Understanding Type 2 Diabetes

By Gerald Bernstein, MD, FACP

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Type 2 diabetes results from the body’s failure to keep your blood glucose level normal. Glucose (sugar) comes into our bloodstream as a result of what we eat and what the liver produces. Insulin produced in the pancreas allows glucose to enter different cells for growth and energy. With Type 2 diabetes, the insulin-producing cells secrete less insulin than is needed, the liver produces more glucose than it should, and the muscles don’t respond to insulin normally, resulting in insulin resistance. Chronically elevated blood glucose levels increase the risk of complications, such as blindness, kidney failure, and loss of limbs.

Type 2 diabetes is best treated with nutritional control and physical activity. There are also a variety of medications used to treat the disease.

  • Metformin - This helps control the amount of glucose (sugar) in your blood. It decreases the amount of glucose made by your liver and the amount of glucose you absorb from food. 
  • Sulphonylureas (glyburide, glimeparide) and Meglitinaides (prandin) - Stimulate the cells in the pancreas to make more insulin.
  • TZDs, rosiglitazone, and Pioglitazone - Sensitize the muscles to be more reactive to insulin.
  • Incretins Byetta, Bydureon, Victoza and Januvia - Make the pancreatic cells more sensitive to glucose.

What should my first step be after receiving a diabetes diagnosis?

Ask your doctor if a diabetes educator would be helpful. They can assist you in understanding your diagnosis, and getting proper food and exercise advice.

How can I use my pharmacist to help?

Most people are going to be on combination therapy, the use of more than one medication or other therapy, as well as lipid and blood pressure-lowering medications. Your pharmacist can help you know what risks there are and what to be mindful of.

Gerald Bernstein, MD, FACP

Article written by Gerald Bernstein, MD, FACP
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