Summaries for Patients21 February 2017

Oral Pharmacologic Treatment of Type 2 Diabetes

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      What is type 2 diabetes?

      Type 2 diabetes is a disorder in which there is too much sugar (glucose) in your blood.

      Most people with diabetes make at least some insulin, but it doesn't work to keep their blood sugar under control. This is called type 2 diabetes. When type 2 diabetes is not controlled, it can cause sugar to build up in your blood.

      High levels of sugar can damage your heart, kidneys, nerves, eyes, and feet. It is very important to keep type 2 diabetes under control to prevent health problems.

      Symptoms of type 2 diabetes include extreme thirst or hunger, feeling tired, frequent need to urinate, weight loss, blurred vision, and tingling in the hands and feet.

      How is type 2 diabetes treated?

      Some patients can control their blood sugar with diet and lifestyle changes. However, many patients need to take medicines to control blood sugar levels. These medicines may include insulin, a medicine you inject, and a variety of oral medicines.

      Usually, lifestyle changes are the first line of treatment. If these changes do not control your blood sugar well enough, your doctor may prescribe medicines to help.

      Who developed these recommendations?

      The American College of Physicians (ACP) developed guidelines for the treatment of type 2 diabetes. Members of the ACP are internists, physicians who specialize in the care of adults.

      How did the ACP develop these recommendations?

      The authors looked at studies and trials related to medicines for type 2 diabetes. This information was used to develop advice for clinicians and patients.

      What does the ACP recommend that patients and doctors do?

      If you have type 2 diabetes, it's important to eat a healthy diet and exercise regularly. Losing weight also may help keep your blood sugar under control.

      If diet, exercise, and weight loss are not enough to control blood sugar levels, doctors should prescribe an oral medicine.

      If a medicine is added to diet and exercise, the first choice should be metformin. Metformin is better than other oral type 2 diabetes medicines at reducing blood sugar levels.

      Metformin may help with weight loss and is cheaper than other oral medicines. It is also less likely to cause dangerous side effects.

      If both lifestyle changes and metformin are not enough to control blood sugar, doctors should add a second medicine to treat patients.

      The ACP also recommends that patients discuss the benefits, risks, and costs of all types of treatments for type 2 diabetes with their doctors.

      What are the cautions related to these recommendations?

      Metformin may be unsafe if you have kidney damage. Talk with your doctor to make a decision that is best for you and your health.

      Questions for my doctor

      What types of foods can I eat?

      What type of exercise is best for me?

      Will I need oral medicines to control my type 2 diabetes?

      Does metformin have side effects?

      How can I tell if I need another medicine added to the metformin?

      How much will the oral medicines cost?