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New Type 2 Diabetes Treatment Options
Over the past decade, the list of type 2 diabetes medications has grown -- helping people gain better blood sugar control. But the drugs' side effects -- plus taking several pills every day -- can be frustrating.

"There are two problems with diabetes," explains Ronald Goldberg, MD, associate director of the Diabetes Research Institute at the University of Miami Medical Center. "Your body doesn't make enough insulin. And your organs are resistant to using insulin that is produced."

If lowering high blood sugar is the primary goal, today's diabetes drugs do their job "but only to a limited extent," Goldberg tells WebMD. "Even when patients respond to one drug, they will need more and more drugs over time, as the pancreas deteriorates."

Fortunately for many, advances in treatment are helping to make a difference, giving people with type 2 diabetes a growing list of options.

Treating Diabetes With Insulin
Insulin is a hormone that controls the amount of glucose in the blood. When used as a medication, it is derived from either pork (porcine) insulin or is genetically made to be identical to human insulin.

People who may need insulin therapy include:

- People with type 1 diabetes (insulin is the only medication that can be used to control the increases in blood glucose that occur with the disease.)
- People with type 2 diabetes (insulin can be used alone or in combination with diabetes pills)
- Women with gestational diabetes. (Oral diabetes medications are not used in pregnant women.)

The Insulin Pump
There's no substitute for the body's own blood sugar control mechanism, but insulin pumps may be the next best thing, say diabetes experts. An insulin pump is a compact, pager-sized, computerized device that can be worn on a belt. It is connected to the body via a flexible plastic tube through which insulin is delivered. The pump releases insulin in a steady, continuous background or "basal" dose, but also allows the wearer to add an additional dose, or "bolus" of insulin when needed, such as before a meal or snack.

"It provides more stable insulin deliveries and smoothes out glucose fluctuation compared with injections," explains Howard A. Wolpert, MD, senior physician and director of the insulin pump program at the Joslin Diabetes Center in Boston, in an interview with WebMD. "I think the advantage from a lifestyle standpoint is what attracts many people, because it does allow people much more flexibility in terms of eating times."

Oral Medicine (Pills) Used to Treat Diabetes
Oral diabetes medicines help control blood glucose levels in people whose bodies still produce some insulin (the majority of people with type 2 diabetes). These drugs are NOT insulin and are usually prescribed to people with diabetes along with recommendations for making specific dietary changes and getting regular exercise. Several of these drugs are often used in combination to achieve optimal blood glucose control.

Remember that people with type 2 diabetes tend to have two problems that lead to increased glucose in the bloodstream:

1. They don't make enough insulin to move glucose into cells where it belongs.
2. The body's cells become "resistant" to insulin (insulin resistance), meaning they don't take in glucose as well as they should.

In time, people with type 2 diabetes develop what's called "beta-cell failure." This means that the cells in the pancreas that make insulin no longer are able to release insulin in response to high blood glucose levels. Therefore, these people often require insulin injections, either in combination with their oral medications, or just insulin alone to manage their diabetes.

Herbs, Vitamins, and More for Diabetes
Alternative or complementary treatments spark the interest of many people with diabetes. The prospect of having better control over blood sugar levels or being less dependent on insulin injections by taking herbal supplements or vitamins is certainly attractive.

But do any of the things often touted as alternative diabetes treatments really work?

First, anyone interested in going down this road should consider the difference between the terms "alternative" and "complementary." When it comes to managing diabetes, the latter is the term experts prefer. "Alternative" implies that you ditch one treatment in favor of another. Rather, if you want to look into taking supplements, you should do so as a possible complement to the treatment program your doctor has prescribed.

Saving on the Cost of Diabetes Care
Carol Phillips has a problem -- a big one, but a common one. She is grappling with the cost of diabetes. At the end of May, her COBRA benefits from a former employer will run out, and she will join the ranks of more than 43 million Americans without health insurance. Because she was recently diagnosed with type 2 diabetes, it will be hard for her to afford a new policy.

"I have called a couple of places and inquired," she tells WebMD. "Either I am non-insurable, or the premiums that are quoted are ridiculous."

Phillips is too young for Medicare, and as a self-employed consultant in the travel industry, she makes too much annually to qualify for Medicaid. Nevertheless, her out-of-pocket diabetes costs will take a bite out of her income. "It's going to be very scary," she says.

Since her diagnosis in January, she says she has been able to get her blood sugar under control with the diabetes drug Avandamet and major lifestyle modification. "I'm a changed individual in terms of what I do and what I consume," she says. She exercises daily and has already lost 25 pounds.

She says she hopes to reduce her costs by getting off diabetes medication altogether, and managing her blood sugar by diet and exercise alone. For people who are diagnosed early in the course of the disease, that is sometimes possible.

Who's BJs membership store is now matching Wallmart's $4/mo generics, which is actually more cost effective than his on-line pharmacy, but his testing supplies remain more expensive than his medications...
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Fascinating. New and old drugs, complete with side effects!

My OH My! Metformin causes flatulence! And i thought it was the soybean derivative TVP. Gale warnings are still in effect...

And now, a drug that inhibits an endocannabinoid receptor that stops the munchies! They should have been researching cannabis and its multifarious effects decades ago. What irony: research on endocannabinoid receptors may supply a substitute for speed (amphetamines), the olde-fashioned diet pill.

Oh, well. i'll keep on taking the metformin, and let the winds blow where they may. Maybe i can get the cannabis-receptor inhibitor later (weight loss would be nice), providing it doesn't cause chronic bummers.


wondering what new miracle will come out of the labs to relieve me of the resposibility of eating less and doing an extra half hour on the Treadmill of Death.

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Carol Phillips has a problem -- a big one, but a common one.

Stop whining! This is the USA, the home of the free. If you, through utter stupidity or gross laziness, <*> lost your job and didn't get another one with benefits, don't blame me! If you can't pay your medical bills, do without! Donate your body to Science, and you won't even have to pay for your burial plot (ask the recipient to burn the remains and dump them out back). The good news: Maybe you won't be able to afford food and will slim down and not need the medical care you will not be getting.

To repeat: This is America. We don't like the meddling Nanny State. Socialized medicine will destroy healthcare for all us rich folks. Shut up and drop dead like a good girl!

Maybe the Healthcare system will save huge sums of money treating the complications of untreated diabetes if Ms Phillips goes broke and qualifies for Medicaid or survives long enough to go on Medicare. Then again, maybe the US ought to join the civilized world.


<*> or because your boss offshored your job, but that was your fault as well: Should have begged for a pay cut.

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Are you bitter about something?

Who's just saying you seem to find the worst in everything...
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Yes. i am bitter that the truth is unpleasant.


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