Decision Assist

Diabetes type 2 medications

Introduction

The purpose of this tool is to help you decide whether diabetes medication is right for you. When making a decision like this, you must balance:

This tool is not a substitute for professional medical care and advice. Work with your doctor to help you make this decision. A second opinion from another doctor may be valuable. Medication always has potential side effects, and you should be fully informed about the risks and benefits of this type of medication. There is usually no exact “right” or “wrong” answer.

Your doctor may make certain recommendations to you. However, the final decision about whether to use this medication rests with you.

What is the medication?

Type 2 diabetes occurs when the pancreas does not make enough insulin to keep blood sugar (glucose) levels normal, often because the body does not respond well to the insulin (insulin resistance).

Pancreas

Type 2 diabetes makes up more than 90% of all cases of diabetes and usually occurs in adulthood. An estimated 19 million Americans have this disease, and half are unaware they have it. Type 2 diabetes is becoming more common due to the growing number of older Americans, increasing obesity, and failure to exercise.

Losing weight, eating a healthy diet, and exercising may help you control your diabetes. If not, you may need medication. Medications to treat type 2 diabetes include insulin, other injectable drugs, and glucose-lowering pills called oral hypoglycemic agents.

Insulin is not available in oral form. It is delivered by injections that are generally required 1 - 4 times per day. Some people use an insulin pump, which is worn at all times and delivers a steady flow of insulin throughout the day.

Insulin pump
Click the icon to see an illustration detailing an insulin pump.

Several oral medications lower blood glucose in people with type 2 diabetes. They fall into one of three groups:

Key points

How much time this decision tool will take

What this tool will provide


Review Date: 9/19/2010
Reviewed By: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. Previously reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc. (9/11/2008).

References:
  • American Diabetes Association. Standards of medical care in diabetes -- 2010. Diabetes Care. 2008 Jan;33 Suppl 1:S11-61.
  • Bolen S, Feldman L, Vassy J, Wilson L, Yeh HC, Marinopoulos S, et al. Systematic review: comparative effectiveness and safety of oral medications for type 2 diabetes mellitus. Ann Intern Med. 2007 Sep 18;147(6):386-99. Epub 2007 Jul 16.
  • Inzuchhi SE and Sherwin RS. Type 2 diabetes mellitus. In: Goldman L and Ausiello D, eds. Cecil Medicine. 23rd ed. Saunders; 2007:chap 248.
  • Mensing C, et al. National standards for diabetes self-management education. Diabetes Care. 2006;29:S78-S85.
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