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April 10, 2004

Daily Care, Pills for Diabetes

Question from Garmisch, Germany:

Are there are oral medications used for type 2 that can reduce the daily insulin requirement in type 1 patients?


Drugs from the class of drugs known as insulin sensitizers have the theoretical effect of decreasing insulin requirements. These might be helpful in patients with evidence of insulin resistance. Such patients may come from a family where type 2 diabetes may be evident or there may be elements of the insulin resistance syndrome in patients previously diagnosed with type 1 diabetes. Of the medications that may fall into the category of insulin sensitizers, two medications classes stick out: the biguanides, of which metformin is the prototype, may have that potential; and the thiazolidinediones, of which Actos or Avandia are examples. The thiazolidinediones originally arrived in the market as a way to decrease insulin requirements in patients with type 2 diabetes. If you have type 1 diabetes without significant insulin resistance, there is a question as to whether this will help very much.