Type 2 Diabetes Slideshow Pictures Diabetes and Foot Problems Slideshow Take the Diabetes Quiz!

Medical Author:

Robert Ferry Jr., MD

Robert Ferry Jr., MD

Robert Ferry Jr., MD, is a U.S. board-certified Pediatric Endocrinologist. After taking his baccalaureate degree from Yale College, receiving his doctoral degree and residency training in pediatrics at University of Texas Health Science Center at San Antonio (UTHSCSA), he completed fellowship training in pediatric endocrinology at The Children's Hospital of Philadelphia.

View Full Profile

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

View Full Profile

Diabetes Medications

Many different types of medications are available to help lower blood sugar levels in people with type 2 diabetes. Each type works in a different way. It is very common to combine two or more types to get the best effect with fewest side effects.

• Sulfonylureas: These drugs stimulate the pancreas to make more insulin.
• Biguanides: These agents decrease the amount of glucose produced by the liver.
• Alpha-glucosidase inhibitors: These agents slow absorption of the starches a person eats. This slows down glucose production.
• Thiazolidinediones: These agents increase sensitivity to insulin.
• Meglitinides: These agents stimulate the pancreas to make more insulin.
• D-phenylalanine derivatives: These agents stimulate the pancreas to produce more insulin more quickly.
• Amylin synthetic derivatives: Amylin is a naturally occurring hormone secreted by the pancreas along with insulin. An amylin derivative, such as pramlintide (Symlin), is indicated when blood sugar control is not achieved despite optimal insulin therapy. Pramlintide is administered as a subcutaneous injection along with insulin and helps achieve lower blood sugar levels after meals, helps reduce fluctuation of blood sugar levels throughout the day, and improves hemoglobin A1C levels.
• Incretin mimetics: Incretin mimetics promote insulin secretion by the pancreas and mimics other blood sugar level lowering actions that naturally occur in the body. Exenatide (Byetta) was the first incretin mimetic agent approved in the United States. It is indicated for diabetes mellitus type 2 in addition to metformin or a sulfonylurea when these agents have not attained blood sugar level control alone.
• Insulins: Synthetic hyuman insulin is now the only type of insulin available in the United States; it is less likely to cause allergic reactions than animal-derived varieties of insulin used in the past. The type of insulin chosen to customize treatment for an individual is based on the goal of providing optimal blood sugar control. Different types of insulin are available and categorized according to their times of action onset and duration. Commercially prepared mixtures of insulin may also be used to provide constant (basal) control and immediate control.
  • Examples of rapid-acting insulins
    • Regular insulin (Humulin R, Novolin R)
    • Insulin lispro (Humalog)
    • Insulin aspart (Novolog)
    • Insulin glulisine (Apidra)
    • Prompt insulin zinc (Semilente, slightly slower acting)
  • Examples of intermediate-acting insulins
    • Isophane insulin, neutral protamine Hagedorn (NPH) (Humulin N, Novolin N)
    • Insulin zinc (Lente)
  • Examples of long-acting insulins
    • Extended insulin zinc insulin (Ultralente)
    • Insulin glargine (Lantus)
    • Insulin detemir (Levemir)