There are multiple treatment options for diabetes, which differ based on the type and severity of your condition. Treatment options for diabetes include healthy eating and lifestyle choices, oral medications, and insulin therapy. The right combination of treatment options can reduce the risk of serious complications, such as kidney disease and vision loss. Explore treatment options for diabetes in this comprehensive informational article.
The treatment options for diabetes vary depending on the type and severity of your condition.
Lifestyle Management
Many cases of diabetes can be prevented or controlled with lifestyle changes. This includes following a diet that is low in sugar, salt, and fat and getting regular exercise. These essential factors can help reduce the risk of developing type 2 diabetes, the most common disease. It is also crucial to get enough sleep and reduce stress levels.
Individuals with diabetes should work with their doctor and dietitian to develop a dietary plan that fits their needs. This should include a variety of foods high in nutrients and fiber. People should eat more fruits, vegetables, and whole grains and limit red meat and processed sugars.
In addition to dietary changes, it is recommended that adults with diabetes engage in 150 minutes of moderate-to-vigorous intensity physical activity weekly. This can be spread out over three days or more and should include two to three sessions of resistance exercises on nonconsecutive days. All individuals with diabetes should receive individualized nutrition therapy and participate in DSME and DSMS programs designed to improve clinical outcomes, health status, and quality of life while supporting the individual's self-management behaviors and preferences.
Oral Medications
There are a variety of oral medications available to treat diabetes. Your primary care physician and diabetes specialist will recommend the best medication. Some medicines can cause low blood sugar (hypoglycemia). Talk to your doctor about the side effects of any medication you consider.
One of the longstanding oral drugs is metformin. It reduces glucose production in the liver and decreases the amount of glucose absorbed from food. It also helps with weight loss. Common side effects include gastrointestinal distress, such as bloating and gas.
A new class of medication called DPP-4 inhibitors can also be used. These tablets block DPP-4 from destroying the hormone incretin, which causes your kidneys to absorb less sugar and pass it out through urine. These medications have been shown to reduce heart failure and slow the progression of kidney disease in those with type 2 diabetes. They are taken once per day. Brand names include Forxiga, Jardiance, and Invokana.
Insulin Therapy
Insulin is the hormone that helps lower blood sugar levels. It tells your cells what to do with the glucose (sugar) you eat and drink. Different types of insulin vary in how fast and long they work. Typically your doctor will recommend a combination of other insulins to fit your needs.
Oral medications can often be effective for people with type 2 diabetes. But for, people with type 1 diabetes may need insulin therapy to supplement their daily regimen.
Insulin therapy is recommended in specific circumstances, including severe uncontrolled hyperglycemia with ketonuria, marked symptoms, or a medical illness that disturbs metabolic control. Intensive insulin treatment at diagnosis can also prevent the progression of advanced diabetes.
Typically, insulin is injected into the body through an area of fatty tissue, like the abdomen, arm, or buttocks. The injections are given at least twice a day or more, depending on the type of insulin you use and your lifestyle. Some people also wear an insulin pump that delivers rapid-acting insulin through a thin tube inserted under the skin.
Injectable Medications
Injectable medications are combined with oral medication to treat type 2 diabetes. These medications help lower blood sugar levels and can contribute to weight loss. Some injectable medications cause side effects such as nausea and vomiting, but these usually improve with time.
Insulin is a hormone the body produces that helps lower blood sugar levels. It comes in different forms, such as rapid-acting, short-acting, and long-acting. A doctor or nurse usually gives it in a healthcare setting.
Another type of injectable medicine is glucagon-like peptide-1 receptor agonists (GLP-1 RAs). The FDA approved the first GLP-1 RA, exenatide (Byetta), in 2022. The drug is given by injection once or twice per day.
In addition, another type of injectable medicine is SGLT2 inhibitors, which are taken before meals. These drugs slow the digestion of food and decrease the absorption of glucose into the bloodstream. They are sometimes prescribed with metformin and may be recommended for people with heart failure or a high risk of developing cardiovascular disease.
Bariatric Surgery
For people with Type 2 diabetes who are unable to control their blood sugar through diet and exercise, a surgical procedure called bariatric surgery may help. "Metabolic surgery," which involves shrinking a person's stomach, typically by removing it (sleeve gastrectomy) or by dividing it into two portions and connecting the smaller portion to the small intestine (Roux-en-Y gastric bypass), can lead to significant weight loss, with up to 80% of surgically treated patients achieving apparent remission of their diabetes.
In a new set of clinical guidelines, the American Diabetes Association recommends that metabolic surgery be considered as a treatment option for those with Type 2 diabetes. This is a radical change from previous guidelines, and it follows multiple studies that found that gastrointestinal surgeries improve blood sugar levels more effectively than medication or lifestyle changes.
However, the surgery isn't a cure and is not suitable for everyone. Patients should consider it only after trying other weight-loss methods and have a serious health problem related to obesity, such as severe sleep apnea or high blood pressure.
Acupuncture
Acupuncture has been shown to help with various conditions related to diabetes, such as diabetic neuropathy and fatigue. It increases insulin production, improves blood circulation, and stabilizes blood sugar levels by correcting endocrine system imbalances. It also treats overall health imbalances that often accompany diabetes.
It is important to note that an experienced practitioner should perform acupuncture, and individuals with diabetes should stay in close contact with their doctor and follow all medical recommendations regarding diet and medications.
Complications of Diabetes
Uncontrolled blood sugar can damage the heart and kidneys, leading to several complications, including nerve damage (neuropathy), which can cause numbness, tingling, or pain, and vascular disease, which can lead to dialysis or amputation. Severe low blood sugar (hypoglycemia) can cause blurred vision, clumsiness, and disorientation and may require emergency treatment with glucagon.
The Bottom Line
The key to avoiding serious complications from diabetes is a rigorous self-management plan that includes careful measurement of insulin, daily blood glucose testing and monitoring, achieving and maintaining a healthy weight, exercising regularly, seeking treatment for sleep disorders, and managing other health conditions. A person can also help prevent diabetes complications by monitoring blood sugar levels frequently and recognizing symptoms such as high or low blood sugar (hypoglycemia or hyperglycemia), dark urine, fatigue, and eye problems.
