Diabetes Treatment (cont.)
Robert Ferry Jr., MD
Robert Ferry Jr., MD, is a U.S. board-certified Pediatric Endocrinologist. After taking his baccalaureate degree from Yale College, receiving his doctoral degree and residency training in pediatrics at University of Texas Health Science Center at San Antonio (UTHSCSA), he completed fellowship training in pediatric endocrinology at The Children's Hospital of Philadelphia.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Diabetes treatment facts
- What is the treatment for diabetes?
- Medications for type 2 diabetes
- Meglitinides (Prandin and Starlix)
- Metformin (Glucophage)
- Canagliflozin (Invokana) and dapagliflozin (Farxiga)
- Thiazolidinediones: pioglitazone (Actos) and rosiglitazone (Avandia)
- Acarbose (Precose)
- Pramlintide (Symlin)
- Exenatide (Byetta)
- Liraglutide (Victoza)
- Long-acting exenatide (Bydureon)
- Albiglutide (Tanzeum)
- Dulaglutide (Trulicity)
- DPP-IV inhibitors (sitagliptin, saxagliptin, linagliptin)
- Combination medications
- Treatment of diabetes with insulin
- Different methods of delivering insulin
- Diabetes diet
- The future of pancreas transplantation
- Find a local Endocrinologist in your town
Treatment of diabetes with insulin
Insulin remains the mainstay of treatment for patients with type 1 diabetes. Insulin is also important therapy for T2D when blood glucose levels cannot be controlled by diet, weight loss, exercise, and oral medications.
Ideally, insulin should be administered in a manner that mimics the natural pattern of insulin secretion by a healthy pancreas. However, the complex pattern of natural insulin secretion is difficult to duplicate. Still, adequate blood glucose control can be achieved with careful attention to diet, regular exercise, home blood glucose monitoring, and multiple insulin injections throughout the day. Taking care of your diabetes with careful home care and monitoring assists in controlling blood sugar levels and effective diabetes treatment.
Until the late 1990s, insulin was often derived from animal sources, particularly cows and pigs. This created a supply problem to meet demand. Also, insulin derived from bovine or porcine caused immune reactions in some people. Such patients could become intolerant or resistant to animal insulin. Revolutions in molecular biology during the 1950s-70s led to the cloning the gene for human insulin in 1977. In October 1982, synthetic human insulin became the first drug created from recombinant DNA technology to be approved by the FDA. Human insulin has widely replaced insulin from animal sources.
Various formulations of insulin differ in the pharmacokinetics, i.e., the amount of time until they begin to work and the duration of their action after injection. These different insulins allow for more tailored regimens to optimize blood sugar control. The types of insulin currently available are:
- Rapid-acting insulin begins to take effect 5 minutes after administration. Peak effect occurs in about 1 hour, and the effect lasts for 2 to 4 hours. Examples are insulin lispro, insulin aspart, and insulin glulisine.
- Regular insulin takes effect within 30 minutes, peaks at 2 to 3 hours after injection, and lasts 3 to 6 hours total.
- Intermediate-acting insulin typically begins to lower blood glucose about 2 to 4 hours after injection, peaks 4 to 12 hours later, and lasts about 12 to 18 hours.
- Long-acting insulin takes effect within 6 to 10 hours. It is usually lasts for 20 to 24 hours. The two long-acting insulin analogues available, glargine and detemir, lower glucose levels fairly evenly over a 24-hour period (without major peaks or troughs).
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