Type 2 Diabetes Treatments

You have lots of options to manage diabetes. Diet, exercise, and medication work together to bring your blood sugar under control.

Your doctor will help you figure out if you need to take medicine, which kind is right for you, and how often you should take it.

Over your lifetime, you'll probably handle your disease in different ways. Sometimes medications stop working, and you'll have to switch. You'll need to adjust to changes in your body as you age. And researchers are looking for new diabetes medicines and ways to treat it.

Check Your Blood Sugar

Your blood glucose number tells you how well your treatment is working. Your doctor will let you know how many times a day you need to check it. It depends on what diabetes medications you're taking.

When you're sick, you'll have to check your ketones, too.

Diet and Exercise

There's no one-size-fits-all diabetes diet. You'll need to pay attention to carbs, fiber, fat, and salt to manage your blood sugar and avoid complications of diabetes. How much and when you eat are important, too. Talk to your diabetes team or a registered dietitian to help you plan your meals and snacks.

Physical activity -- from working out to doing chores -- lowers your blood sugar. It helps your cells use insulin. It also helps your muscles use glucose. Make sure you check your blood sugar before and after exercise.

Eating right and being active help you lose extra pounds and stay at a healthy weight. That will also help control your blood sugar.

Pills

Oral medications are often the first kind of medicine people with type 2 diabetes try when diet and exercise alone aren't enough to keep their blood sugar in a healthy range. There are many of them, and they work in different ways.

A drug doctors often prescribe tells your liver to hang on to some of the glucose it makes. The generic name is metformin.

Some medications tell your pancreas to make more insulin. These are meglitinides and sulfonylureas.

One kind keeps your body from breaking down hormones that give your pancreas the "go" signal for insulin. This means they work longer when you need to lower your blood sugar after a meal. They're known as DPP-4 inhibitors.

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Other medicines help insulin work better. They lower insulin resistance from your cells so your pancreas doesn't have to work as hard. Doctors call these thiazolidinediones, TZDs, or glitazones.

Some slow the digestion of food with complex carbohydrates, like bread, pasta, rice, potatoes, and corn. This keeps your blood sugar from shooting up after you eat. These are alpha-glucosidase inhibitors.

Some work by letting your kidneys pee out extra sugar. They're SGLT2 inhibitors.

Cholesterol-lowering drugs called bile acid sequestrants can also help lower your blood glucose.

You can take these medications by themselves or in combination with others, including insulin. Some pills have more than one kind of drug.

Injectable Drugs

These medications slow how quickly food leaves your stomach and make you feel full. And they tell your liver to back off making glucose around mealtimes.

Some also help your pancreas make insulin. These are GLP-1 receptor agonists. Some of them you take every day, while others last a week.

A different drug acts like a hormone, amylin, that your pancreas sends out with insulin. You only take pramlintide (Symlin) if you're also using insulin.

Insulin

People with type 2 diabetes sometimes need insulin. It could be a short-term fix for a stressful situation, or because other medicines aren't enough to control their blood sugar.

You can take insulin with a needle and syringe, with a device called an insulin pen, or with an inhaler. Some people use an insulin pump to get it continuously.

Types of insulin are grouped by how fast they start to work and how long their effects last. You might have to use more than one kind of insulin. Some insulins come pre-mixed.

Weight Loss Surgery

Of course, this gets rid of extra pounds. And that alone will help control your blood sugar.

But it also raises the level of hormones in your gut called incretins. These tell your pancreas to make insulin. Over time, you may be able to take less medication.

It isn't for everyone, though. Doctors usually recommend weight loss surgery only for men who are at least 100 pounds overweight and women with at least 80 extra pounds.

WebMD Medical Reference Reviewed by Michael Dansinger, MD on September 10, 2016

Sources

SOURCES:

University of California, San Francisco: Diabetes Education Online: "Monitoring Your Blood," "Checking for Ketones."

American Diabetes Association. "Standards of Medical Care in Diabetes - 2015," Diabetes Care, January 2015.

American Diabetes Association: "Blood Glucose Control and Exercise," "Weight Loss," "What Are My Options?" "Can Diabetes Pills Help Me?" "Insulin Basics," "Type 2," "Insulin Routines," "What About Insulin?" "Other Injectable Medications."

Joslin Diabetes Center: "Oral Diabetes Medications Summary Chart," "The Truth about Insulin and Type 2 Diabetes."

UpToDate: "Sulfonylureas and meglitinides in the treatment of diabetes mellitus."

Diabetes UK: "DPP-4 Inhibitors (Gliptins)," "Thiazolidinediones (Glitazones)."

Diabetes.co.uk: "SGLT2 Inhibitors (Gliflozins)."

FDA: "FDA Approves Afrezza to Treat Diabetes."

National Diabetes Information Clearinghouse: "Types of Insulin."

Massachusetts General Hospital: "Bariatric Surgery for People with Type 2 Diabetes and Prediabetes."

University of California, San Francisco: Division of General Surgery: "Type 2 Diabetes."

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