There are a host of oral medications available for the treatment of type 2 diabetes. Almost everyone is put on metformin as long as their kidneys aren't already damaged. Metformin works by decreasing liver glucose production, decreasing glucose absorption in the gut and increasing peripheral insulin sensitivity. If someone has particularly resistant type 2 diabetes, insulin can be used.
Type 2 Diabetes Treatment
There is no known cure for type 2 diabetes. However, if you manage your condition effectively, you can expect a long, healthy life. Type 2 diabetes is treated with a combination of diet, exercise, and regular blood glucose, or blood sugar, testing.
Recently Answered
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American Diabetes Association answeredSee All 4 AnswersThe accepted, tried-and-true treatment for type 2 diabetes is a balance of diet and exercise. Even if you need medications, healthy eating and exercise habits continue to be key in caring for your type 2 diabetes. Most people with type 2 diabetes are advised to lose weight and improve their physical fitness. This can help to lower the body’s resistance to insulin. The severity of type 2 diabetes can be greatly reduced by maintaining a healthy body weight. Even a modest weight loss—10 pounds—can have benefits. By building a healthy lifestyle around a low-fat, well-rounded diet and regular exercise, it is possible to decrease body weight and insulin resistance. Exercise helps by taking some glucose from the blood and using it for energy during a workout, an effect that lasts even beyond the workout. Healthy eating, especially watching the amount of food eaten, helps glucose levels stay lower. As your level of physical fitness improves with regular exercise, so does your body’s sensitivity to insulin. -
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American Diabetes Association answeredNot everyone with type 2 diabetes will be helped by oral diabetes medications. Oral medications are more likely to lower blood glucose levels in people who have had high blood glucose levels for less than 10 years, who are using a healthy meal plan, and who have some insulin secretion by their pancreas. The drugs work poorly in people who are very thin.
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American Diabetes Association answeredThe following are some weight loss recommendations if you have type 2 diabetes:
- Begin a weight loss program with the help of your healthcare team.
- Ask for a referral to a dietitian who can help you find a diet you can use every day.
- Don't try to do everything at once. Take one step at a time and make changes you can stick with.
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See All 2 AnswersWeight loss, or bariatric, surgery can be helpful in treating type 2 diabetes and can even cure it entirely. If someone is obese with type 2 diabetes and is not able to lose weight with diet and exercise, bariatric surgery should be explored as an option for improvement and treatment of type 2 diabetes. -
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Dr. Jack Merendino, MD , Endocrinology Diabetes & Metabolism, answeredFor most people, the type of insulin that should be used first depends upon when during the day their blood sugar is not well-controlled. By “when,” I don’t mean the time on the clock, I mean whether the sugar is at its most poorly-controlled when the person is fasting or after they have been eating.
Many patients have very high sugars when they first awaken in the morning. They have “fasting hyperglycemia,” and they typically find that their blood sugar levels are higher before breakfast than they are before dinner. Often these people are surprised because they have would not have expected to have high glucose values after so many hours without eating. But it turns out that our liver begins to release glucose into the blood stream about 4 to 5 hours after hour last meal. This is so that we do not run out of fuel between meals. In many people with diabetes, however, much too much glucose is released resulting in a very high sugar before eating anything in the morning. These people are best treated with a long-acting or “basal” insulin. This word is derived from “base” or “baseline,” and this kind of insulin provides a baseline or background amount of insulin over a period of 24 hours or more. Because the many non-insulin medications provide better control of the glucose rise that occurs with eating than they do of the glucose release that occurs with fasting, most people with type 2 diabetes who need insulin are first treated with basal or long-acting insulin.
Long-acting insulins include glargine and determir which are marketed under the brand names Lantus, Toujeo and Levemir.
For those people whose morning glucose values are generally within an acceptable range but who have a big rise in glucose values after eating, short-acting (also called “bolus”) insulin given with one or more meals of the day may be the best form of insulin.
