Over the past several years there have been advances in medications to treat diabetes, including new types of oral agents or pills and the manufacture of human insulin analogues and pen injection devices.

Insulin was discovered in 1921 by Frederick Grant Barting and Charles Herbert Best.

Oral agents (pills)

Only patients who are producing some insulin on their own can use oral agents. Pills are not insulin and cannot take the place of meal planning, exercise, or managing stress. There are five types of oral agents that can help control blood sugar levels:

Sulfonylureas - Helps the pancreas to release more insulin and lower the blood sugar

Biguanides - Metformin (Glucophage) helps the liver respond to insulin, resulting in reduced sugar output and lower blood sugar levels. This medication should not be used by people with kidney disease or heart disease.

Thiazolidinediones - Works mainly on the muscle and fat cells to help absorb glucose, thus lowering the blood sugar. People with liver problems should not take this drug.

Meglitinide - Repaglinide (Prandin) causes the pancreas to release insulin quickly and lower the blood sugar after meals. It is fast-acting and should be taken with meals.

Alpha-glucosidase inhibitors - Acarbose (Precose) or Miglitol (Glyset) decrease the absorption of starches. This medication may cause stomach upset and gas and the dosage should be increased very slowly.

Insulin therapy

Since the discovery of insulin in 1921, improvements continue to be made. Animal-source insulin is extracted from the pancreas of cows and pigs and is rarely used. In 1981, human insulin made in a lab became available.

There are several types of insulin available. It is important to know the type(s) of insulin that a person takes. The physician has prescribed the type of insulin that works best and no other type or brand of insulin should be used without the advice or direction of the physician.

Insulin is injected under the skin in the fatty areas of the body. The most consistent absorption occurs in the abdomen. The top of the legs and back of the arms and hips can also be used.

Insulin Pumps

The insulin pump administers insulin to the body through a long plastic tube attached to a machine that is small enough to fit in the palm of the hand. The tube attaches to the body under the skin through a tiny catheter and delivers insulin. Insulin pumps allow for different amounts of insulin to be given depending upon the body's needs.

Types of medications

Drug family Brand name Generic name    
  Amaryl Glimepiride
  Diabeta Glyburide
  Glucotrol XL Glipizide
  Glynase Micronized Glyburide
  Glucophage Metformin
  Avandia Rosiglitazone
  Actos Pioglitazone
Alpha-glucosidase inhibitors    
  Precose Acarbose
  Glyset Miglitol
  Prandin Repaglinide
  Starlix Nateglinide
Combination oral agents    
  Glucovance Glyburide + Metformin
  Avandamet Rosiglitazone + Metformin