What Is Type 2 Diabetes Treatment Like?
There are various types of diabetes. Approximately
34 million Americans are living with some form of diabetes, and 90% to 95% are living with type 2 diabetes – the most common form. In this article, you will learn about type 2 diabetes treatment, but first, let’s see how diabetes actually works.
How Does Diabetes Work?
When we eat carbohydrates, it is broken down into sugar in the bloodstream. As our blood sugar begins to rise, a signal is sent to the pancreas to release insulin. The pancreas basically acts as a “key” so that the sugar can enter cells, being transported through the body, where it can be used as energy.
With type 2 diabetes, there is a problem with this process. The body is either not making enough insulin, or more likely, the body cannot use the insulin as well as it should (insulin resistance). When this occurs, blood sugar levels begin to rise, ultimately causing type 2 diabetes.
Symptoms of Type 2 Diabetes
Symptoms of all types of diabetes are similar because they are caused by high blood sugar (hyperglycemia). Each person is a little bit different and develop these symptoms at different blood sugar numbers. Unfortunately for many people, symptoms do not develop until blood sugar levels are quite high. However, at some point, symptoms will develop:
- Excess hunger (polyphagia)
- Excess urination (polyuria)
- Excess thirst (polydipsia)
- Dry mouth
- Dry skin
- Blurred vision
- Yeast infections
- Poor wound healing
- Pain or numbness in the lungs
Diagnosis of Type 2 Diabetes
The most common test that is used to diagnose type 2 diabetes is the A1c test; the A1c measures average blood sugar over a period of two to three months:
- Normal: less than 5.7%
- Prediabetes: 5.7% to 6.4%
- Type 2 diabetes: 6.5% and above
Your provider may also order a fasting blood sugar test:
- Normal: <99mg/dL
- Prediabetes: 100mg/dL to 125mg/dL
- Type 2 diabetes: >125mg/dL
What Are the Risk Factors?
It is believed that your risk of developing type 2 diabetes increases if you:
- Have prediabetes
- Are overweight or are obese
- Are over 45
- Have a parent or a sibling with type 2 diabetes
- Are not physically active
- Have had gestational diabetes or given birth to a baby weighing more than 9 pounds
- Are African American, Hispanic/Latino American, American Indian, or Alaskan Native
How Is Type 2 Diabetes Treated?
It is recommended that all people with type 2 diabetes alter their diet and exercise regimen. Typically, insulin resistance is reoccurring, so altering the diet and increasing exercise can reduce insulin resistance.
Generally, a diet for someone with type 2 diabetes should be:
- Low in calories
- Free of trans fats
- Low in saturated fats and cholesterol
- Nutritionally balanced, containing fruits, vegetables, monounsaturated oils and whole grains
Exercise is an important component of treatment because it:
- Helps with weight reduction
- Increases the body’s sensitivity to insulin
- Helps to control glucose elevations
It is generally recommended to get 150 minutes of activity each week. This can be obtained by doing 20 to 25 minutes of exercise on most days of the week. You should also try to do strength training at least twice weekly.
You do not need to jump into a new fitness routine, doing exercise every day. Start small and increase incrementally. Pick an exercise that you enjoy. Perhaps enlist a friend or family member to work out with you!
Though some people can control their diabetes through diet and exercise, many people require the use of oral medications, non-insulin injections and insulin to control their blood sugar levels.
Medications serve various functions, such as reducing the absorption of carbohydrates from the intestines, increasing the insulin production from the pancreas, increasing insulin sensitivity and slowing the emptying of the stomach.
There are also different types of medications used:
- Metformin: This is the first-line oral medication used to treat type 2 diabetes. This medication has various functions, but it mainly increases the body’s sensitivity to insulin, thereby reducing insulin resistance.
- Sulfonylureas: This can increase the output of insulin produced by the pancreas; they do have an increased risk of hypoglycemia.
- Meglitinides: Working similarly to sulfonylureas, they are very short-acting. They are taken with meals. They may cause hypoglycemia but are less likely to do so if taken with carbohydrates.
- Thiazolidinediones (TZDs): These can increase the sensitivity of the cells to insulin. They should not be used in people with heart failure and bone fractures
- Alpha-glucosidase inhibitors: These help reduce the absorption of carbohydrates from the intestine.
- SGLT2 inhibitors: This medicine blocks the kidney’s reabsorption of glucose; this means that glucose is excreted through the urine.
- DPP-4 inhibitors: This medicine works with the incretin system; incretin “tells” the body to release insulin after eating. Dipeptidyl peptidase-4 (DPP-4) removes incretin from the body. Therefore, DPP-4 inhibitors stop this from happening, allowing insulin to be released, lowering glucose levels.
- GLP-1 receptor agonists: These also work with the incretin system. Glucagon-like peptide-1 is another incretin hormone that functions very similarly to DPP-4. These medications are stronger than DPP-4 inhibitors and most are non-insulin injections.
Insulin can be used in combination with diet and exercise, as well as medications.
According to MedicineNet, “Ideally, insulin should be administered in a manner that mimics the natural pattern of insulin secretion by a healthy pancreas. However, the complex pattern of natural insulin secretion is difficult to duplicate.”
We can prescribe in various ways, but typically we use a “basal/bolus” method, which uses a long-acting, or basal, insulin. A rapid-acting insulin is used to “cover” carbohydrates eaten, as well as correcting hyperglycemia.