Let's Talk About Diabetes Medication

Stable blood sugarplays a crucial role in helping you feel stronger and more energetic every day. It also lowers your risk of dangerous diabetes complications, such as nerve damage and heart disease. Diabetes medications that moderate blood sugar levels are often used in combination with each other—you may find yourself using two or more drugs at some point as you find a plan that gets you back to feeling good. Here’s what you should know about the options available to you.

Diabetes Medication

Our Pro Panel

We went to some of the nation’s top experts in diabetes to bring you the most up-to-date information possible.

Nilem Patel, M.D.

Endocrinologist

Adventist Health White Memorial Hospital

Los Angeles, CA

Emily Nosova, M.D.

Endocrinologist

Mount Sinai Hospital

纽约，纽约

Laura Cason, R.D.

Certified Diabetes Educator and Spokesperson

Illinois Academy of Nutrition and Dietetics

芝加哥，伊利诺伊

What Is Diabetes Again?

A quick refresher: There are three main types of diabetes: type 1, type 2, and gestational diabetes (which occurs during pregnancy). All three types cause people to have higher-than-normal levels of sugar—or, glucose—in their blood.

Here how it gets there:

• 你吃完后,你的消化系统去上班breaking down the food into glucose (among other things).

• When the glucose enters the bloodstream, and your pancreas responds by releasing insulin, a hormone that helps glucose enter muscle and fat cells where it is used for energy.

• Your brain, heart, muscles, and just about everything else in your body rely on glucose for fuel.

In1型糖尿病, people don’t make insulin at all so glucose builds up in their blood. Intype 2 diabetesand gestational diabetes, the pancreas makes insulin but the body doesn’t use it very well, also resulting in excessive sugar in your bloodstream. Over time, high blood sugar can lead to a host of serious health problems.

治疗for Diabetes

Whatever yourpath of treatment, most likely you’ll start by checking your glucose every day, or even several times per day, in order to make decisions about insulin dosages, food, and exercise.

To do this, you’ll likely use a home glucose meter to poke your fingertip with a specialized lancet “pen,” then drop the blood onto a test strip in the meter to determine your blood sugar level. In some cases, your doc might suggest a continuous glucose monitor, where a tiny sensor is inserted under the skin of your abdomen, arm, or thigh to check glucose levels regularly.

以下是您的医生将考虑保持葡萄糖水平稳定的几种药物，基于您的糖尿病类型：

Insulin for Diabetes

All people with type 1 diabetes need to take insulin daily. Unfortunately, insulin can’t be taken as a pill because it would be broken down and digested before getting into your blood.

There are a couple of different ways insulin can be delivered to the body:

• Injection:This is the most common way to take insulin. To inject the drug, you will use a syringe or “pen,” usually in your belly, upper arm, thigh, or butt.

• Insulin Pump:People who need multiple injections per day or are high risk of ketoacidosis may prefer an insulin pump, which automatically delivers insulin throughout the day through a tiny catheter that’s worn on your body.

• Insulin Inhaler:Some adults use inhaled insulin, a powder you breathe into your lung through an inhaler. It’s meant to be taken before every meal, but people will still need to take an injectable, longer-acting insulin.

Newer methods of insulin delivery include a high-pressure “jet injector” that sprays insulin into the skin rather than injecting liquid through a needle. Some people also use an injection port: a tube inserted into your skin that you inject insulin into rather than directly into your skin.

Insulin Types

不同类型的胰岛素通常被他们持续多久的胰岛素分类，他们踢进了多久，当他们击中高峰效力时。很多人需要多种类型。这些是常见的选择：

• Rapid-Acting Insulin:这种药物开始在大约15分钟内工作。你可能会在饭前服用它以防止血糖上升。它适用于两到四个小时。例子包括Apidra(glulisin),Humalog(lispro) andNovolog(aspart).

• Short-Acting Insulin:Also called “regular” insulin, this med takes about 30 minutes to kick in. You’ll take it before a meal to help lower increased levels of blood sugar when you eat. It works for three to six hours. Examples includeHumulin RandNovolin R.

• Intermediate-Acting Insulin:通常与快速作用的胰岛素相结合，该MEC在服用和平衡您的身体葡萄糖水平12至18小时后开始工作大约两到四小时。例子包括Humulin NandNovolin N（NPH）。

• 长效胰岛素：These meds take several hours to kick in. They work to maintain lower blood sugar levels for up to 24 hours. Examples includeLantus(insulin glargine) andLevemir(insulin detemir).

• Ultra-Long-Acting Insulin:These meds can take up to six hours to reach your bloodstream and last about 36 hours. Examples includeToujeo(glargine u-300) andTresiba(degludec).

Other Diabetes Medications

There are several different pills and liquids that can help people manage their diabetes. They’re often taken in combination with each other, or with insulin, to control blood sugar. Most of these medications are only used in people with type 2 diabetes.

