Type 2 Diabetes Management: Treatment & Medications

Medically Reviewed By: Dr. Surajeet Kumar Patra, MBBS, MD, FDIAB, MBA & APMP November 17, 2022

Last updated on October 17th, 2023

Diabetes has emerged as a growing health challenge for 21st-century people. The number of people impacted by diabetes has tripled within the past 20 years. The growing rate of type 2 diabetes among adults is a serious concern. But with time changing, practices for type 2 diabetes management have also changed (and they’re pretty simple). It’s just that we need to take some integrated steps to adapt to those practices. This is not limited to only an individual’s health; understanding the steps for effective management of diabetes mellitus will ultimately lead to controlling its global prevalence rates. So, in this article, we’ll learn about the best practices that will help us greatly in managing type 2 diabetes in 2023. But before we dive deep into the practices for type 2 diabetes management, let us set the context straight about the condition.

Also Read: How to Reduce Blood Sugar Level Immediately?

What Is Type 2 Diabetes?Type 2 diabetes blog image

Before knowing how to manage diabetes, let’s have an overview of the condition. Type 2 diabetes is a long-lasting health condition that messes with how your body handles sugar in your blood. Think of sugar as the fuel for your body. Normally, when you eat food, the sugar from it, called glucose, enters your cells with the help of a hormone called insulin. But in type 2 diabetes, something goes wrong.

The cells in your body start resisting the insulin’s attempts to let glucose in. It’s like they’re saying, “No thanks, insulin, we don’t want any glucose right now.” As a result, the glucose gets stuck in your bloodstream instead of entering the cells where it’s needed.

When there’s too much glucose hanging around in your blood, your body gets a little worried and tries to compensate by increasing insulin production. However, the increased insulin production doesn’t help it as there’s resistance by the cells. This insulin resistance by the cells causes high blood sugar levels, ultimately leading to type 2 diabetes. Therefore the question, of how to manage diabetes comes into the fold. Keep reading to find the answer.

Also Read: mmol l to mg dl converter

What Are The Risk Factors For Type 2 Diabetes?

You are at higher risk of having Type 2 Diabetes if you come under any of the following factors:

  1. A family history of diabetes (A sister, brother, or parent who has type 2 diabetes)
  2. If the person is 45 years of age or older.
  3. Their ethnicity is African American, Alaska Native, Native American, Asian American, Hispanic or Latino, or Pacific Islander American.
  4. Women have a condition called polycystic ovarian syndrome (PCOS).
  5. If the person is already prediabetes.
  6. If they have high levels of triglycerides.

However, there are some other factors that are in the person’s control. That is if the person is – :

  1. Overweight or obesity, due to which the cells become more resistant to insulin.
  2. Stress and anxiety
  3. Consuming an excess of junk food or processed foods.
  4. Having a sedentary lifestyle
  5. Avoiding alcohol and smoking.

Management of Diabetes Mellitus

Type 2 diabetes is more common in adults as compared to the younger generation. It is, therefore, known as adult-onset diabetes. The management of type 2 diabetes mellitus involves a combination of medication, lifestyle changes, and monitoring. The majority of treatments revolve around constantly checking your blood glucose and being in continuous touch with your doctor. There will be many lifestyle modifications that the doctor might suggest for diabetes management. Some of them are:

  • Consuming foods abundant in dietary fiber and complex carbs.
  • Having small meals regularly
  • Avoiding overeating and eating as per your body’s requirements.
  • Management of body weight if you are overweight. Along with maintaining good heart health
  • Keeping refined carbs at bay which includes sweets, and animal fats, to a bare minimum.
  • Engaging in regular muscle-building workouts to enhance your muscle growth.
  • Check your sugar levels at specific hours of the day.

