Noninsulin Diabetes Medications.

Pharmacotherapy for diabetes has changed greatly owing to drugs and drug classes available. There are 11 classes of noninsulin diabetes medications available in the United States. With the use of 1 drug alone or in combination with different drugs, it is possible to improve glycemic control in patients with diabetes. Important properties of antidiabetic agents play a role in the choice of that particular medication for individual patients. Prescribing a diabetes medication regimen is based careful assessment of patient needs, and consideration of the medication's efficacy, impact on weight, hypoglycemia risk, potential side effects, cost, and patient preferences.

Co-Managing Patients with Type 1 Diabetes and Cancer.

The life expectancy of people with type 1 diabetes is improving and now approaches that of those without diabetes. As this population ages, a growing number will be diagnosed with and treated for cancer. Cancer treatments can drastically affect insulin requirement and glycemic control through multiple mechanisms including high doses of glucocorticoids and targeted therapies that directly interfere with cellular pathways involved in the action of insulin. Patients with cancer frequently also have alterations in gastrointestinal motility or appetite and require supplemental enteral or parenteral nutrition. Few studies have evaluated these patients directly, but data on patients with and without diabetes suggest that glycemic control may play a larger role in cancer outcomes than is often recognized. Collaboration between the treating oncologist and diabetologist allows people with diabetes to receive the most effective therapies for their cancers without undue risk of hypoglycemia or adverse outcomes due to hyperglycemia.