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.
Diet and Exercise are crucial in Type 2 Diabetes
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 bloodstream. This benefit of exercise occurs even if there is no associated weight loss.
Benefits of Medications for the Patients with Diabetes
If 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 used 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 bloodstream.
Sulfonylureas or dpp-4
After metformin doctors often prescribe sulfonylureas or dpp-4. Inhibitors like metformin sulfonylureas are inexpensive and effective. They work by increasing insulin release from the pancreas, however they may cause hypoglycemia.
What causes 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.
What is Incretin?
Incretin 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. Incretin levels are reduced.
Medications to improve the levels of Incretin
There are two types of medications that work to improve the levels of incretin in the body, the oral dpp-4 inhibitors and the injectable glp-1 analogs.
The dpp-4 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 analogs replace the incretin 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 hypoglycemia.
Thiazolidinediones are another class of oral anti-diabetic 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 sglt2 inhibitors, alpha-glucosidase inhibitors and bromocriptine and colas of elam.
Use of Insulin
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.
Types of Insulin
There are two types of insulin, long-acting or basal insulin and short acting or mealtime insulin. An insulin pump can be used in type 2 diabetes to deliver insulin just like the pancreas.
Changes in Lifestyle
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 dietitian 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. Ensuring adequate sleep and managing 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.