A number of drug options exist for treating type 2 diabetes, including:

Diabetes and Sulfonylurea drugs. These medications stimulate your pancreas to produce and release more insulin. For them to be effective, your pancreas must produce some insulin on its own. Second-generation sulfonylureas such as glipizide (Glucotrol, Glucotrol XL), glyburide (DiaBeta, Glynase PresTab, Micronase) and glimepiride (Amaryl) are prescribed most often.

Diabetes and Meglitinides. These medications, such as repaglinide (Prandin), have effects similar to sulfonylureas, but you're not as likely to develop low blood sugar.

Diabetes and Biguanides. Metformin (Glucophage, Glucophage XR) is the only drug in this class available in the United States. It works by inhibiting the production and release of glucose from your liver, which means you need less insulin to transport blood sugar into your cells. One advantage of metformin is that is tends to cause less weight gain than do other diabetes medications. Possible side effects include a metallic taste in your mouth, loss of appetite, nausea or vomiting, abdominal bloating, or pain, gas and diarrhea.

Diabetes and Alpha-glucosidase inhibitors. These drugs block the action of enzymes in your digestive tract that break down carbohydrates. That means sugar is absorbed into your bloodstream more slowly, which helps prevent the rapid rise in blood sugar that usually occurs right after a meal. Drugs in this class include acarbose (Precose) and miglitol (Glyset).

Diabetes and Thiazolidinediones. These drugs make your body tissues more sensitive to insulin and keep your liver from overproducing glucose. Side effects of thiazolidinediones, such as rosiglitazone (Avandia) and pioglitazone hydrochloride (Actos), include swelling, weight gain and fatigue. A far more serious potential side effect is liver damage. The thiazolidinedione troglitzeone (Rezulin) was taken off the market in March 2000 because it caused liver failure. If your doctor prescribes these drugs, it's important to have your liver checked every two months during the first year of therapy. Contact your doctor immediately if you experience any of the signs and symptoms of liver damage, such as nausea and vomiting, abdominal pain, loss of appetite, dark urine, or yellowing of your skin and the whites of your eyes (jaundice).

By combining drugs from different classes, you may be able to control your diabetes in several different ways. Each class of oral medication can be combined with drugs from any other class. Most doctors prescribe two drugs in combination, although sometimes three drugs may be prescribed. Newer medications, such as Glucovance, which contains both glyburide and metformin, combine different oral drugs in a single tablet.

In recent years, researchers have focused increasing attention on transplantation for people with type 1 diabetes. Pancreas transplants have been performed since the late 1960s. Most are done in conjunction with or after a kidney transplant. Kidney failure is one of the most common complications of diabetes, and receiving a new pancreas when you receive a new kidney may actually improve kidney survival. Furthermore, after a successful pancreas transplant, many people with diabetes no longer need to use insulin.

Although still considered an experimental procedure, transplanting islet cells may offer a less invasive, less expensive and less risky option than a pancreas transplant for people with diabetes. In islet cell transplantation, doctors infuse fresh pancreas cells into the liver of the person with diabetes. The cells spread throughout the liver and soon begin to produce insulin.