Management of Juvenile Diabetes Mellitus

Management of juvenile diabetes mellitus is slightly different from managing type 2 diabetes. Juvenile diabetes mellitus happens due to a sudden halt in insulin production. This is a genetic ailment that happens due to damage in the insulin-producing pancreatic beta cells. Diabetes management becomes difficult in juveniles due to their age. It happens as an outcome of some illness that alters the body’s glucose metabolism. A doctor will monitor the juvenile’s sugar level trends and impose lifestyle modifications and restrictions accordingly. These will help in the better management of juvenile diabetes mellitus. According to the ADA (American diabetes association), a juvenile diabetic should have an HbA1c level of 7% and below. Along with monitoring the sugar levels, the doctor will also check the following:

  • Blood pressure
  • Growth
  • Cholesterol levels
  • Thyroid function
  • Kidney function
  • Feet
  • Eyes

Medical Management of Diabetes Mellitus: Diagnosis and TestsDiagnosis-and-Tests

A proper diagnosis is crucial for appropriate type 2 diabetes management. It is done through various blood tests. The medical management of diabetes mellitus starts after these tests and is based on its results. These tests aim to measure blood sugar levels.

Glycated Haemoglobin (HbA1c) Test 

It determines a patient’s average blood sugar level over the past two to three months. The A1C test measures the amount of sugar attached to haemoglobin. If your A1C is 5.7% to 6.4%, the person is said to be a pre-diabetic and type 2 diabetes, in India, is diagnosed when the A1C is 6.5% and above. High HbA1c calls for immediate type 2 diabetes management methods.

Fasting Plasma Glucose Test

It determines the blood sugar level on an empty stomach. If the fasting blood sugar is 100 to 125 mg/dL, the person is said to be a pre-diabetic, and if it is 126 mg/dL or higher, the person is said to be diabetic. This situation calls for the need for quick type 2 diabetes management.

Random Plasma Glucose Test

If the random plasma glucose test doesn’t come out well, it’s high time for urgent management of diabetes mellitus. This test is performed if you have symptoms of diabetes. It can be done at any time without considering your last meal. Random blood sugar levels of 200 mg/dL or higher suggest that you have diabetes.

Oral Glucose Tolerance Test (OGTT)

Check the blood glucose before and 2 hours after you drink a sugary liquid. If the blood sugar level is between 141 mg/dL and 200 mg/dL, then you have impaired glucose tolerance, and above 200 mg/dL after 2 hours is diagnosed as diabetes.

Now that we know the right ways to check for diabetes, it’s time to jump right on to best practices for type 2 diabetes management.

Summary: If your fasting sugar levels are above 100 mg/dL, blood sugar levels 2 hours after meals are more than 140 mg/dL, and HbA1C is 5.7% and above, you seek help from our Diabetes Reversal Expert at Breathe Wellbeing.

Managing Type 2 Diabetes

Lifestyle-Changes-&-Diet

There are two best way to manage type 2 diabetes, which involves two dominant lifestyle changes. First is dietary control and eating foods that impact gradually and not rapidly to your sugar levels. And second is doing some strength and muscle-building exercises for weight management. For newly diagnosed diabetes type 2 management, these natural steps are generally preferred to increase the chances of reversal.

Lifestyle Changes & Diet

The biggest misconception about type 2 diabetes is that it cannot be reversed. Well, wrong! Research has proved that a proper lifestyle and healthy diet help in improving insulin sensitivity (opening the cells’ door to let glucose in). With these steps, you can do proper management of diabetes mellitus, initially controlling it and then reversing it.

There are people who had type 2 diabetes for 12 years, and they reversed it without any medications. What they did right was implement the following lifestyle changes for type 2 diabetes management.

Consistent Exercise

Regular exercise is the key to notable results of type 2 diabetes management. Helps improve insulin signalling, making the body’s cells more responsive to insulin. It enhances the communication between insulin and the cells. Thus allowing insulin to effectively transport glucose from the bloodstream into the cells for energy.

Weight Management 

Another good practice for the management of type 2 diabetes mellitus is weight management. When you manage your weight effectively, it can help lower your HbA1c levels. This means your blood sugar control improves, and it reduces the risk of complications related to diabetes.

Healthy Diet

“A healthy diet is all you need for the right type 2 diabetes management!” No matter how easy it may sound, it’s still a vague answer to “How to manage diabetes?” Management of diabetes mellitus is not just about eating healthy. It’s more about balancing that healthy diet well. You can engage in dietary management of diabetes by including foods that get you a good mix of vitamins, minerals, and fibre. Choose complex carbohydrates over refined carbohydrates. Pay attention to your portion sizes to avoid overeating, and opt for naturally sweet food over sugary foods, drinks, and desserts.

