which must be taken prior to food, sometimes some hours before, depending on the drug. There are several anti-diabetic drugs available for type 2 diabetics. They comprise of several classes and are not equivalent, nor can they be simply alternated one for another. All of them are prescription drugs. One of the most extensively used drugs now is the biguanide metformin. The classes of newer drugs include; Thiazolidinediones (TZDs) (rosiglitazone, pioglitazone, and troglitazone); glucosidase inhibitors; Meglitinides; Incretin mimetics; analog exenatide; Dipeptidyl peptidase-4 (DPP-4) inhibitors and Amylin agonist analog. Incretin mimetics increase insulin output of the beta cells.
The injectable peptide analogs include DPP-4 inhibitors and GLP-1 analogs. Both these classes offer an option to other anti-diabetic drugs. Insulin therapy may be necessary, in case of failure of anti-diabetic drugs. This typically adds to oral medication therapy to support normal or near normal glucose levels. The best timing and the amounts of insulin dosage depends on diet, as well as the extent of insulin resistance. Recently, a trial found that the long acting insulin were less successful, however, they were related with reduced hypoglycemic occurrences. One of the studies recommends that type2 diabetes mellitus patients should be treated with ACE inhibitors provided they have one of the following: hypercholesterolemia or reduced low high-density lipoprotein cholesterol levels, microalbuminuria, hypertension, and nicotine addiction.
Gastric Bypass procedures are currently considered a non-compulsory procedure with no unanimously accepted algorithm to decide who should have the surgery. Some physicians suggest that such surgery is helpful in type2 patients, particularly those who are obese.
The variety of available agents can be confusing and the scientific disparity among medications of type2 diabetes mellitus compounds the problem. The choice of drugs at present for type2 diabetes mellitus is rarely uncomplicated and in most illustrations has elements of repeated trial and adjustment. One thing that you must remember is that type2 diabetes mainly comes about in people who are overweight, live an inactive lifestyle and have uncontrollable food habits. The key to get rid of type2 diabetes is to live on a healthy diet and do regular exercises.