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Pharmacology - Diabetes MedicationType diabetes treatment -
They work to lower blood sugar levels, similar to the sulfonylureas, but they act more quickly than sulfonylureas and should be taken right before a meal; they might also be recommended in people who are allergic to sulfonylureas. They are taken in pill form. Meglitinides are not generally used as a first-line treatment, because they are more expensive than sulfonylureas.
Repaglinide can be used in patients with kidney failure. Thiazolidinediones — This class of medicines includes pioglitazone brand name: Actos and rosiglitazone brand name: Avandia , which work to lower blood sugar levels by increasing the body's sensitivity to insulin.
They are taken in pill form and usually in combination with other medicines such as metformin, a sulfonylurea, or insulin. The risk of heart failure is small but serious.
An early sign of heart failure is swelling of the feet and ankles. People who take thiazolidinediones should monitor for swelling.
Alpha-glucosidase inhibitors — These medicines, which include acarbose brand name: Precose and miglitol brand name: Glyset , work by interfering with the absorption of carbohydrates in the intestine.
This helps to lower blood sugar levels but not as well as metformin or the sulfonylureas. They can be combined with other medicines if the first medicine does not lower blood sugar levels enough.
The main side effects of alpha-glucosidase inhibitors are gas flatulence , diarrhea, and abdominal pain; starting with a low dose may minimize these side effects. The medicine is usually taken three times per day with the first bite of each meal.
Insulin — In the past, insulin treatment was reserved for patients with type 2 diabetes whose blood sugar was not controlled with oral medicines and lifestyle changes ie, diet and exercise.
However, there is increasing evidence that insulin treatment at earlier stages may improve overall diabetes management over time. Side effects include low blood sugar, if you take more insulin than your body needs, and weight gain.
Adjusting the dose of insulin to the body's needs can minimize the risk of these side effects. It may be necessary to readjust your dose frequently. In some situations, insulin injections shots can be used as a first-line treatment for type 2 diabetes.
In other cases, insulin can be added to or substituted for oral medicines. If you take insulin, you will need to get comfortable giving yourself the injections or have a family member or housemate learn how to do it for you. More detailed information about insulin treatment is available separately.
Living with type 2 diabetes can be stressful. It is a lot of responsibility to have to monitor your blood sugar if you need to do this , watch your diet, exercise regularly, keep all your appointments, and take your medications every day. It can also be scary to think about the potential complications of diabetes.
It can help to involve your family and friends and make sure you have a solid support system in place to provide encouragement, reminders, and help as you need it. It is not uncommon for stress to lead to burnout or even depression, and this can make taking care of yourself more difficult.
Having an open and honest discussion with your doctor, nurse, or other health care provider can help you to understand your diagnosis, treatment plan, and what to do if you are overwhelmed.
Some people also benefit from talking with a counselor or social worker to help them cope with their responsibilities and worries. Your health care provider is the best source of information for questions and concerns related to your medical problem.
This article will be updated as needed on our website www. Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials.
The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition.
These articles are best for patients who want a general overview and who prefer short, easy-to-read materials. Patient education: Treatment for type 2 diabetes The Basics Patient education: Type 2 diabetes The Basics Patient education: Using insulin The Basics Patient education: Low blood sugar in people with diabetes The Basics Patient education: Nonalcoholic fatty liver disease The Basics Patient education: Exercise and movement The Basics Patient education: Carb counting for adults with diabetes The Basics Patient education: Lowering your risk of prediabetes and type 2 diabetes The Basics Patient education: Diabetic ketoacidosis The Basics Patient education: Hyperosmolar hyperglycemic state The Basics.
Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon. Patient education: Type 2 diabetes: Overview Beyond the Basics Patient education: Type 2 diabetes: Insulin treatment Beyond the Basics Patient education: Type 2 diabetes and diet Beyond the Basics Patient education: Glucose monitoring in diabetes Beyond the Basics Patient education: Hypoglycemia low blood glucose in people with diabetes Beyond the Basics Patient education: Exercise and medical care for people with type 2 diabetes Beyond the Basics Patient education: Preventing complications from diabetes Beyond the Basics.
Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based.
Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading.
Alpha-glucosidase inhibitors for treatment of diabetes mellitus Measurements of chronic glycemia in diabetes mellitus Glycemic control and vascular complications in type 2 diabetes mellitus Insulin therapy in type 2 diabetes mellitus Management of persistent hyperglycemia in type 2 diabetes mellitus Metformin in the treatment of adults with type 2 diabetes mellitus Overview of general medical care in nonpregnant adults with diabetes mellitus Sodium-glucose cotransporter 2 inhibitors for the treatment of hyperglycemia in type 2 diabetes mellitus Sulfonylureas and meglitinides in the treatment of type 2 diabetes mellitus Thiazolidinediones in the treatment of type 2 diabetes mellitus.
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Patient education: Type 2 diabetes: Treatment Beyond the Basics. Formulary drug information for this topic. No drug references linked in this topic.
Find in topic Formulary Print Share. Official reprint from UpToDate ® www. com © UpToDate, Inc. All Rights Reserved. Author: Deborah J Wexler, MD, MSc Section Editor: David M Nathan, MD Deputy Editor: Katya Rubinow, MD. All topics are updated as new evidence becomes available and our peer review process is complete.
Literature review current through: Jan This topic last updated: Jul 27, TYPE 2 DIABETES OVERVIEW Type 2 diabetes mellitus is a disorder that is known for disrupting the way your body uses glucose sugar ; it also causes other problems with the way your body stores and processes other forms of energy, including fat.
This topic review will discuss the medical treatment of type 2 diabetes. DIABETES CARE DURING THE COVID PANDEMIC COVID stands for "coronavirus disease Getting vaccinated lowers the risk of severe illness; experts recommend COVID vaccination for anyone with cancer or a history TYPE 2 DIABETES TREATMENT GOALS The main goals of treatment in type 2 diabetes are to keep your blood sugar levels within your goal range and treat other medical conditions that go along with diabetes like high blood pressure ; it is also very important to stop smoking if you smoke.
DIET AND EXERCISE IN TYPE 2 DIABETES Diet and exercise are the foundation of diabetes management. TYPE 2 DIABETES MEDICINES A number of medications are available to treat type 2 diabetes.
LIVING WITH TYPE 2 DIABETES Living with type 2 diabetes can be stressful. Daily care will include serving healthy foods, giving insulin injections, and watching for and treating hypoglycemia low blood sugar. They will help you understand the treatment plan and how to help your child stay healthy.
Much of the information that follows applies to children as well as adults. Type 1 diabetes is thought to be caused by an autoimmune reaction the body attacks itself by mistake. This reaction destroys the cells in the pancreas that make insulin, called beta cells. This process can go on for months or years before any symptoms appear.
Some people have certain genes traits passed on from parent to child that make them more likely to develop type 1 diabetes. A trigger in the environment, such as a virus, may also play a part in developing type 1 diabetes.
It can take months or years before symptoms of type 1 diabetes are noticed. Type 1 diabetes symptoms can develop in just a few weeks or months.
Once symptoms appear, they can be severe. Some type 1 diabetes symptoms are similar to symptoms of other health conditions. If you think you could have type 1 diabetes, see your doctor to get your blood sugar tested. Untreated diabetes can lead to very serious—even fatal—health problems. Risk factors for type 1 diabetes are not as clear as for prediabetes and type 2 diabetes.
However, studies show that family history plays a part. A simple blood test will let you know if you have diabetes. If your doctor thinks you have type 1 diabetes, your blood may also be tested for autoantibodies.
These substances indicate your body is attacking itself and are often found with type 1 diabetes but not with type 2. You may have your urine tested for ketones too. Ketones are produced when your body burns fat for energy. Having ketones in your urine indicates you have type 1 diabetes instead of type 2.
