This video is going to do a run through of all the different medications that are available to Diabetes sufferers today.
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What type of diabetes medications are available today? Dr. Larry Ellingson: I think the good news that's happened over the last several years are many, many more choices for patients today with their medications and diet and nutrition and so forth. The Sulfonylureas where one class of drugs that came out in the late 50's and early 60's, and these drugs are very efficient at stimulating the pancreas to produce more insulin so that you can utilize a sugar that you are eating in your meals. Over time they tend to wear the pancreas out sometimes and newer drugs such as the Biguanides or Metformin have come out and they work on the liver. So each of these oral drugs work on different parts of the body and the system, one on the pancreas, Sulfonylureas. Metformin works on the liver to suppress glucose output. The new class of drug called Thiazolidinediones or TZDs work on muscle sensitivity or increasing sensitivity to the utilization of glucose. So, the good news about all that is that you've got different therapeutic approaches, and often times, doctors can use one, two, or sometimes three, combination of all those drugs to help reduce the blood sugar in people, and if necessary, move on to a combination of an oral plus insulin. So, many more choices today than we ever had before. Richard Rubin: Most people with Type II diabetes now are on more than oral medication. I think the average is something like two of those medications. Dr. Larry Ellingson: There are different types of insulin. If you go back 100 years, almost 80 years now, I guess, 1922 when it was discovered by Banting and Best at the University of Toronto, it was one type of insulin what we call today Regular Insulin, that was all that was available. People took four-five shots a day, usually around meal time to suppress the glucose from the food you are eating. About 15 or 20 years after that, they modified the insulins with protamine to extend the time action and you produced NPH insulin, which is a little longer, lasts 8-12 hours. In recent years, the last decade or so, they have introduced, what we would call Designer Molecules or Insulin Analogs, which really act -- really short acting insulin, sort of mimics what your body produces. When you eat something, your body spikes blood sugar, because of the food you've been taking. As a result of that, your pancreas squirts out some insulin to suppress that glucose. The new insulin, short acting analogs actually work much like your body does, very quickly, 15-30 minutes reach a peak, drive the sugars down, which is very good, which allows some patients to actually eat, and then dose their insulin, much more flexible. The old insulins, you had to give 30-45 minutes ahead of time, wait till they peak, hope the food came so the blood sugar in the peak of insulin match the same time. And then there are some new longer acting insulins, basal insulins we call them. Your body actually produces about a-half to one unit of insulin per hour round the clock to maintain a body -- a level to suppress your glucose, as your brain needs the sugar for energy and for working. That basal level, the old insulins, animal insulins and sometimes NPH or Ultralente were used had a slight peak, so people would take one shot, and during the night, because of the peak, their sugars would drop low, and sometimes they'd wake up sweating and it was very uncomfortable. The new basal insulins get to a flat peak, there is no real peak, they stay leveled all the time. So they work much like an insulin pump where it's delivering like your pancreas does, a certain amount of insulin each hour flat. Then when you eat, you program your pump to spike or you give a short acting insulin to suppress your glucose. So those designer insulins have added tremendous flexibility, I think, for the patients' regimen and as we're dealing with behavior and adjusting lifestyle, they've afforded, I think, the patients a lot of flexibility, both on the oral side and the insul