Type 2 diabetes is a progressive condition
What that means to you is that over time things change and your diabetes may be more difficult to control. If and when that happens adjustments in treatment have to be made. It seems that the better you care for yourself the slower diabetes progresses so for that reason you want to do all you can every day to stay healthy. Eating the proper foods in the right amounts and doing regular exercise is always a very big part of living healthy with diabetes.
For some people with type 2 diabetes, dietary changes and exercise aren’t enough to keep blood glucose levels in check. If after beginning to eat proper amounts of healthy foods and starting a regular exercise program your blood sugar is still not at target levels then medicine must be started.
What is going on with Type 2 diabetes?
Unlike type 1 diabetes which comes on very quickly, type 2 is slow to show up. The natural progression of type 2 diabetes starts with two main problems. One is called “insulin resistance” and that is possibly a trait inherited from our ancestors and often connected with being overweight. Because of this “insulin resistance” in the tissues of our body, the insulin that we do have does not work as well as it is supposed to so the pancreas has to produce higher than normal amounts to get the job done. The second problem is the loss of beta cell function. Beta cells in the pancreas produce insulin and in type 2 diabetes some of those cells seem to quit making enough insulin over time.
There are some other “players” in the type 2 diabetes game that contribute to the problem. Fat cells, the liver, alpha and beta cells in the pancreas, muscle tissue, hormones in the gut, the kidney, and the brain all have something to do with blood sugar control and one or more of those systems can stop doing their job at some point. The really good news is that we have medicines to help treat all of those problems so it’s just a matter of picking the best one for you.
When should you start taking medicine?
We know from experience that it is critical to start treatments early because the longer we wait the more damage is done to the body and the diabetes gets worse at a faster rate. Remember, the better you control your blood sugar early on the slower diabetes progresses.Why are there so many diabetes medicines? We now have many different medicines to treat diabetes. We divide them up into “families” of drugs, and each drug within a “family” works in a similar way and usually in a similar part of the body. When two or more diabetes drugs are prescribed together they are almost always from different “families” because often the combinations work much better than either drug alone. Here are some of the places that different diabetes drugs may work:
- The intestines
- The satiety centre in the brain
- The muscle and fat tissue
How does my healthcare provider decide what medicine to use?
Healthcare providers look at diabetes drug therapy in general terms first. They want to give you something that won’t cause hypoglycemia or weight gain if possible and they want to give you something that has the best chance of working for you as an individual. Some of the things to consider are:
- How high your blood sugar is
- What other medicines you are taking
- How long you’ve had diabetes
- Other medical conditions or drug allergies you may have
- What your goals are
- What your financial situation will allow (is it covered by insurance)
- Do you need to lose weight
The bottom line Many of us don’t like the thought of taking medicine but when nothing else works you have to do something. It is then important that you look at medicine as being your friend that helps you out when you are heading for trouble. It’s also important to remember that if what you are doing is not working after three months you should talk to your provider about making a change.