Unlike many health conditions, diabetes is managed mostly by you, with support from your health care team:. Also ask your family, teachers, and other important people in your life for help and support. Managing diabetes can be challenging, but everything you do to improve your health is worth it!
Insulin is needed to manage your blood sugar levels and give your body energy. Your doctor will work with you to figure out the most effective type and dosage of insulin for you. Taking those two units of insulin prior to eating the apple helps to avoid a high or low blood-sugar fluctuation post-snack.
Get tips on carb counting. Following a balanced and nutritious diet is paramount to the health of a person living with T1D. Ensuring proper nutritional intake and keeping a healthy weight help curb the effects of T1D wear on the body.
Learn more about food and diet with T1D. Physical activity can help regulate blood sugar levels and improve overall health. Keep in mind that monitoring insulin and carbohydrate intake is essential when exercising to prevent hypoglycemia low blood sugar or hyperglycemia high blood sugar.
Learn more about exercise and T1D. People with T1D regularly meet with a team of medical professionals, including an endocrinologist, retinal specialist, and dietitian, to help manage their disease and to prevent and treat complications. Adjunctive therapies are treatments that complement insulin to achieve glucose control and to help manage additional metabolic conditions experienced by people with T1D, including insulin resistance and obesity.
Improved control of glucose and metabolism also plays an important role in slowing progression of long-term complications associated with T1D. Pramlintide is a synthetic amylin analog administered via syringe.
It is approved for people with T1D who use mealtime insulin and do not achieve their glycemic targets despite optimal insulin therapy. Pramlintide limits glucose fluctuations after meals. Pramlintide therapy can also lead to weight-loss and improvements in risk factors for cardiovascular disease.
Originally developed for the treatment of type 2 diabetes T2D , metformin , administer ed via a pill, can be prescribed to people with T1D in addition to insulin therapy, diet, and exercise to help improve insulin sensitivity and reduce insulin dose requirements.
People with insulin resistance, of higher weight, and at risk for cardiovascular disease may be more likely to experience metabolic benefits with metformin.
Glucagon-like peptide-1 GLP-1 receptor agonists are commonly used to treat T2D. Though not approved for T1D, GLP-1 agonists, administered both orally and through injections, have been shown to have glycemic and metabolic benefits in people with T1D.
They can lead to reduced insulin needs, weight loss, and may reduce risk of cardiovascular disease. Sodium-glucose co-transporter SGLT inhibitors lower blood sugar levels by preventing glucose reabsorption in the kidneys and increasing glucose excretion through the urine.
In addition to glycemic control, SGLT inhibitors, which are taken orally, also have metabolic benefits in weight loss and improved cardiac and kidney function. These benefits have led to approval of SGLT inhibitors for T2D, chronic kidney disease, and heart failure.
SGLT inhibitors are not approved for glycemic control in T1D due to the elevated risk of diabetic ketoacidosis DKA. A key JDRF priority is to find ways to mitigate this risk so people with T1D can also take advantage of the SGLT cardiovascular and renal benefits.
In T1D, hyperglycemia high blood sugar and poor glycemic control impact cardiovascular outcomes, including blood pressure and cholesterol levels. Long disease duration and increased risk of microvascular complications in T1D also contribute to the high prevalence of cardiovascular disease in T1D.
Therapies such as angiotensin-converting enzyme ACE inhibitors, angiotensin receptor blockers ARBs , statins, and other lipid-lowering drugs may be prescribed to manage cardiovascular disease and reduce the risk of cardiovascular complications.
JDRF content is for informational purposes only and is not a substitute for professional medical advice. Please contact your doctor or other qualified health provider with any questions you may have regarding type 1 diabetes treatments or any medical condition.
Type 2 Blood sugar level is usually diagnosed Protein requirements for vegans diabetfs glycated hemoglobin A1C dlabetes. This blood test indicates your average blood sugar Protein requirements for vegans for the past two to three months. Results are interpreted as follows:. If the A1C test isn't available, or if you have certain conditions that interfere with an A1C test, your health care provider may use the following tests to diagnose diabetes:. Random blood sugar test. Fasting blood sugar test.Type diabetes treatment -
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Explore Mayo Clinic studies testing new treatments, interventions and tests as a means to prevent, detect, treat or manage this condition. Diabetes is a serious disease. Following your diabetes treatment plan takes total commitment.
