Diabetes

TREATMENT

While there is no cure for diabetes, symptoms can be managed with your doctor’s careful and ongoing medical care. Your doctor will want you to have routine office exams and testing. You will need to monitor your blood sugar frequently and may need to take insulin to help keep glucose levels within normal ranges.

Type 1:

Insulin is the most common treatment for Type 1 diabetes.  Insulin is injected through the skin into the fatty tissue below. There are various ways of delivering insulin Injections and new ways of delivering this medication are constantly being researched.  Currently, insulin is delivered through: 

• syringes, into which insulin is drawn as it is for a vaccination or any typical injection
• insulin pens with fine needles that dispense pre-filled cartridges
• jet injectors using high pressure air sending a spray of insulin through the skin
• insulin pumps that dispense insulin through a flexible tube into a catheter under the skin of the abdomen (below the stomach).

Type 2:

Depending on the severity of the patient’s Type 2 Diabetes, it is treated with a combination of lifestyle changes and various medications. Some Type 2 Diabetes patients are able to treat their illness with diet and exercise alone.

Diet – Managing one’s weight is often a key ingredient in managing one’s blood sugar levels. Even a small weight loss can often make a significant change in a person’s blood sugar levels.  Proper nutrition for a diabetic, such as limiting sugar intake and carbohydrates is typically the first recommended piece of the puzzle. Other nutritional factors, such as the intake of fiber, fat and salt also need to be discussed with your health care provider as they affect the way your body metabolizes food and nutrients, thus affecting your blood sugar levels. 

Exercise – Research has shown that physical activity directly affects the level of sugar in the body. Those who are sedentary are encouraged to becoming more physically active, as it may also help control blood sugar as well as having the extra benefit of possible weight loss. In fact, diabetic patients who take a brief walk immediately after eating often find they are able to better control their body’s blood sugar levels.

Medication – There are a myriad of medications that treat Type 2 Diabetes. There are several major categories of medications for treating Type 2 Diabetes including:

• Metformin  – Typically, metformin is the first medication prescribed for type 2 diabetes. It improves the sensitivity of your body tissues to insulin so that your body uses insulin more effectively and also lowers glucose production in the liver.
• Sulfonylureas – These medications help your body create more of its own insulin.
• Meglitinides – These are medications that work similarly to sulfonylureas. They are fast acting and stimulate the pancreas to secrete more insulin.
• Thiazolidinediones – Because they often are associated with some weight gain as a side effect, they are used a little less often, but these medications work similarly to metformin and help the body use insulin more effectively.
• DPP-4 inhibitors – Medications that tend to modestly reduce blood sugars.
• SGLT2 inhibitors – these are some of the newer diabetes drugs which work by preventing the kidneys from reabsorbing sugar into the blood and it is then excreted in the urine.
• Insulin therapy – Just as in Type 1 Diabetes, insulin must be injected, as digestion interferes with insulin absorption if it is taken orally. There are various types of insulin that act slightly differently; mostly in terms of how long or short their effect is in the body. Some patients take different types of insulin at different times of the day to control their blood sugars.