The Oral Exam: Staying Up-To-Date with Type 2 Medications

It’s not easy to navigate the crowded waters of type 2 oral medications. There are dozens of them, and their names have a lot in common with tongue twisters. They’re hard to pronounce, and harder to remember. But they’re necessary. Of the 20 million Americans with diabetes, 90 to 95 percent have type 2. Although some people with diabetes are able to manage their condition through diet and exercise alone, the majority cannot control their blood sugar without medication. According to the CDC, among adults diagnosed with diabetes, 57% take oral medication; 16% take insulin; 12% take both insulin and oral medication; and only 15% take neither insulin nor oral medication.

Of the myriad medications used to treat type 2 diabetes, the vast majority are oral medications. They fall into roughly five categories and are organized in Your Complete Type 2 Medications Reference Guide from Diabetes Health. It might be a good idea to keep the chart as a reference, for use when you meet with your doctor to discuss your medication regimen. But there are three medications, not listed in the chart because of their unique characteristics, which deserve special mention. They are not administered in pill form, and they’re causing a lot of talk: Byetta and Symlin, which are both administered via injection, and Exubera, an inhaled form of insulin.

The idea of an inhaled insulin was first reported by the media over ten years ago. Exubera, which was released in September 2006, was highly anticipated by the medical and patient communities. The only product of its kind currently on the market, Exubera is manufactured by Nektar Therapeutics and is marketed and sold by Pfizer. (Novo Nordisk requested that sales of Exubera be stopped because it allegedly violated five of their patents, but a U.S. district judge denied the request.)

Some patients report trouble getting their doctors to write them a prescription for Exubera. Some patients are put off by the bulkiness of the Exubera inhaler. Others are wary of the medication because at this time it delivers only short-acting insulin. Some patients, however, find Exubera easy to use and effective.

Byetta (exenatide) is the first in a new group of drugs called incretin mimetics. It has many of the same effects as the human incretin hormone glucagon-like peptide-1 (GLP-1), which improves post-meal blood sugar by increasing insulin delivery. Amylin Pharmaceuticals and Eli Lilly are the makers and distributors of Byetta.

The FDA recently approved Byetta for type 2 diabetics for whom prescribed oral medications do not work to control blood sugars. According to Byetta’s website, it is used along with metformin (an oral medication that helps control blood sugars), sulfonylureas (medications that increase the pancreas’ insulin production), or a combination of both. Byetta, which comes in a pre-filled pen, is also said to help patients lose excess weight. Partly for this reason, it has become extremely popular.

Symlin (pramlintide), developed by Amylin Pharmaceuticals, is a synthetic version of the hormone amylin, which the pancreas releases along with insulin in healthy individuals. Symlin’s website states: “Symlin is an injectable medicine for adults with [insulin-requiring] type 2 or type 1 diabetes to control blood sugar. Symlin works with mealtime insulin to smooth out the peaks in patients’ blood glucose [sugar] levels to give them more stable levels after meals.”

Not every person taking type 2 diabetes medications will experience better blood glucose levels right off the bat. Of course, weight loss, diet, and exercise are always crucial, no matter what medication you’re taking. It is strongly recommended that you test often, get your A1C results, and work with your physician to constantly refine your drug, exercise, and diet treatment plan in your ongoing effort to achieve good blood glucose control.

If you’d like more information on these three medications, visit There are plenty of interviews with experts who explain these medicines and more, plus videos of engaging personalitie from all aspects of diabetes care and research.

See Your Complete Type 2 Medications Reference Guide.

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