Short-acting insulins include the generic form “regular” insulin and the brand-name insulins Humalog, NovoLog and Apidra.
If a person needs both long-acting and short-acting insulin, they can take the two separately or can sometimes take a pre-mixed form of a short-acting insulin with the intermediate-acting insulin NPH. -
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American Diabetes Association answeredIf you seek to intensively manage your type 2 diabetes, keep the following suggestions in mind:
• If you manage your blood glucose with food and physical activity, you may
need to add an oral diabetes medication.•If you already take medication, you may need to add another pill, once-a-day
insulin, or other inject able medication.• If you already take insulin, you may need to take a more aggressive
approach such as three or four shots a day. Your therapy might even be
similar to a person with type 1 diabetes.• You may choose to wear an insulin pump if you begin taking more frequent
insulin shots.• Watch out for weight gain that accompanies lowered blood glucose levels.
You may need to add an extra workout a week to counteract the fact that
you’re not losing as much glucose in your urine anymore. -
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Mr. Eliot LeBow, CDE, LCSW , Endocrinology Diabetes & Metabolism, answeredYes! There are even some of us who have created psychotherapy practices solely to help people living with diabetes. Diabetes comes with great change and great loss. You lose your way of living, your lifestyle. The loss of one's past lifestyle would be less traumatic if it is addressed and processed out in psychotherapy.
it is a very traumatic event in the beginning and the traumas continue while living with it. As time goes on, depression can set in. Whether it is because a person is struggling to manage the day-to-day tasks or a person is dealing with complication, it is best to get emotional help to adjust.
One of the interesting facts and most problematic is that most people have lived with diabetes for 5 to 15 years. During that time blood sugars rise and the symptoms of high blood sugars start impacting a person’s life long before diagnosis. The symptoms mirror the symptoms found in depression.
High blood sugars trigger depression and depression causes poor motivation to control one's diabetes management, in turn causing higher blood sugar. This process is an endless cycle if left alone. Going to a therapist can help you turn that around. Once you get your depression under control, your blood sugar should follow suit.
Higher levels of anxiety, fear and guilt come along for the ride. In the here and now, diabetes management is like having a second job. If you have ever had 2 full-times jobs you probably can relate to some of the emotional stress and anxiety living with diabetes comes with.
Fear sets in even if you have no complications, and for some people, those thoughts become a consistent part of everyday life. This causes problems with relationships and the individual's emotional well-being.
The guilt and self-blame--"How did I let this happen?"--tears at the very fabric of one's emotional stability. How does one deal with that? How does one cope? It is a tough problem but there are answers.
Psychotherapists help facilitate growth and change in their clients. So clients with diabetes can find those answers and come to acceptance around living with chronic illness. It's not easy but it is a lot easier with someone to talk to without bias or judgment.
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Type 2 diabetes drugs that have been shown to reduce the risk of cardiovascular disease in people with diabetes at high risk include empagliflozin and liraglutide. The results of a trial of the type 2 diabetes drugs empagliflozin and liraglutide unexpectedly demonstrated beneficial cardiovascular effects in people with type 2 diabetes who had high pre-existing cardiovascular risk.
The importance of these findings is that specific glucose-lowering therapies have been found to reduce cardiovascular disease in high-risk patients with type 2 diabetes. -
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American Diabetes Association answeredIf you have type 2 diabetes, keeping track of your diabetes ABCs will tell you if your diabetes treatment is working. The ABCs of diabetes are:
- A: the A1C or estimated average glucose (eAG)
- B: blood pressure
- C: cholesterol levels
Besides getting an A1C/eAG blood test several times a year to keep track of blood glucose levels, many people check their own blood glucose using a blood glucose meter. Talk with your health care team about how and when to check your blood glucose. You can use the results to make decisions about food, medication, and physical activity. Your health care team will also see if your treatment is working by doing regular checkups and special tests as needed. Your plan needs to change over time. If something in your daily routine changes, or if you're not reaching your ABC goals, it is time for a new plan.