• Actos and Avandia(thiazolidinediones): These oral medications help glucose get out of the bloodstream and into your muscles. Possible side effects include fractures, heart problems, and weight gain.

• Amaryl, DiaBeta, Glucotrol, Glynase PresTab, and Micronase(sulfonylureas): This class of drugs encourages the pancreas to make more insulin. The increased insulin helps lower blood sugar. Possible side effects include low blood sugar, skin rash, and weight gain.

• Bromocriptine and Cyclocet(D-2 dopamine agonist): This drug causes the liver to release less glucose. Possible side effects include fatigue, weakness, and constipation.

• Farxiga, Invokana, and Jardiance（钠葡萄糖转运蛋白2抑制剂）：这些药物从尿液中降低葡萄糖的重吸收，降低血液中的糖量。可能的副作用包括酵母和尿路感染。

• Glucophage, Glumetza, Fortamet, and Riomet(二甲双胍):这些药物减缓碳水化合物的分解ohydrates into sugar and reduce how much glucose your liver produces. Metformin is usually prescribed to people with type 2 diabetes, but it’s sometimes used along with insulin in type 1. Possible side effects include nausea and diarrhea.

• Glyset and Orecose（α-葡糖苷酶抑制剂）：这种类型的药物减缓了淀粉的消化和分解成葡萄糖，并切割了小肠吸收了多少葡萄糖。可能的副作用包括气体，腹泻和胃痛。

• Januvia and Onglyza(dipeptidyl-peptidase 4 inhibitors): These drugs trigger the pancreas to produce more insulin. Possible side effects include upper respiratory tract infections, headache, and sore throat.

• Prandin and Starlix(meglitinide): Like sulfonylureas, these medications trigger the release of additional insulin. Possible side effects include low blood sugar, weight gain, and nausea.

• Symlin(pramlintide): This injection, given at mealtimes, slows digestion of food in your stomach, thereby slowing the speed at which glucose enters the blood. It can be prescribed with insulin for people with type 1 diabetes, or with other medications for people with type 2. Possible side effects include low blood sugar, nausea, and vomiting.

• Welchol.(bile acid sequestrant): This medication lowers blood sugar and cholesterol. Possible side effects include indigestion, constipation, gas.

• Other medications:Because diabetes is a risk factor for cardiovascular disease, drugs that treat high cholesterol and high blood pressure are sometimes prescribed for people with diabetes as a way to help lower their heart risk.

Diet, Exercise, and Diabetes

You might not think of them as medication in the traditional sense, but along with pharmaceutical prescriptions, diet and exercise are nature-made remedies to helplower your risk for, and symptoms of, type 2 diabetesby keeping blood sugar stable.

What to Eat

There is no single best diet for diabetes, but plant-based meals and the Mediterranean diet (with a focus on fruits, vegetables, fish, and healthy fats) are both recommended to help control blood sugar levels.

Some people with diabetes may also need to count the grams of carbohydrate in their meals in snacks to help make sure blood sugar doesn’t spike after meals, or to figure out the proper dose of mealtime insulin.

Talk with your endocrinologist, registered dietitian, or a certified diabetes educator to create personalized eating guidelines that work for your life.

How to Exercise

Moving your body is a key part of managing blood sugar levels, especially in type 2 diabetes and gestational diabetes. That’s because physical activity helps your body use insulin better, reduces insulin resistance, and lowers blood sugar levels. The national health guidelines for exercise (whether you have diabetes or not) call for 150 minutes of moderate exercise per week.

That’s the equivalent of 30 minutes, five days a week. You don’t have to be an athletic superstar to exercise. We’re talking about taking a brisk walk around the block a time or two before you head to work, or after dinner in the evening.

Are There Supplements for Diabetes?

Researchers have looked into dozens of different dietary supplements, from cinnamon to apple cider vinegar to chromium, to see if they help treat or prevent diabetes. So far there is some weak scientific evidence suggesting that chromium may help keep blood sugar levels stable. Other preliminary research indicates that an antioxidant called alpha-lipoic acid might help with diabetes-related nerve issues.

But there isn’t enough evidence yet to show that most supplements move the needle when it comes to treating diabetes, according to the National Center for Complementary and Integrative Health.

Your best bet: Eat smart, exercise regularly, and talk with your doctor about the growing number of medications available to help treat the disease so you can get back to living your life.

Meet Our Writer

Sunny Sea Gold

阳光健康的记者我深厚的专业知识n women's and children’s health who has written for some of the largest and most well-known print and digital publications in the United States. She’s also the author of the bookFood: The Good Girl’s Drug, and writes essays and reported pieces on body image, eating disorders, parenthood, and mental health. She lives in Portland, OR, with her husband and two daughters.

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