Sugar alcohol formation in particular is directly involved in cataract development and loss of nervous function. Maintaining blood glucose homeostasis is therefore critical for preserving the health of the patient and reducing the risk of associated pathological disease. Diabetes Management Fundamental to the successful management of Type II diabetes is dietary modification including the strict control of simple carbohydrate intake and increasing the percentage of complex carbohydrates and fiber. While many cases of Type II diabetes can be controlled by weight loss and diet alone, in some instances the use of insulin or oral hypoglycemic drugs, such as sulphonylureas, biguanidines, acarbose , or a new drug, Troglitazone are necessary to help keep blood glucose at a normal level. These drugs are administered orally, singly or in combination.
Side effects range from hypoglycemia to lactic acidosis, kidney and cardiovascular damage.
The sulphonylureas sensitize the beta cells in the islets of Langerhans in the pancreas to glucose, resulting in enhanced internal secretion of insulin and the simultaneous suppression of glucose production in the liver. Hypoglycemia occurs with individuals on a lowered calorie intake, those who are generally weak and debilitated or have kidney impairment. Biguanides prevent synthesis of glucose by the liver and produce mild impairment of intestinal glucose absorption stimulating lactic acidosis and gastrointestinal disturbances. Biguanides are contraindicated in persons with hepatic and kidney dysfunction and cardiac failure. Finally, Troglitazone was developed to reduce insulin resistance.