Proper Sleep

Having a proper sleep schedule can help in managing type 2 diabetes. Sleep improves insulin sensitivity, thereby regulating blood sugar levels. Moreover, proper sleep provides the necessary energy to engage in physical activities and helps in appetite regulation.

Summary: A proper lifestyle and proper diet shall help in controlling type-2 diabetes efficiently.

Also Read: Diabetic Diet Chart Indian

 

Dietary Management of Diabetes

The dietary management of diabetes involves taking a break from your unhealthy food choices. Your choice of foods all these past years has greatly contributed to diabetes. But now is the time to put a full stop. When managing type 2 diabetes foods, your intake plays a significant role.

  • The foods you choose to eat should have high nutritional value and less in empty calories.
  • Eat mindfully and be aware of the portion sizes you consume.
  • Before eating a food item, check its labels to get knowledge of its calories, sugar content and simple carbs.

Moreover, choose a diet consisting of food items that can suffice your cravings as well as be ok for diabetes. A very strict and restrictive diet won’t be one you can stick to for long. Here is a list of foods you can choose for the dietary management of diabetes mellitus:

  • Non-starchy veggies like broccoli, cauliflower, beans, carrots, kale, spinach, etc.
  • Whole grains like barley, bajra, ragi, oats, etc.
  • Lentils or Dals
  • Legumes like beans, chickpeas, kidney beans, etc.
  • Seeds like chia seeds, flax seeds, etc
  • Nuts like almonds, walnuts, pistachios, cashews, etc.
  • Lean proteins like soy milk, tofu, eggs, etc.
  • Healthy oils like olive oil and mustard oil
  • Herbals teas

All these foods, when taken as a part of a balanced diet, will definitely help you in managing type 2 diabetes with diet.

Diabetes Medications

If dietary and lifestyle changes alone are not enough for type 2 diabetes management, the doctors may suggest the following medications to start your medical management of diabetes mellitus.

  • Metformin Tablet Uses– (the most preferred medication) lowers glucose production in the liver and improves the body’s sensitivity to insulin.
  • Sulfonylureas – The oral medications that help your body secrete more insulin.
  • Meglitinides – It stimulates the pancreas to release more insulin. The medication is fast-acting but short-durational.
  • Thiazolidinediones – It makes the body’s tissues more sensitive to insulin. Therefore, it has serious side effects and is not the first-choice treatment.
  • DPP-4 inhibitors – A milder medication to reduce blood sugar levels.
  • GLP-1 receptor agonists – It slows digestion and regulates blood glucose levels.
  • SGLT2 inhibitors – The medications inhibit the reabsorption of glucose in the kidney and, thereby, lower blood sugar.
  • Alpha-glucosidase inhibitors – It helps your body break down starchy foods and table sugar, lowering blood sugar.

Apart from these medicines, there are also methods of surgical management of diabetes mellitus type 2. However, we recommend avoiding those methods as the best way to manage diabetes type 2 is naturally through lifestyle modifications.

Note: The doctors shall decide on the choice and dosage of medicine. So, if you are allergic to any medications or skipped doses, please consult your doctor immediately for appropriate type 2 diabetes management.

Also Read: How to Reverse Type 2 Diabetes Permanently?

Insulin Therapy for Managing Diabetes

Insulin Therapy

How to control type 2 diabetes after having tried everything? Or how to manage diabetes when medicines stop working?

This is a more critical stage for the management of diabetes mellitus. Here, your body does not respond well to the medicines. This generally means that the pancreas is no longer producing enough insulin, thereby making the patient dependent on external insulin therapy.

Insulin therapy is provided through a needle, insulin pump, or inhaler. There are different types of insulin, and insulin treatment varies from person to person.

They differ in how quickly they start working when they reach their peak effectiveness, and how long they stay active in the body. Here are some common types of insulin used for managing type 2 diabetes in the elderly:

Rapid-Acting Insulin

This type of insulin starts working within 15 minutes after injection, reaching its peak effectiveness within 1-2 hours. And remains active for about 3-4 hours. It is often taken before meals to control post-meal blood sugar spikes. Examples include insulin lispro, insulin aspart, and insulin glulisine.

