*Please note: This slide show represents a visual interpretation and is not intended to provide, nor substitute as, medical and/or clinical advice.
Type 2 diabetes is a metabolic disorder that causes sugar, in the form of glucose, to accumulate in the blood rather than being used as fuel by the cells in our body.
The goal of type 2 diabetes treatment is to safely keep blood glucose within the normal range.
Improving diet and exercising regularly are important parts of type 2 diabetes management and treatment.
In overweight or obese persons, weight loss can often return blood glucose levels to normal if it occurs early
Exercise decreases the resistance of the cells to the action of insulin, making it easier for the glucose to enter the cells from the blood stream. This benefit of exercise occurs even if there is no associated weight loss.
If weight loss, improved diet, and exercise do not reduce blood glucose levels adequately, then medication is the next step.
There are a variety of oral and injectable medications to treat type 2 diabetes.
Most persons with diabetes are initially prescribed metformin.
Metformin blocks the production of glucose by the liver.
Metformin also decreases the resistance of cells to insulin, making it easier for the cells to take up glucose from the blood stream.
After metformin, doctors often prescribe sulfonylureas, or DPP-IV inhibitors.
Like metformin, sulfonylureas are inexpensive and effective. They work by increasing insulin release from the pancreas.
However they may cause hypoglycemia.
Hypoglycemia occurs when the blood glucose level drops too low.
It is important for patients to recognize the symptoms of hypoglycemia such as shakiness, sweating, palpitations and weakness before it leads to more dangerous effects such as confusion, fainting or loss of consciousness.
Incretins are essential chemicals secreted by the gut in response to meals and have important anti-diabetic effects. They work by slowing the emptying of the stomach so you feel full longer, increasing insulin secretion, improving insulin sensitivity, and decreasing glucose production.
In diabetes, incretins levels are reduced. There are two types of medications that work to improve the levels of incretins in the body. The oral DPP-IV inhibitors and the injectable GLP-1 analogues.
The DPP-IV inhibitors prevent the breakdown of incretin hormones and increase their anti-diabetic effects.
These newer medicines work by increasing insulin production, they have little risk of hypoglycemia. They also make cells more sensitive to the action of insulin.
The injectable GLP-1 analogues replace the incretins directly.
They also slow the movement of food through the digestive tract so you feel fuller longer; they improve insulin secretion and may promote weight loss.
They also have a low risk of hypoglycaemia.
Thiazolidinediones are another class of oral antidiabetic agents. They work by making the cells more sensitive to insulin and decreasing glucose production. They do not cause hypoglycemia but they may cause weight gain.
Other types of pills for diabetes include SGLT-2 inhibitors, alpha-glucosidase inhibitors, and bromocriptine and colesevelam.
Over time, medications often become less effective. Rather than switching a medication, your doctor may combine two different ones that have been shown to work well together.
If your blood glucose cannot be controlled by pills alone, your doctor may put you on insulin.
Insulin is the most common injectable medication used to treat diabetes. There are two types of insulins: long-acting or basal insulin, and short-acting or meal-time insulin.
An insulin pump can be used in type 2 diabetes to deliver insulin just like the pancreas.
Healthy diet, exercise and maintaining a healthy body weight are important aspects of diabetes management even if you are on medications.
You should develop a self-management plan with your doctor and other health professionals, such as a dietician and certified fitness professional.
Your plan should include eating healthy foods and incorporating regular moderate intensity exercise into your lifestyle.
Important dietary interventions specific to diabetes include reducing sugars, starches, and fatty foods.
Strategies to reduce stress at home and at work, ensure adequate sleep, and manage depression, if present, are also important.
In summary, Type 2 diabetes is treated by a combination of diet, exercise and medication. A variety of drugs are available to treat diabetes, however self-management through lifestyle plays a very important role.