If you have type 2 diabetes, you will have to combine lifestyle changes with the use of medications to help control your blood sugar. It’s not always easy, but the well-known treatments for type 2 diabetes, along with new treatments and some natural treatments for type 2 diabetes, often help patients successfully control the disease.
Natural treatments for type 2 diabetes
A major component of this disease management involves natural treatments for type 2 diabetes. This includes healthier eating and more physical activity. “I believe that lifestyle changes are more important than drugs,” said Dr. Maria Subang, an endocrinologist at Kaiser Permanente in Colorado Springs, Colorado. “It is not a pleasant medical visit if we always have to say, ‘Eat less and move more’, but American society in general needs to make healthier choices.”
You and your healthcare professionals form your diabetes care team. “We found that the most successful changes are made when we can negotiate the changes that patients can make,” said Dr. Robert Gabbay, scientific director and medical officer at the American Diabetes Association and formerly Joslin medical director and senior vice president Diabetes Center, part of Harvard Medical School. This means finding out where you can insert healthier eating or physical activities into your lifestyle. For example, if you like to go shopping, you can spend more time walking while you are there to help you stay physically active.
[See: 8 Tiny Lifestyle Changes That Deliver Huge Health Rewards.]
It can be difficult to make healthier permanent changes on your own, so Subang refers patients to the National Diabetes Prevention Program, designed by the Centers for Disease Control and Prevention. This program, available throughout the United States, provides accurate information on diabetes control and provides support for those who have the disease. Ultimately, the behavioral changes recommended by the program, including weight loss and more physical activity, help control blood sugar. If you are under better control, you are less likely to have complications from diabetes.
“Healthy food choices and physical activity are not easy, but they are important,” says Subang.
Many people with diabetes also use dietary supplements. The American Diabetes Association states that people with diabetes are more likely to use supplements than people without diabetes. However, the ADA says there is no research to prove that dietary or herbal supplements (including supplements of omega-3, cinnamon and other herbs) help control diabetes. It is better to get vitamins and minerals from the foods you eat, says the ADA.
Preventing Diabetes Previous
The first step in keeping diabetes under control is to realize that you have it. Early detection of diabetes allows you and healthcare professionals to initiate treatment and lifestyle adjustments.
To that end, the screening guidelines for type 2 diabetes and pre-diabetes have just been updated to include more people at risk. On March 16, the U.S. Preventive Services Task Force, an influential and independent panel of medical experts, released preliminary guidelines advising doctors to consider screening overweight and obese adults from the age of 35. This instead of starting screening at age 40 according to previous USPSTF recommendations.
Even earlier screening is recommended for members of specific ethnic / racial groups who are at a higher risk of developing diabetes, as well as for individuals whose medical or family history puts them at greater risk.
Get examined now
According to the new USPSTF recommendations, you should be screened for diabetes if:
– You are an overweight or obese adult from 35 to 70 years old.
– You are of black / African American descent, American Indian / Alaskan native, Asian American, Hispanic / Latino or Hawaiian / Pacific Islander.
– You have a family history of diabetes or a personal history of gestational diabetes or polycystic ovary syndrome or PCOS.
When it comes to being screened if you are under 35, “It is critical to observe these warnings to the recommendations, especially when treating diverse populations, where there are greater risks of diabetes in individuals of normal weight,” said Dr. Emily Gallagher, professor assistant medicine, endocrinology, diabetes and bone disease at the Icahn School of Medicine on Mount Sinai, New York City.
Among American adults, diabetes is the leading cause of kidney failure and new cases of blindness, notes the USPSTF. “Screening asymptomatic adults for pre-diabetes and type 2 diabetes may allow early detection, diagnosis and treatment, with the ultimate goal of improving health outcomes,” say the authors of the guidelines.
Type 2 diabetes treatments
In addition to lifestyle changes, patients newly diagnosed with type 2 diabetes usually receive a prescription for an oral medication called metformin. “Metformin has been around for a long time,” says Gabbay. “We tend to choose because it reduces morbidity, helps to control blood sugar and helps a little in weight loss”. Morbidity refers to health complications.
Your doctor will likely start with a lower dose of metformin because it can disrupt your digestive system and cause bloating, gas, or diarrhea. You will probably start to notice changes in your blood sugar level after a few weeks, although it may take longer.
Your dose of metformin will depend on how much the drug affects (or does not affect) your digestion and how well controlled your diabetes is. If you’re doing well with lifestyle changes, the only medication you may need for your type 2 diabetes is metformin, says Subang.
