Tablet treatment for Type 2 Diabetes

Can everybody with Diabetes take tablet treatment?

Tablet treatment is for people with type 2 Diabetes except certain situation like pregnancy when you can not take Insulin. Also Insulin is needed during surgery, severe infection and for some reason or other you are not able to eat. Insulin is a must for people with type 1 Diabetes; they should not take tablet in any circumstances.

When is the right time to start tablet?

After diagnosis of type 2 Diabetes is confirmed, it is advisable to try diet for some time, may be for three months. This is mainly to make you realise the nature of food you should take and the ones you need to avoid. After this trial period of diet only, you should check your diabetes control and if the control is not acceptable you should start on diet plus tablet treatment.

Are all the tablets same?

Certainly not. There are different groups of Diabetes tablets available and each group has a few subgroups. To complicate the issue further, several companies in India make the same medicine. So same group or subgroup medicine is available in different names, some of them may be in 50 different names. Please make sure the name in prescription matches the medicine you buy. To confuse the issue further, some company marketed tablets almost sound like Insulin, but they are tablet, not oral Insulin.

What are the different types of tablets available for Diabetes?

When should I take tablets, before or after food?

Some tablets should be taken before and some after food. Some tablets even should be taken with the first bite of food, because that is the time they work best. This is very important and you should make this clear from your doctor. If it is before, correct time is around 30 minutes before food.

How do they work?

Different tablets work in different ways. Some stimulate the pancreas to produce more Insulin, some tries to help body’s Insulin to work more efficiently while some others do not allow sugar to be absorbed from the stomach. Few tablets work in more than one way.

Can I combine different tablets together?

Yes, if needed. Generally the rule of thumb is to try the maximum dose or maximum tolerated dose of one group and then combine the second tablet from a different group so that they can work together. But now-a-days we are using combination tablet even from the beginning.

Do they have side-effects?

Every medicine available in the market can have side-effects, so does Diabetes tablets. It is very important that you tolerate medicine, because if you do not tolerate you can not take them for a long time. If you have side-effects, you must make sure that is due to the tablets before stopping. Interestingly, some of the side-effects like indigestion, belching, loose motion with Metformin group of tablet disappear over time, so they should be started with a small dose to get adjusted with your system. Once adjusted, dose can be increased.

Once started, do I need to take them for life?

This all depends on your Diabetes. If your Diabetes is very well controlled, you may try only with diet. If that is fine, why not to control your Diabetes only with diet and life-style measures. But if you see, your control is not good with diet alone, you must accept that your body needs medicine and you should start again. Remember, there is a genuine chance, over the time your requirement of medicine is going to go up as type 2 Diabetes worsens with time.

Initially I was controlled with tablets, but despite doing the same things my sugar is uncontrolled?

This is very common question we face in our daily practice. The reason for telling again and again is that modern research established clearly that Diabetes never remains the same. The time for this worsening is different for different people. This is neither a fault of yours nor your doctor’s. If you have looked after yourself very well, it is very likely Diabetes will worsen slowly and the opposite is true as well. So, if you find despite doing the same thing your control is slipping, you should modify the treatment.