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| Diabetes |
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| Diabetes
Treatment |
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| Treatment of Type 2 Diabetes
is diet. If diet alone does not work, then tablets have to be
taken. If diet and tablets together still do not work, insulin
injection may be needed. |
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| Tablets |
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Oral anti-diabetes tablets are
useful for treating Type 2 diabetes only. |
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| Type |
Action |
Remarks |
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Sulphonylureas |
| eg. |
Chlopropamide |
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Tolbutamide |
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Glibenclamide |
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Gliclazide |
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Glipizide |
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Glimepiride |
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| Help pancreas to release more of its
own insulin. Also helps the body to use glucose more effectively. |
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| Take the tablet every day
30 minutes before meals. Do not miss or delay meals or
a low blood sugar reaction could occur. Certain other
tablets (eg. those for blood pressure) can react with
diabetic tablets. Discuss this with your pharmacist or
doctor. |
| Take the tablet immediately
before food. |
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| Help the body to use glucose more effectively. |
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| Take the tablet with meals
or after meals. |
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α-Glucosidase Inhibitors
eg. Acarbose |
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| Help to prevent the undesirable, rapid
rise of blood glucose following a meal. Taken over time,
overall glucose levels will also be reduced. |
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| Take the tablet with the first mouthful
of each of your three main daily meals, or immediately
just before the meal.
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Insulin Sensitisers
eg. Rosiglitazone |
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| Enhancing insulin action on the liver,
muscle and fat tissue without affecting insulin secretion |
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| Take the tablet with or after a meal
or on an empty stomach. It is best to take the tablets
at the same time every day. |
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Insulin Secretagues
eg. Repaglinide |
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| A prandial glucose regulator. Increase
endogenous insulin secretion. |
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| Take the tablet with meals |
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| Proper use of anti-diabetes tablets |
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Know the name and dosage of your
anti-diabetes tablets. |
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Do not take more or less than your doctor
ordered, and take it at the same time each day. |
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Follow the recommended diet plan. If you start
to eat too much, the tablets will lose their effect. |
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If you miss a dose of the tablet, take it
as soon as possible unless it is time for your next dose. In
this case, do not take the missed dose and do not double the
next one. Instead, go back to your regular dosing schedule. |
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| Insulin |
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Treatment for Type 1 diabetes
is with diet and insulin injections. |
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Some Type 2 patients may also required insulin
injections. |
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Insulin loses its effect if taken by mouth,
so it has to be injected. |
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| Types of insulin |
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| Type |
Start Of Action |
Maximum Action |
How Long
Action Lasts |
Remarks |
RAPID-ACTING
eg. Lispro
Aspart |
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| Low blood sugar or hypo-reaction is
more likely to occur around the time of maximum action
if you have not had enough food or have had too much insulin
or exercise. |
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SHORT-ACTING
eg. Actrapid Humulin
R |
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0.5 to 1hr |
1 to 3 hrs
2 to 4 hrs |
6 to 8 hrs
6 to 8 hrs |
INTERMEDIATE-ACTING
eg. Insulatard
Humulin N |
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1.5 hrs
1 to 2 hrs |
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| High blood sugar or hyper-reaction is
more likely to occur before the insulin starts acting.
Or when its action is ending. |
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PRE-MIXED
| eg. |
Mixtard
30/70,
50/50,
20/80 |
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Humulin
30/70 |
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NovoMix |
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2 -8 hrs
1-3 hrs |
24 hrs
24 hrs |
LONG-ACTING Ultratard
Lantus |
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4 to 6 hrs
No peak |
8 -24 hrs |
28 hrs
24 hrs |
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