Your doctor will work with you on a target blood sugar level for your type 2 diabetes while you use metformin. If you have other health complications related to diabetes and difficulty controlling your blood sugar, you may need to take other diabetes medications as well.
In addition, using homemade blood sugar test kits will help you monitor your blood sugar level every day.
Over time, exercise, healthy eating and the use of metformin alone may not be enough to control blood sugar. “The good news is that there are now more treatments available to improve your health,” said Dr. Loren Wissner Greene, clinical professor of endocrinology at NYU Langone Health in New York City.
There are also new treatments for type 2 diabetes, including medications that can help your body produce more insulin (leading to better blood sugar control) or improve your body’s sensitivity to the insulin it already produces. Some of these new drugs change the way blood sugar is released into the body. Other medications help to control blood sugar, decrease the risk of heart disease and promote weight loss. Side effects vary with the drug, but can include digestive problems, an increased risk of heart failure or urinary tract infections.
The different types or classes of treatments for type 2 diabetes include:
– Alpha-glycosidase inhibitors.
– Biguanides.
– Bile acid sequestrants.
– Dopamine-2 agonists.
– DPP-4 inhibitors.
– Meglitinides.
– SGLT2 inhibitors.
– Sulphonylureas.
– Thiazolidinediones or TZDs.
– Combined oral therapy.
The decision to add other drugs to the treatment of type 2 diabetes in addition to metformin comes down to several factors, including cost, whether the drugs promote weight loss or gain and whether the drugs interact with other drugs you can use. “There is not always a better next choice and this leads to shared decision making with the patient,” says Gabbay.
Insulin and other injectable treatments
Sometimes oral medications for type 2 diabetes are not enough to keep your blood sugar under control. In that case, your doctor may add insulin to your treatment. Insulin is what people with type 1 diabetes use to control their blood sugar. Although the actual rate of insulin use among patients may vary, Greene estimates that about a third of people with type 2 diabetes use it.
There are different types of insulin that your doctor may prescribe. Some insulin has a shorter action versus a long action. Other types of insulin are injected before you eat. Your doctor will help you find the right type of insulin for you. In many cases, it is easier to use insulin today because the needles are smaller and easier to inject, says Greene.
If you have type 2 diabetes and need to take insulin, don’t feel bad. “Taking insulin is not a personal failure. It can become a major barrier to starting insulin,” says Gabbay. “It is part of the natural course of the disease.”
[See: Got Diabetes? Why You Must Protect Your Feet.]
Along with insulin, there are also new types of injectable drugs to treat diabetes, including:
– GLP-1 receptor agonists, such as albiglutide (Tanzeum), dulaglutide (Trulicity), exenatide (Byetta), prolonged release exenatide (Bydureon) and liraglutide (Victoza).
– Amylin analog, such as pramlintide (Symlin).
Taking multiple pills or injectable drugs like insulin for diabetes is difficult, especially if you also have to use medications for other illnesses. “I know that when people are working, it can be a big challenge, and they’ll say they don’t have time to take medicine,” says Subang. Still, it is important to take medication regularly. If you miss doses, you will have a harder time controlling your blood sugar and this can lead to a variety of health problems.
“The patient has to be in control because the doctor cannot be there 24 hours a day, 7 days a week,” says Greene.
If you are taking medication for type 2 diabetes and your blood sugar is above the target range without any explanation, tell your doctor. It may be time to reevaluate your medications. Your doctor may also change your treatment if your hemoglobin A1C level – used to control your average blood sugar over three months – is above normal.
[See: The Best Diets to Prevent and Manage Diabetes.]
General Diabetes Management
Along with diet, exercise and medication, there are other important steps to successfully control type 2 diabetes.
– Test A1C and blood glucose levels as directed by your doctor.
– Control your blood pressure and cholesterol, again with the help of your doctor.
— Stop smoking.
– Get the vaccines recommended to prevent diseases, which can affect blood glucose levels.
– Consult a dentist, an ophthalmologist and a foot specialist regularly, as diabetes can damage your teeth and gums, eyes and lower extremities.
The National Institutes of Health recommends that you consult your healthcare team at least twice a year and more often if you have problems or are having trouble meeting your blood glucose, blood pressure or cholesterol goals. At each visit, check your blood pressure, feet and weight. Talk to your healthcare team about your medications and whether you need to adjust them.