At the start
Many people hear ‘diabetes’ and think ‘insulin’. This is definitely the case for type 1 diabetes, but not necessarily for those with type 2 diabetes. For people newly diagnosed with type 2 diabetes, the diabetes health care team will initially recommend lifestyle changes, such as:
- eating a healthy, balanced diet, and
- following a regular exercise program.
Follow a healthy diet
Many foods contain carbohydrates which break down into glucose when they are eaten. This causes blood glucose (sugar) levels to rise. It is therefore important to learn which foods cause blood glucose levels to rise more than others, and to balance your food choices. Some foods such as non-starchy vegetables, meats and alternatives such as fish, legumes or cheese, have a minimal effect on blood glucose levels.
To learn more about making healthy food choices, speak with a dietitian.
Exercise is actually another type of 'treatment' for managing diabetes, since exercise lowers blood glucose levels. Being physically active can help you lose weight, lower your blood pressure, manage your cholesterol and help you deal with stress. It is recommended that every week, people with diabetes do aerobic activity for 150 minutes and resistance exercises at least three times.
Add medications if targets are still not being met
If blood glucose targets are not met with this "lifestyle' plan in 3-6 months, type 2 diabetes treatment may include oral medications. In some situations, if the blood glucose levels are high enough at the time of diagnosis, oral medication (usually metformin) may be started right away. In rare cases, where the blood glucose levels are dangerously high, insulin will be started at the time of diagnosis.
If lifestyle changes and metformin are not enough to help you reach your target blood glucose levels, other medications can be added. These include:
- Sulfonylureas: decreases the amount of glucose released from liver and makes insulin more efficient
- Meglitinides: stimulates the pancreas to produce more insulin after a meal
- Thiazolidinediones: makes body’s insulin more efficient and decreases amount of glucose released from the liver
- Alpha-glucosidase inhibitors: slows absorption of glucose into the bloodstream after eating
- DPP-4 inhibitors: increases the production and release of insulin from the pancreas after a meal and decreases amount of glucose made by your body
- SGLT2 inhibitors: blocks reabsorption of glucose in the kidney, increases excretion of glucose and lowers glucose levels.
- GLP-1 agonists: increases the production and release of insulin from the pancreas after a meal and decreases the amount of glucose released by the liver
- Insulins: replaces insulin that is normally produced in the body which controls blood glucose
The choice of drug is based on a variety of factors including side effects, cost, and other health conditions you may have. For more information on type 2 diabetes medications, read this article.
Other medications may be needed too
Many people living with type 2 diabetes will also be prescribed medication for managing high blood pressure and/or high cholesterol.
Your diabetes healthcare team will determine the best treatment plan that will work for you. The important thing is to stick with it so that you can reach your blood glucose targets and reduce your risk of complications.
Weight loss surgery treatment
There are several different types of weight loss surgery, but not everyone is a candidate for these procedures. Get more information about current weight loss surgery options in Canada, and discuss this with your doctor at your next diabetes-related visit if you think you might be a candidate.