Treatment for Type 2 Diabetes
The aim of treating type 2 diabetes is primarily to help control blood glucose levels but another key aim is to help with weight loss or weight management.
Keeping blood sugar levels under control is important as high sugar levels have been shown to significantly increase the risk of health problems (complications) developing later in life.
Type 2 diabetes can be treated by a number of different methods ranging from lifestyle adjustments to tablet medication and injections, through to bariatric surgery (weight loss surgery).
Lifestyle changes are advised for everyone with type 2 diabetes, with medications available if blood glucose levels are too high without drug treatments.
Your GP and health centre
Your GP is an important part of your treatment and will be able to advise you on how you can treat your diabetes as well as being able to refer you to diabetes education and lifestyle courses, refer you to medical specialists where needed and prescribe medication.
Your GP will also be responsible for monitoring your health and ensuring you undergo a number of important diabetes health checks each year which will include monitoring your blood glucose control as well as blood pressure and cholesterol.
When it comes to diet, weight loss is often a primary goal for those of us with type 2 diabetes because if we are overweight, losing weight can help to improve our sensitivity to insulin and therefore make diabetes easier to manage.
In the modern world, many of us have become accustomed to eating energy dense foods such as bread, rice, pasta and potato based foods. Whilst these high energy foods are convenient they’re less good for those of us that are not working physically hard.
Vegetables (not counting potatoes) are a strong choice because they provide a variety of nutrients whilst having a relatively low calorie count. Because vegetables are a great source of soluble fibre, they also help us to stay full for longer.
If you are at a healthy weight, aim to eat a balanced diet that allows you to keep your blood glucose levels under control.
Physical activity can be particularly effective in controlling blood glucose levels. When our muscles work they take in glucose from our blood and make use of the stores of sugar the body keeps in muscles and the liver.
After we have completed exercise, the body will start replenishing its stores of glucose by steadily taking in available glucose from the blood.
As well as helping to lower blood sugar levels, exercising makes use of the energy we take in from our diet, meaning that if we exercise more and don’t increase calorie intake, then we’re in a better position to lose weight.
Other lifestyle changes
In addition to diet and physical activity, other lifestyle adjustments, such as reducing intake of alcohol and quitting smoking, will also help your diabetes and general health.
Blood glucose monitoring
Blood glucose monitoring can be a useful tool when it comes to controlling blood sugar levels, as it can show how diet and activity impacts on your blood sugar levels. If you are on insulin you may need to regularly test your blood glucose levels to help prevent blood glucose levels from going too low.
Blood glucose monitoring is highly valued by some people with diabetes and has helped people to achieve excellent control of their diabetes. A certain amount of education is needed to make the most of blood glucose testing.
The main role of diabetes medication is to help lower blood glucose levels, although more recently developed medications may also support weight loss. Each form of medication has side effects and it is important to be aware of what the side effects are. Known side effects will be detailed in the patient information leaflet in every pack of medication.
You may be put onto medication as soon you are diagnosed or some time after if your blood glucose levels start to become too high.
You can be moved onto stronger medication if blood glucose levels begin to get too high. By contrast, you can also be moved onto less strong medication if your blood glucose levels improve. Whilst less common, some people may even be able to come off medication, particularly if significant weight loss is achieved.
Diabetes medication needs to be supported with diet changes and regular physical activity to keep you healthy.
Medication for type 2 diabetes includes tablets and/or injectable medication.
There are a range of tablets available for type 2 diabetes and many of these work in different ways. For example, metformin helps the body to better respond to insulin whereas sulphonylureas prompt the pancreas to produce more insulin.
Metformin is often the first tablet prescribed to people with type 2 diabetes and stronger acting medication may be prescribed in addition to metformin or in place of it if blood glucose levels remain too high.
There are now a number of different injectable medications available for treating diabetes. These fall into two main groups:
Insulin is the most well known type of injectable medication for diabetes. Insulin is the hormone which helps to move sugar out of the blood and into cells to be used as energy or to be stored as fat.
Insulin is a powerful medication for lowering blood glucose but can lead to dangerously low blood sugar levels (hypoglycemia) if too much insulin is taken than the body needs. For this reason it is important for people to be able to recognise the symptoms of low blood sugar levels and know how to treat hypos should they occur.
Incretin mimetics have been used for treating diabetes since 2005. Incretin mimetics are medications which mimic the action of a hormone called glucagon-like-peptide-1. This hormone plays a number of roles in response to digestion such as increasing the amount of insulin released and decreasing the amount of glucagon (a hormone that helps raise blood sugar) released. A group of tablet medications, known as DPP-4 inhibitors, work in a similar way to incretin mimetics.
Compared with insulin, incretin mimetics are a new medication and its long term effects on the body are still not so well understood. Whilst incretin mimetics have been shown to be effective in reducing blood glucose levels and helping to reduce appetite, the drug has been linked with an increased risk of pancreatitis.
Weight loss surgery
Bariatric surgery, also known as weight loss surgery, is an option that may be considered if weight gain is leading to a high risk of suffering dangerous health conditions, which may include difficulty breathing and loss of mobility.
There are significant health risks involved in surgery and therefore bariatric surgery is only offered to people that are very overweight and have not had success with less dangerous weight loss methods.