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December 19, 2000

Medications: Pills for Diabetes

Question from Tickfaw, Louisiana, USA:

I am 31 years old and have had type 1 diabetes for 25 years. I have recently been given Actos to lower my need for insulin. I am overweight and have tried all types of things to lose weight. My doctor seems to think that this treatment will help me decrease my need for insulin, and therefore help me to lose weight. He has my blood work done every three months. I have taken Glucophage before because another doctor thought the same thing. I quit because my blood sugar was so low that I could not function for several days because of the insulin reactions. I spoke to my doctor about this, and he told me that the body absorbs Glucophage and Actos differently. Do doctors normally prescribe Actos for type 1 diabetes?


Actos [pioglitazone] is an effective medication for the treatment of diabetes. It has primarily been used in the treatment of patients with type 2 diabetes in which insulin resistance is a prominent feature in the cause of the elevated blood sugars. Originally, medications from this class of drugs were used only in individuals who were on insulin, with the goal of decreasing insulin requirements and improving glycemic control. Since their introduction, they have been used with other oral medications in the treatment of type 2 diabetes. They have been studied and used sparingly in patients with type 1 diabetes where there is a component of insulin resistance. You can tell this is present by the need for a large dose of insulin to control your blood sugars. The goal is to improve the action of the insulin you are taking. You need to talk with your physician about the risks of this medication versus the improvements you may see. It has not always been the case that patients were able to lose a lot of weight with the institution of this regimen. If you were getting low before with Glucophage [metformin, you may not need the medication for blood sugar control.