What Role Does Medication Play In Managing Type 2?
Currently, there are seven classes of medications approved by the FDA for treatment of type 2 diabetes (Insulin, Sulfonylureas, Meglitinides, Biguanides, Alpha-Glucosidase Inhibitors, Thiazolidinediones, and GLPs). It's important to know that few studies on the safety and effectiveness of these medications have been conducted in children so few drugs are approved by the FDA for use in children. However, metformin and insulin have been approved by the FDA. Since drugs are not tested specifically in children in the United States, physicians who treat children will often prescribe FDA-approved medications beyond what the pharmaceutical label says they can be used for. This is called "off-label" use and doctors do this frequently because even though the FDA has not approved the drug's use in children, it might be the best available treatment. The NIDDK has more information about medications for type 2 diabetes.
Many medication trials in children and youth with type 2 diabetes are underway or in the planning process. These trials are an important way to see if these medicines are effective and what side effects they have, since they may not have the same risks or benefits for children with type 2 as they do in adults with type 2. You can learn more about current research studies at CWD's website and at the NIH's website.
Treating type 2 diabetes includes diabetes education for you and your family that emphasizes the importance of increasing exercise and following an appropriate eating plan. Specific blood glucose targets should be set with your healthcare provider. You and your family should be taught how to use the tools of diabetes management, including: using appropriate medications, testing your blood sugar, creating meal plans, becoming more physically active and living well with diabetes. The goal of your treatment plan is to have your A1c < 7.0% and fasting glucose levels < 120 mg/dL. While these levels may be difficult to achieve, they are worth striving for as as your target levels.
For many people with type 2 diabetes, controlling blood glucose means either taking medicine by mouth, injecting insulin, or both. Very soon, inhaling insulin will also be a treatment option. Few pediatric patients with type 2 diabetes can be treated with diet and exercise alone, so medicine is most often required. For most children and youth with type 2 diabetes today, doctors choose a medicine called metformin. Insulin is also frequently used in youth with type 2. Insulin is particularly used when a patient has glucose levels in excess of 250 mg/dL. Often metformin is added to the insulin treatment to try and decrease or eliminate the need for insulin. If doctors are unclear whether a patient has type 1 or 2 diabetes when they are diagnosed, therapy starts with insulin while they wait for other test results (such as testing antibodies and c-peptide levels). Other problems, such as high blood pressure and high blood lipids may also require medicine.
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Last Updated: Saturday April 20, 2013 13:31:34
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