Type 2 diabetes treatment involves lifestyle changes as well as medical care.
Treatment of type 2 diabetes includes both self-care by the patient and medical care provided by physicians and other healthcare providers.
Diabetes care may include:
- Nutrition therapy
- Physical activity
- Other lifestyle measures (see below)
- Specialist care to prevent and treat complications
- Bariatric surgery
If you have diabetes, you should have an individualized meal plan that not only helps to manage blood sugar levels but also helps to manage blood cholesterol and blood pressure and any other medical conditions.
It is often helpful to work with a registered dietitian or diabetes educator to design a diabetes meal plan that meets your diabetes goals and accommodates your food likes and dislikes, daily schedule, and usual access to food.
The American Diabetes Association recommends the following exercise guidelines for adults with type 2 diabetes:
- 150 minutes per week of moderate-intensity aerobic activity (for example, a brisk walk)
- Resistance training at least twice a week
Before starting a formal exercise program or increasing your level of physical activity, it’s important to get your doctor’s OK and to find out which activities you can do safely.
If you have uncontrolled high blood pressure, severe neuropathy (nerve damage), or proliferative retinopathy (diabetes-related eye disease), you may need to limit the types of exercise you perform.
Other Lifestyle Measures
Managing the emotional side of diabetes is an important part of managing your diabetes and your overall health.
Practicing a form of relaxation therapy (such as yoga or meditation), participating in a support group, and/or seeing a mental healthcare professional for any psychological or relationship problems can all be helpful in the management of diabetes.
Many people with type 2 diabetes start with the oral drug metformin to help control blood sugar levels, and then add other drugs to the regimen, either soon afterdiagnosis or months or years later.
There are currently more than 10 classes of diabetes drugs, each of which lowers blood sugar in a different way. If your current drug regimen isn’t lowering blood sugar enough, your doctor may elect to add a drug from a different class.
Many people with type 2 diabetes eventually need to use insulin. Some will need to take one or two doses of long-acting insulin per day, and others will need to take long-acting insulin with rapid-acting insulin before meals.
Insulin is needed when the pancreas can no longer produce enough insulin to meet the body’s needs.
For certain types of screenings or medical care, your primary-care doctor will likely refer you to specialists, including a:
- Eye doctor (optometrist or ophthalmologist)
- Kidney specialist
Also known as weight-loss surgery, bariatric surgery either restricts the amount of food that can be eaten and/or changes the way in which nutrients are absorbed in the digestive tract. The result is usually significant weight loss.
In some people with type 2 diabetes, bariatric surgery has been found to effectively reverse their diabetes. Their blood sugar levels become normal, and they no longer need to take drugs to lower blood sugar levels.
Often, the normalization of blood sugar levels happens before a person has lost much weight.
The diabetes-reversing effects of bariatric surgery can last for many years, but it’s still important for people who once had type 2 diabetes to be monitored for its recurrence.
Changes Over Time
Most people with type 2 diabetes need changes in their treatment regimen from time to time, as their lives and bodies change.
If you see your blood sugar numbers creeping up or if you’re having frequent episodes of hypoglycemia (low blood sugar) or trouble carrying out any part of your diabetes plan, talk to your doctor.
Use your doctor appointments to discuss how well your treatment plan is working and how it might be changed to serve you better.