The American Diabetes Association recommends routine screening for type 2 diabetes for those that are 45 years of age, especially if you’re overweight.
If the results are normal, then you should repeat the test every three years, but if the results are borderline, then you should ask your doctor when to come back for another test.
Screening is also recommended for people who are under 45 and overweight if there are other heart diseases or risk factors for diabetes, such as a sedentary lifestyle, a family history of diabetes, a personal history of gestational diabetes or blood pressure above 140/90 millimeters of mercury (mm Hg).
Taking insulin or other diabetes medicines is often part of treating diabetes, along with healthy food choices and physical activity. Medicine can help you manage the disease, and some other treatment options are also available.
The medicine you take will vary by your type of diabetes and how well the medicine controls your blood sugar levels. Other factors, such as your other health conditions, medication costs, and your daily schedule may play a role in the type of diabetes medication you take.
For Type 1 Diabetes
If you have type-1 diabetes, you must take insulin because your body no longer secretes this hormone, and you will need to take it several times during the day, including with meals.
You also could use an insulin pump, with the advantage of giving you small, steady doses throughout the day.
For Type 2 Diabetes
Some people with type-2 diabetes can manage their disease by making healthy food choices and lifestyle changes like being more physically active.
Many people with type 2 diabetes need diabetes medicines as well, and such medicines may include diabetes pills or medicines you inject under your skin, such as insulin.
In time, you may need more than one diabetes medicine to control your blood glucose level. Even if you do not take insulin, there may be special times, such as during pregnancy or if you are in the hospital, when you may need it.
For Gestational Diabetes
If you have gestational diabetes, you should try to control your blood glucose level by making healthy food choices and getting regular physical activity first. But if you can’t reach your blood glucose target, your health care team will talk with you about diabetes medicines, such as insulin or the pill metformin, that may be safe for you to take during pregnancy.
Your health care team may start you on diabetes medicines right away if your blood glucose is considered very high.
Treatment For Diabetes
Management of Type 2-Diabetes
Contrary to popular opinion, there’s no specific diabetes diet. However, it’s important to center your diet on high-fiber, low-fat foods like fruits, vegetables, and whole grains.
You’ll also need to eat fewer animal products, and if possible, eliminate refined carbohydrates and sweets from your diet. Remember that low glycemic index foods also may help you achieve a more stable blood sugar (the glycemic index is a measure of how quickly a food causes a rise in your blood sugar). Foods with a low glycemic index are usually foods that are higher in fiber.
A registered dietitian can help you put together a meal plan that fits your health goals, food preferences and lifestyle.
You should also learn how to monitor your carbohydrate intake and know how many carbohydrates you need to eat with your meals and snacks to keep your blood sugar levels more stable.
Everyone needs regular aerobic exercise, and people who have type 2 diabetes are no exemption to the rule. However, it is important to get your doctor’s approval before you start an exercise program.
Then choose activities you enjoy, such as walking, swimming, biking, etc…It is important to make physical activity part of your daily routine.
Aim for at least 30 minutes of aerobic exercise five days of the week, and if you haven’t been active for a while, start slowly and build up gradually. Stretching and strength training exercises are also important.
A combination of exercises such as walking or dancing on most days, combined with resistance training, such as weightlifting or yoga twice a week, often helps control blood sugar more effectively than engaging in either type of exercise alone.
Physical activity lowers blood sugar, and don’t forget that. Remember to check your blood sugar level before any activity, and you might need to eat a snack before exercising to help prevent low blood sugar if you take diabetes medications that lower your blood sugar.
Blood Sugar Monitoring
Depending on your treatment plan, you may need to check and record your blood sugar level regularly, and if you’re on insulin, then do that multiple times a day.
Careful monitoring your blood sugar level is the only way to make sure that your blood sugar level remains within your target range.
Sometimes, blood sugar levels can be unpredictable, but with help from your diabetes treatment team, you’ll learn how your blood sugar level changes in response to food, exercise, alcohol, medication, and other illnesses.
These steps will help keep your blood sugar level close to normal, which can delay or prevent complications from the condition.
Medications For Type 2 Diabetes
If you have type 2-diabetes, your body can’t make enough insulin to keep your blood sugar levels normal, and the goal of treatment for you is to help your body use your insulin better or to get rid of extra sugar in your blood.
Most medications for type-2 diabetes are oral pills, but a few come as injections. Some people with type-2 diabetes may need to take insulin.
These medications help your body break down starchy foods and table sugar, lowering your blood sugar levels as a result.
For the best results, you should take these drugs before meals, and such drugs include:
- acarbose (Precose)
- miglitol (Glyset)
Biguanides decrease how much sugar your liver makes, and decrease how much sugar your intestines absorb, making your body more sensitive to insulin, and helping your muscles absorb glucose.
The most common biguanide is metformin (Glucophage, Metformin Hydrochloride ER, Glumetza, Riomet, Fortamet), which can also be combined with other drugs for type-2 diabetes.
Other Treatment Options For Diabetes
When medicines and lifestyle changes are not enough to control your diabetes, a less common treatment may be an option. Such treatments options include:
- Bariatric surgery for certain people with type 1 or type-2 diabetes, and
- An “artificial pancreas” and
- pancreatic islet transplantation for some people with type-1 diabetes.
Also known as weight-loss surgery or metabolic surgery, bariatric surgery may help some people with obesity and type-2 diabetes lose a large amount of weight and regain normal blood glucose levels.
Some people with diabetes may no longer need their diabetes medicine after bariatric surgery. Blood glucose levels improvement seems to vary by the patient, type of weight-loss surgery, amount of weight the person loses and whether or not the person uses insulin.
Recent research suggests that weight-loss surgery also may help improve blood glucose control in people with type-1 diabetes who are obese, and researchers are studying the long-term results of bariatric surgery in people with type-1 and type-2 diabetes.
The artificial pancreas” technology has been developed. An artificial pancreas replaces manual blood glucose testing and the use of insulin shots or a pump to control sugar levels.
A single system monitors blood glucose levels around the clock and provides insulin or a combination of insulin and glucagon, automatically.
The system can also be monitored remotely by parents or medical staff. In 2016, the FDA approved a type of artificial pancreas system called a hybrid closed-loop system, that tests your glucose level every 5 minutes throughout the day and night, and automatically gives you the right amount of insulin, required to balance it.
Even though you may still need to manually adjust the amount of insulin the pump delivers at mealtimes, the artificial pancreas frees you from some of the daily tasks needed to keep your blood glucose stable.
It helps you sleep through the night without the need to wake and test your glucose or take medicine.
The hybrid closed-loop system should be available in the U.S. Talk with your doctor or health care provider about whether this system might be right for you.
The NIDDK has funded several important studies on different types of artificial pancreas devices to better help people with diabetes manage their disease. The devices may also help people with gestational diabetes.
Pancreatic Islet Transplantation
Pancreatic islet transplantation is an experimental treatment for poorly controlled type-1 diabetes. Pancreatic islets are clusters of cells in the pancreas that help make the hormone insulin.
In type-1 diabetes, the body’s immune system attacks these cells, and kills them, but a pancreatic islet transplant replaces destroyed islets with new ones that make and release insulin.
This procedure takes islets from the pancreas of an organ donor and transfers them to a person with type-1 diabetes. However, researchers are still studying pancreatic islet transplantation, and the procedure is only available to people enrolled in research studies.