Short-acting insulin

Also known as regular insulin, short-acting insulin starts working within 30 minutes after injection, peaks in 2-3 hours, and remains active for about 3-6 hours. It is commonly taken before meals to manage blood sugar levels. Regular human insulin is an example of short-acting insulin for rapid diabetes management.

Intermediate-Acting Insulin

Intermediate-acting insulin takes longer to start working, usually within 1-2 hours, and reaches its peak effectiveness in around 4-8 hours. It remains active for about 12-18 hours. This type of insulin is often taken once or twice daily to provide a basal or background insulin level. Examples include NPH insulin (Neutral Protamine Hagedorn) and insulin detemir.

Long-Acting Insulin

Long-acting insulin provides a steady release of insulin over an extended period, typically 24 hours. It starts working several hours after injection and does not have a pronounced peak. Long-acting insulin is commonly taken once a day to provide basal insulin coverage. Examples include insulin glargine and insulin detemir.

Pre-Mixed Insulin

Pre-mixed insulin formulations combine specific ratios of short- or rapid-acting insulin with intermediate-acting insulin. They provide both mealtime and basal insulin coverage in one injection. These formulations can help simplify the insulin regimen for some individuals with type 2 diabetes.

The specific type of insulin and regimen prescribed for type 2 diabetes management will depend on various factors, including blood sugar control, lifestyle, meal patterns, and individual needs. It’s important to work closely with your doctor, such as an endocrinologist or diabetes specialist, to determine the most appropriate insulin therapy plan for your situation. They can guide you on the correct type, dosage, timing, and injection technique for optimal management of diabetes mellitus.

Note: All of the above insulin treatments suggested are strictly to be taken under medical supervision on the prescription of a registered doctor.

Conclusion

In conclusion, effectively managing type 2 diabetes is a multi-dimensional approach that undertakes a combination of medical intervention, lifestyle adjustments, and a well-informed understanding of the condition. With a comprehensive understanding of what type 2 diabetes entails and the available strategies for the management of diabetes mellitus, individuals can take proactive steps to maintain their health and well-being. The tests suggested above will provide a precise picture of the sugar levels inside your body. Diets and exercise will play an important role in diabetes management apart from medicines. However, the medications and therapies suggested above are to be strictly only under your doctor’s advice. Focus more on lifestyle modifications and less on medication for controlling and even reversing diabetes.

We at Breathe Well-Being have proven records of clinically reversing diabetes naturally. With our impeccable team of experienced health experts and comprehensive diabetes management strategies, we are bringing changes in the lives of many who are grappling with this disease. So why wait? Choose us! Choose life!

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FAQ’s:

What is the Best Blood Test for Diabetes Diagnosis?

There are various methods for checking blood sugar levels, and each one of the tests has a different suitable time. However, The best blood test for diabetes diagnosis is the HbA1C test.

What is the Best Medicine for Diabetes Type 2?

Again, the best medicine for type diabetes is something that varies from person to person. Some of the common medicines suggested for type 2 diabetes management are:

  • Metformin (the first-line treatment for type 2 diabetes in most cases) 
  • Sulfonylureas 
  • Meglitinides 
  • Thiazolidinediones 
  • DPP-4 inhibitors 
  • GLP-1 receptor agonists 
  • SGLT2 inhibitors 
  • Alpha-glucosidase inhibitors 

Remember, the medicines mentioned above are not a cure for diabetes and should not be taken without a doctor’s prescription.

 

What is the Best Treatment for Diabetes?

There’s no single best treatment for type 2 diabetes. However, if type 2 diabetes management is done only through natural methods, it’s far better than going for the conventional methods that involve medicines and insulin.

 

What is the best time for the blood test for diabetes diagnosis?

Test blood sugar before meal and 1 to 2 hours after the meal.

Is it possible to have type-2 diabetes at a younger age (children)?

Type-2 diabetes is more common in adults. But with increasing obesity rates and less physical activities among children, the rates of type-2 diabetes among children are also increasing. Thus, yes children can also have type-2 diabetes. But symptoms of it appear very slowly.

Is it possible to manage Type-2 Diabetes without medicines?

With a lifestyle change and proper diet you can manage blood glucose levels even without medication. But taking medicines or not taking them is to be decided based on your condition by the doctor.

 
Last Updated on by Dr. Damanjit Duggal 

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