Careful management of diabetes can lower your risk of serious or life-threatening complications. Make physical activity part of your daily routine. Regular physical activity can help prevent prediabetes and type 2 diabetes. It can also help those who already have diabetes to maintain better blood sugar control.
A minimum of 30 minutes of moderate physical activity — such as brisk walking — most days of the week is recommended. Aim for at least minutes of moderate aerobic physical activity a week.
Getting regular aerobic exercise along with getting at least two days a week of strength training exercises can help control blood sugar more effectively than does either type of exercise alone. Aerobic exercises can include walking, biking or dancing.
Resistance training can include weight training and body weight exercises. Also try to spend less time sitting still.
Try to get up and move around for a few minutes at least every 30 minutes or so when you're awake. Keep your vaccinations up to date. High blood sugar can weaken your immune system. Get a flu shot every year.
Your provider may recommend the pneumonia and COVID vaccines, as well. The Centers for Disease Control and Prevention CDC also currently recommends hepatitis B vaccination if you haven't previously had it and you're an adult ages 19 to 59 with type 1 or type 2 diabetes.
The most recent CDC guidelines suggest vaccination as soon as possible after diagnosis with type 1 or type 2 diabetes. If you are age 60 or older, have been diagnosed with diabetes, and haven't previously received the vaccine, talk to your provider about whether it's right for you. If you drink alcohol, do so responsibly.
Alcohol can cause either high or low blood sugar. This depends on how much you drink and if you eat at the same time. If you choose to drink, do so only in moderation — one drink a day for women and up to two drinks a day for men — and always with food. Remember to include the carbohydrates from any alcohol you drink in your daily carbohydrate count.
And check your blood sugar levels before going to bed. Many substances have been shown to improve the body's ability to process insulin in some studies.
Other studies fail to find any benefit for blood sugar control or in lowering A1C levels. Because of the conflicting findings, there aren't any alternative therapies that are currently recommended to help everyone to manage blood sugar. If you decide to try any type of alternative therapy, don't stop taking the drugs that your provider has prescribed.
Be sure to discuss the use of any of these therapies with your provider. Make sure that they won't cause bad reactions or interact with your current therapy. Also, no treatments — alternative or conventional — can cure diabetes.
If you're using insulin therapy for diabetes, never stop using insulin unless directed to do so by your provider. Living with diabetes can be difficult and frustrating. Sometimes, even when you've done everything right, your blood sugar levels may rise.
But stick with your diabetes management plan and you'll likely see a positive difference in your A1C when you visit your provider. Good diabetes management can take a great deal of time and feel overwhelming.
Some people find that it helps to talk to someone. Your provider can probably recommend a mental health professional for you to speak with. Or you may want to try a support group. Sharing your frustrations and triumphs with people who understand what you're going through can be very helpful.
And you may find that others have great tips to share about diabetes management. Your provider may know of a local support group. You can also call the American Diabetes Association at DIABETES or the Juvenile Diabetes Research Foundation at CURE You're likely to start by seeing your health care provider if you're having diabetes symptoms.
If your child is having diabetes symptoms, you might see your child's health care provider. If blood sugar levels are very high, you'll likely be sent to the emergency room. If blood sugar levels aren't high enough to put you or your child immediately at risk, you may be referred to a provider trained in diagnosing and treating diabetes endocrinologist.
Soon after diagnosis, you'll also likely meet with a diabetes educator and a registered dietitian to get more information on managing your diabetes. Preparing a list of questions can help you make the most of your time with your provider.
For diabetes, some questions to ask include:. Diabetes care at Mayo Clinic. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press.
This content does not have an English version. This content does not have an Arabic version. Diagnosis Type 1 diabetes FAQs Endocrinologist Yogish Kudva, M. Care at Mayo Clinic Our caring team of Mayo Clinic experts can help you with your diabetes-related health concerns Start Here.
