Resource Guide 2005

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FOR TYPE 2

Class Action

There are now five classes of diabetes pills and several combination oral meds as well. Each has a different way of helping you control your diabetes.
by Marie McCarren

Type 1 diabetes is a clearcut problem with a clearcut solution. Problem: The pancreas no longer makes any insulin. Solution: Inject insulin.

Type 2 diabetes is not so basic. If you're a typical person with type 2, your blood glucose levels are high because you have:

• A pancreas that doesn't make enough insulin
• A liver that releases too much glucose
• Muscle cells that don't easily take in glucose

Here's how things worked before you developed diabetes:

You ate. Your blood glucose level started to go up. When your pancreas sensed the glucose, it sent out insulin. When your muscle and fat cells sensed the insulin, they let in glucose.

Your liver helped control your blood glucose levels, too. It tracked insulin levels in your blood. Under normal conditions, when there was insulin in your blood, glucose levels were high, too. Your liver would say, "Oh, good, the body just ate. No need for me to send out glucose."

But when you didn't eat for hours (like when you were sleeping), your liver sensed the lack of insulin in your blood. It then decided to put out glucose to keep your level from dropping too low.

But today you have type 2 diabetes. If your diabetes is typical, it began like this:

You'd eat. Your blood glucose levels would go up. Your pancreas would put out the right amount of insulin. But your muscle cells couldn't sense the insulin. So they didn't take in much glucose.

Your liver may have failed to sense the insulin, too. It would think, "Hmm, no insulin means the body hasn't eaten recently. I'd better put out glucose."

Your pancreas would sense that there was still a lot of glucose in your blood, so it would produce extra insulin. This may have gone on for years. When your pancreas could no longer keep up with the extra demand, your blood glucose levels went up and stayed up. And you were told you had diabetes.

So type 2 diabetes involves several problems with several possible solutions. One is insulin injections. These can overcome insulin resistance. There are also five classes of diabetes pills. Each class acts in a different way to control blood glucose levels. (View the Where the Action Is illustration for more on how each class works.)

Many people benefit from taking two or more diabetes drugs, each of which addresses a different problem. Such combination therapy is so common that some drug companies now market combination pills. (See link below for chart.)

No matter which diabetes pill you use, you still need enough insulin in your body—either natural or injected—to move glucose into cells.

View the Oral Agents For Type 2 chart in PDF format (link will open a new window).
Please Note: Due to the size and layout of this chart, it has been saved in PDF format for easier on-line viewing. This document requires the Adobe® Reader® in order to be viewed. If you do not have this application already on your computer, you can download it for free from Adobe's Web site.

Marie McCarren is the author of Insulin For Type 2 Diabetes: Fears, Myths, And Truths and Carb Counting Made Easy. She lives in Arnold, Md.