There are many ways to control diabetes. Diet, exercise, and medications can all keep a patient’s blood sugar levels under control.
The doctor will help the patient determine if he or she needs to take medication, which medication is most appropriate, and how often to use it. During the disease, patients need to treat the disease in different ways. As they get older, they also need to adjust their medications to accommodate changes in their bodies, and they must change their medications when they are not working.
Checking blood glucose levels
Glucose levels can reflect the effectiveness of treatment. Your doctor will indicate how many times a day you need to have your blood glucose checked. The exact number of checks depends on the medications the patient is taking. In addition, ketone levels need to be checked while the patient is sick.
Diet and exercise
Eating right and exercising properly can help shed excess weight and maintain a healthy weight, while also helping to control blood sugar. There is no one-size-fits-all diet for all people with diabetes. Patients need to watch their carbohydrate, fiber, fat, and salt intake to control blood sugar levels and avoid diabetic complications. Also, the amount consumed and the timing of meals are important. Patients need to talk to their diabetes treatment team or dietitian to work together to develop a diet plan. Exercise (including exercise and housework) can also lower blood sugar. This is because exercise not only helps cells use insulin, but also helps muscles use glucose. However, blood glucose levels need to be checked before and after exercise.
Medications
Oral medications are often the treatment of choice for people with type 2 diabetes when modifying the way you eat and exercising is not enough to keep blood glucose levels in a healthy range. There are many therapeutic medications, and they work in different ways.
- Metformin works in the liver to inhibit gluconeogenesis and reduce hepatic glucose output.
- Glinides and sulfonylureas promote more insulin secretion by the pancreas.
- Dipeptidyl peptidase IV inhibitors prevent the body from breaking down the hormones that promote insulin secretion. As a result, these drugs have a longer duration of action in lowering postprandial blood glucose levels.
- Thiazolidinediones or glitazones help promote insulin to work better. They can reduce cellular resistance to insulin and reduce the burden on the pancreas.
- Some foods contain complex carbohydrates, such as bread, pasta, rice, potatoes, and corn. α-Glucosidase inhibitors slow the digestion of these foods, thus preventing a rise in blood sugar after a meal.
- Sodium-glucose cotransport protein 2 inhibitors promote the kidneys to remove excess sugar through urination.
- Bile acid chelators are cholesterol-lowering drugs that can also help lower blood sugar.
- Patients can take these medications alone or in combination with other medications, including insulin. It is important to note that some tablets contain more than one drug.
- Dopamine agonists act directly on the brain to help it process dopamine. At the same time, dopamine in turn helps to increase the body’s sensitivity to insulin so that the body does not need too much insulin. Patients taking dopamine receptor medications should also make lifestyle changes, such as maintaining a healthy diet and exercising consistently will make the medication more effective.
Injectable medications
Injectable medications slow the rate at which food leaves the stomach, giving a sense of fullness. In addition, these drugs cause the liver to stop producing glucose while the patient is eating.
Glucagon-like peptide-1 agonists can help the pancreas secrete insulin. Some GLP-1 agonists need to be used daily, and some are effective for up to 1 week with 1 dose.
Pancreatic precipitins act like hormones and promote insulin secretion by the pancreas. Pramlintide should only be taken if insulin is being used.
Insulin
People with type 2 diabetes sometimes need to use insulin. Insulin is a short-term solution for emergencies or when other medications are not enough to control blood sugar.
Patients can use needles and syringes to inject insulin, or they can use an insulin pen or inhaler to inject insulin. Some patients choose an insulin pump in order to have continuous injections.
Insulins can be classified into different types depending on how fast they work and how long they last. Patients may need multiple insulins, and some insulins need to be premixed before use.
Bariatric surgery
Bariatric surgery can help control blood glucose levels by shedding excess weight. But it can also raise the level of enteroglucagon in the gut. Enteroglucagon is a hormone that boosts insulin production in the pancreas. It will gradually reduce the use of the drug over time. However, this method is not suitable for everyone. Doctors usually recommend this treatment for men who are at least 90 pounds overweight and for women who are 72 pounds overweight.