Enlarge image Close. Continuous glucose monitor and insulin pump A continuous glucose monitor, on the left, is a device that measures your blood sugar every few minutes using a sensor inserted under the skin.
Request an appointment. Thank you for subscribing! Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. By Mayo Clinic Staff. Show references Ferri FF. Diabetes mellitus. In: Ferri's Clinical Advisor Elsevier; Accessed May 7, Classification and diagnosis of diabetes: Standards of medical care in diabetes — Diabetes Care.
Papadakis MA, et al. McGraw Hill; Accessed May 4, Diabetes risk factors. Centers for Disease Control and Prevention. Accessed June 2, Cunningham FG, et al.
In: Williams Obstetrics. McGraw-Hill Education; Diabetes and DKA ketoacidosis. American Diabetes Association. Diabetes Canada Clinical Practice Guidelines Expert Committee. Complementary and alternative medicine for diabetes. Canadian Journal of Diabetes. Nimmagadda R. Allscripts EPSi.
Mayo Clinic. June 16, Jameson JL, et al. Diabetes mellitus: Diagnosis, classification and pathophysiology. In: Harrison's Principles of Internal Medicine. Pharmacologic approaches to glycemic treatment: Standards of medical care in diabetes — Facilitating behavior change and well-being to improve health outcomes: Standards of medical care in diabetes — Type 1 diabetes mellitus.
Mayo Clinic; Glycemic targets: Standards of Medical Care in diabetes — Comprehensive medical evaluation and assessment of comorbidities: Standards of Medical Care in Diabetes — Prevention or delay of type 2 diabetes and associated comorbidities: Standards of Medical Care in diabetes — Obesity and weight management for the prevention and treatment of type 2 diabetes: Standards of Medical Care in Diabetes — Diabetes technology.
Standards of Medical Care in Diabetes — See also News from Mayo Clinic Science Saturday: Mayo Clinic study indicates U. rural counties have higher diabetes-related deaths Nov.
Your doctor will help you find the right type of insulin for your health needs. When it comes to syringes, your doctor will advise on which capacity you need based on your insulin dose.
In general, smaller capacity syringes can be easier to read and draw an accurate dose. Here are some tips:. The onset is how long it takes for the insulin to start lowering your blood glucose.
If you need a mix of two types, you can talk to your doctor about getting a premixed supply. Rapid-acting insulin begins to work about 15 minutes after injection, peaks in about 1 hour, and continues to work for 2 to 4 hours. Regular or short-acting insulin usually reaches the bloodstream within 30 minutes after injection, peaks anywhere from 2 to 3 hours after injection, and is effective for approximately 3 to 6 hours.
Intermediate-acting insulin generally reaches the bloodstream about 2 to 4 hours after injection, peaks 4 to 12 hours later, and is effective for about 12 to 18 hours. Long-acting insulin reaches the bloodstream several hours after injection and tends to lower glucose levels fairly evenly over a hour period.
Learn more about insulin. Find out more about the side effects of insulin and the side effects of metformin. The fastest way to treat high blood sugar levels is with insulin. If someone has dangerously high blood sugar levels — and are in DKA or HHS — they will need to go to hospital where insulin, replacement fluids and nutrients will be given by an intravenous drip.
If you notice symptoms of low blood sugar levels known as a hypo the fastest way to treat this is to immediately eat or drink 15 to 20g of fast-acting carbohydrate.
Find out what to do if someone is having a severe hypo. We know people with type 2 diabetes who are living with overweight or obesity can manage their blood sugar levels effectively and quickly by losing weight following a very low-calorie diet. They should do this with support from their healthcare team.
In some cases they may be able to put their diabetes into remission. Find out about low calories diets for people with type 2 diabetes on the NHS to help rapid weight loss. We know people can put their type 2 diabetes into remission by losing weight.
It can be life-changing, but it's not possible for everyone. And it is not a cure.
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