Health news blog

In treating Type II diabetes, specialists now advise that a doctor first try a controlled diet and exercise, especially for people who are overweight. If this works, it will keep weight down, and the person’s own insulin will be able to keep things running properly, which is the best possible situation.

If diet and exercise don’t bring Type II diabetes under control, oral drugs may be tried, either alone or in combination with insulin or other drugs. (Today, 30 to 40 percent of those with Type II diabetes in the United States and as many as 50 percent worldwide use oral hypoglycemic drugs. Insulin may be necessary at the beginning of the treatment program. Eventually it may be possible to change to a program of diet alone. Oral agents are most effective for those whose diabetes began after age forty and who have had diabetes less than ten years.

The oral hypoglycemic drugs used today are chemicals called sulfonylureas. The first to be marketed for the treatment of diabetes was tolbutamide, sold under the trade name Orinase. Today, a second generation of highly effective sulfonylurea drugs is available, including Glucotrol (glipizide), and Diabeta (glyburide), which have fewer side effects. These drugs are not insulin substitutes. They work by stimulating the pancreas to increase its secretion of insulin, and by helping to prevent insulin resistance.

A bad thing about the oral antidiabetic drugs is that they falsely lull people (both doctors and patients) into believing that control of diabetes is easy, and that worrying about diet and control of blood sugar is unnecessary. But diet is even more important for those using oral agents, and it may mean the difference between successful blood glucose management and uncontrolled diabetic complications.

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