Diabetes is a disorder of blood sugar levels. There are two main types of diabetes, plus rarer forms such as diabetes that can happen during pregnancy, known as gestational diabetes.
Type 1 diabetes results in high blood sugar levels because the body stops producing insulin, the hormone that regulates sugar levels. Type 2 diabetes leads to high blood sugars because the insulin in the body does not work effectively.
The broad differences in treatment between the two types are:
- Type 1 diabetes is treated with insulin injection. Careful diet and activity planning is needed to avoid complications of treatment.
- Type 2 diabetes is treated with lifestyle measures, drugs taken by mouth, and sometimes also insulin if the other treatments fail.
Contents of this article:
- Medications for type 1 diabetes
- Medications for type 2 diabetes
- Other drugs used in diabetes treatment
- New developments in diabetes medication
Treatment for type 1 diabetes is always with insulin, to replace the body’s absent insulin and keep blood sugar levels under control.
Type 1 diabetes is always treated with insulin. Many patients inject insulin themselves.
Insulin is usually given by injection – by patients themselves, injecting it under the skin, or if hospitalized, sometimes directly into the blood. It is also available as a powder that patients can breathe in.
Insulin injections vary by how quickly they act, their peak action, and how long they last. The aim is to mimic how the body would produce insulin throughout the day and in relation to energy intake.
1. Rapid-acting injections take effect within 5 to 15 minutes but last for a shorter time of 3 to 5 hours:
- Insulin lispro (Humalog)
- Insulin aspart (NovoLog)
- Insulin glulisine (Apidra)
2. Short-acting injections take effect from between 30 minutes and 1 hour, and last for 6 to 8 hours:
- Regular insulin (Humulin R and Novolin R)
3. Intermediate-acting injections take effect after about 2 hours, and last for 18 to 26 hours:
- Insulin isophane, also called NPH insulin (Humulin N and Novolin N)
4. Long-acting injections take effect after 1 or 2 hours and last for between 14 and 24 hours:
- Insulin glargine (Lantus)
- Insulin detemir (Levemir)
5. Premixed injections are combinations of the above types of insulin. All take effect from between 5 minutes and 1 hour, and last for between 10 and 16 hours:
- Insulin lispro protamine/insulin lispro (Humalog Mix50/50 and Humalog Mix75/25)
- Insulin aspart protamine/insulin aspart (NovoLog Mix 50/50 and NovoLog Mix 70/30)
- NPH insulin/regular insulin (Humulin 70/30 and Novolin 70/30)
6. Rapid-acting inhaled insulin is breathed in, takes effect within 12 to 15 minutes, and lasts for 2.5 to 3 hours:
- Insulin human powder (Afrezza)
Other drugs for type 1 diabetes
Metformin is added in for some people with type 1, but it is a drug mainly for type 2 diabetes. The following drugs are also used in type 1 diabetes and are all grouped together as non-insulin injectables:
- Incretin mimetics are drugs that mimic the body’s hormone incretin, which stimulates insulin release after meals: exenatide (Byetta, Bydureon), liraglutide (Victoza), and dulaglutide (Trulicity)
- Amylin analogs: pramlintide (Symlin) mimics another hormone, amylin, that is involved in glucose regulation
- Glucagon is used to reverse blood sugar levels when they fall too low as a result of insulin treatment