In Part One, we looked at the types of diabetes, changing treatment concepts, and directions for treatment. Here, we look at specific categories of medications, non-pharmacologic therapies, as well as on-demand insulin injections.
Categories of Medication to Treat Geriatric Diabetes
Metformin, approved by the FDA in 1994 for the treatment of Type 2 diabetes and the first drug often prescribed today, increases your sensitivity to insulin, reduces the amount of glucose produced by your liver, and suppresses your appetite. Today, it facilitates weight and blood-sugar control in pre-diabetic patients.
Sulfonylureas are medications that increase your natural insulin output. This approach has been used for some time, but new medications result in fewer serious side effects. The drugs quickly reduce your blood sugar levels, as well. Second-gen brands include Glucotrol and Amaryl.
Meglitinides also work by boosting your insulin secretion, but they are very quick-acting, achieving peak effects within an hour. They are most useful when taken 15-30 minutes before meals. Common brands include Starlix and Prandin.
Thiazolidinediones lowers your blood glucose by making your cells more sensitive to insulin. They appear now to have some serious side effects, such as heart failure, liver dysfunction, and bone fractures.
Pramlintide (Symlin) represents a group of anti-high-blood-sugar medications injected in tandem with insulin for both Type 1 and Type 2 diabetes. The drug is a synthetic imitation of human amylin that is produced by your pancreas to control glucose levels.
Combination drugs are a natural development, given the specific and therefore limited action of many drugs and the frequent need for several pharmacologic treatments. However, before choosing the right combination drug, your physician must carefully determine the right doses and combinations.
Inhibitors and Agonists
Alpha-glucosidase inhibitors attack the diabetes problem (high blood sugar) by inhibiting your body’s absorption of carbohydrates from your intestine. Side effects may arise in the digestive tract but are not especially serious.
SGLT2 inhibitors, FDA-approved for Type 2, comprise a relatively new category of ingestible drugs. They work by reducing your kidneys’ glucose levels. The drug facilitates more glucose excretion, thus reducing your blood sugar levels.
DPP-4 inhibitors have a unique way of attacking the diabetes problem. They prevent the removal of the hormone, incretin. For its part, incretin tells your body to release insulin after you eat. Essentially, DPP-4 inhibitors multiply the incretin effect to stimulate insulin production.
GLP-1 receptor agonists stimulate the actions of incretin, mentioned above, in telling the body to release more insulin. Oddly, the formula for this drug derives from the saliva of the Gila monster.
Diet and Exercise Regimes for Geriatric Diabetes
Generally, diet changes and exercise regimes are recommended in conjunction with the above medications. Once, these were the only recourse for managing diabetes. However, they still play a major role in managing the disease today.
Much has been written about the “Diabetes Diet.” Like medication, however, diet plans should be tailored to individuals. For one thing, controlling blood glucose isn’t the diet’s only goal. You must consider nutritional needs and the possibility of dietary deficiencies leading to cardiac complications. The diet must complement eating habits and also account for insulin injections.
Of course, despite these variations, the diet must follow the general principles of nutrition. It should include whole grains, fruits, legumes, lean meats, poultry, or fish. Eating small meals throughout the day, instead of two or three large ones, may also prove beneficial.
Nutritionists who design your diet regime may also focus on the glycemic index and your glycemic load to help you make better diet choices.
Along with diet changes, most diabetics find regular exercise helpful for maintaining optimum weight levels. All this and more should fit into a sensible treatment regimen that is individual to you.
Treatment With Insulin
If the progression of your disease necessitates insulin injections, modern technologies enable convenient ways of doing so. The past regimen of insulin injections several times a day by a nurse or family member required considerable adaptation. Now, an option comprises easy-to-administer, pre-filled “pens” that allow pre-programmed doses.
Meanwhile, implantable insulin pumps have become nanoscopic, more reliable, and safer. Also, there are new ways to automatically measure your need for insulin. If treatment for diabetes of any type now involves more choices, they are also more effective, user-friendly, and come with fewer side effects.
David York Supports New Research for Geriatric Diabetes Treatments
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