5.2 Treatment of diabetes

• Diet 
• Exercise 
• Oral hypoglycemic agents: Sulfonylureas are drugs which stimulate insulin secretion from pancreatic beta cells (tolbutamide, chlorpropamide). Drugs which suppress excessive hepatic glucose release, enhance utilization of glucose by skeletal muscle and adipose tissue by increasing glucose transport across cell membranes (metformin). 
• Insulin: The following categories of patients are treated with insulin:
Juvenile or unstable diabetics 
Those not responsive to oral therapy 
Those presenting with severe infections or those presenting for major surgery. 

There are three types of insulin (Table5.2): Insulin preparations vary from country to country so it is best to become familiar with what is available locally.