Type 2 Diabetes Treatment Guidelines 2018Diabetes is a common disease, yet every individual needs unique care. We encourage people with diabetes and their families to learn as much as possible about the latest medical therapies and approaches, as well as healthy lifestyle choices.
Checking Your Blood Glucose
Blood glucose (blood sugar) is an essential measure of your health. This is the main tool you have to check your diabetes control. This check tells you your blood glucose level at any one time. Keeping a log of your results is vital. When you bring this record to your health care provider, you have a good picture of your body's response to your diabetes care plan.
Type 2 Diabetes Treatments
The major goal in treating type 1 and type 2 diabetes is to control blood sugar (glucose) levels within the normal range, with minimal excursions to low or high levels. Treatment for type 2 diabetes aims to keep your blood glucose levels as normal as possible and control your symptoms to prevent health problems developing later in life.Type 2 diabetes (T2D) is treatments:
- Weight reduction and exercise
- Type 2 Diabetes Diet
- Diabetes medications and insulin therapy
1. Weight reduction and exercise
Weight reduction and exercise are important treatments for type 2 diabetes. Weight reduction and exercise increase the body's sensitivity to insulin, thus helping to control blood sugar elevations.2. Type 2 Diabetes Diet
A type 2 diabetes diet is based on eating foods low on the glycemic index, for example:- Fruits
- Vegetables
- Whole wheat
- Brown rice
- Steel-cut oatmeal
- Beans
- Lentils
Low glycemic index foods may help you achieve a more stable blood sugar. Foods with a low glycemic index typically are foods that are higher in fiber.
3. Diabetes medications and insulin therapy
Some people who have type 2 diabetes can achieve their target blood sugar levels with diet and exercise alone, but many also need diabetes medications or insulin therapy. The decision about which medications are best depends on many factors, including your blood sugar level and any other health problems you have. Oral medications are prescribed when these measures fail to control the elevated blood sugars of type 2 diabetes. If oral medications become ineffective treatment with insulin is initiated.Medications for type 2 diabetes are designed to:
- increase insulin output by the pancreas,
- decrease the amount of glucose released from the liver,
- increase the sensitivity (response) of cells to insulin,
- decrease the absorption of carbohydrates from the intestine, and
- slow emptying of the stomach, thereby delaying nutrient digestion and absorption in the small intestine.
When selecting therapy for type 2 diabetes, consideration should be given to:
- the magnitude of change in blood sugar control by each medication;
- other co-existing medical conditions (high blood pressure, high cholesterol, etc.);
- harmful or abnormal results (adverse effects) of the therapy;
- contraindications to therapy (treatments or medications that may potentially harmful)
- issues that may affect the patient adhering to taking medications - compliance - like timing of medication, frequency of dosing, etc.); and
- cost to the patient and the healthcare system.
A preferred drug can provide more than one benefit (for example, lower blood sugar and control cholesterol). Cost of drug therapy is relatively small compared to costs of managing chronic complications associated with poorly controlled diabetes.
Varying combinations of medications can control diabetes. Newer medications allow tailoring of treatment options to meet individual needs. Not every patient with type 2 diabetes will benefit from every drug, and not every drug is suitable for each patient. Patients with type 2 diabetes should work closely with their health-care professionals to achieve an approach that provides the greatest benefits while minimizing risks and adverse events. People with diabetes must remember the importance of diet and exercise. Control of diabetes begins with a healthy lifestyle, regardless of prescribed medications.
If your blood sugar is consistently out of your target range, or if you're not sure what to do in a certain situation, contact your doctor or diabetes educator.
The Diabetes Prevention Program
The two major goals of the DPP intensive, behavioral, lifestyle intervention were to achieve and maintain aminimum of 7% weight loss and 150min of physical activity per week similar in intensity to brisk walking. The DPP lifestyle intervention was a goal-based intervention: all participants were given the same weight loss and physical activity goals, but individualization was permitted in the specific methods used to achieve the goals.Nutrition
Reducing caloric intake is of paramount importance for those at high risk for developing type 2 diabetes, though recent evidence suggests that the quality of fats consumed in the diet is more important than the total quantity of dietary fat.
Physical Activity
Just as 150min/week ofmoderate-intensity physical activity, such as brisk walking,showed beneficial effects in thosewith prediabetes , moderate-intensity physical activity has been shown to improve insulin sensitivity and reduce abdominal fat in children and young adults
Diabetes self-management education and support programs may be appropriate venues for people with prediabetes to receive education and support to develop and maintain behaviors that can prevent or delay the development of type 2 diabetes.