Type 2 Diabetes Treatment: Insulin, Medication & More

by John Staughton (BASc, BFA) last updated - Medically reviewed by Tamanna Sayed (B.Sc. Applied Nutrition)

India ranks second amongst the diabetes capital of the world with approximately 69.2 million patients with diabetes being in the age group of 20-79 years. It is observed that diabetes amongst the Indians occurs early, commonly striking the younger age group. Worse still to observe is that the disease remains undiagnosed for several years, and by the time the diagnosis is done and treatment begins, complications have already set in. Also, the medication and hospitalization costs are high and are borne by individuals from their family incomes. Let us understand what type 2 diabetes is and its treatment options available in this article.

What is Type 2 Diabetes?

Diabetes is one of the most critical health concerns in modern history. This condition also affects millions of people across the world. Type 2 diabetes mellitus is a condition wherein a person is unable to regulate their blood sugar levels as a result of the inability of the pancreas to produce sufficient insulin. It is either that or the body is unable to properly utilize the insulin that is being produced, also known as insulin resistance.

This results in high blood sugar, which can lead to blurred vision, increased thirst, and hunger, weight gain, cognitive confusion, and fatigue. Long-term effects of type 2 diabetes include diabetic retinopathy, kidney disease, and a shortened life span. [1]

As this disease affects so many people around the world, there are a wide variety of type 2 diabetes treatments and preventative measures available. In a developing country like India, it becomes imperative that the general physicians are well equipped to handle the burden and complications of this disease in a better way.

Treatment measures can help in lowering the risk of developing this condition, as well as managing the symptoms if you have been diagnosed.

Type 2 Diabetes Treatments

Some of the best type 2 diabetes treatments are medications, insulin injections, and bariatric surgery. These are generally considered more formal and involve a doctor’s advice, while others can easily be administered or practiced at home to improve your quality of life and keep you healthy.

Diabetes Medication

There are quite a few options when it comes to diabetes medication, a choice many people make, particularly if they don’t require insulin injections every day.

  • Sulfonylureas: Diabetes medications called sulfonylureas can increase the amount of insulin the body produces, countering the diminishing effects of insulin resistance. The adverse effects include weight gain and hypoglycemia. Caution should be exercised in patients with liver or kidney dysfunction or in people who often skip their meals.
  • Glinides: These classes of medicines have a similar mode of action like the sulfonylureas but have a more rapid onset of action and are of a shorter duration. Hence, they are considered to be an apt choice for people with erratic meal timings. Caution should be carried out in people with liver ailments.

Metformin

Metformin is an oral anti-diabetic drug in the biguanide class for the treatment of Type-2 diabetes mellitus. It is in particular used in overweight and obese people and those with normal kidney function. The use of metformin is associated with less weight gain as compared to insulin and sulfonylureas. [2]

It allows the body to appropriately use the insulin it is already producing. Benefits of metformin include decreased hyperinsulinemia, weight reduction, and improved lipid profile. The use of metformin like any other drug has its safety concerns. However, its advantages and recent research that highlight the nephroprotective activity have compelled the researchers to use this drug more and more often in the insulin-resistant population even before the onset of hyperglycemia.

Other options, such as DPP-4 inhibitors will lower blood sugar levels to put less strain on the pancreas, or perhaps slow down digestion to give the body more time to process the food. All of these medications have their side effects and should be compared carefully with the help of a doctor, based on your particular needs and lifestyle habits.

Insulin Injections

Some people with more severe forms of type 2 diabetes require regular or daily injections of insulin. This delivers the necessary insulin directly into the bloodstream. It tends to have fewer side effects than the oral medications listed above and is relatively easy to administer. Also, it is important to note that insulin cannot be ingested. So, when the body cannot produce enough insulin, as in type 1 diabetes, it has to be injected. Some people dislike the idea of injecting themselves every day for the rest of their lives, but in many cases, this will have fewer negative health effects and is widely prescribed around the world for diabetic patients. [3]

Insulin should be advocated when A1C is > 7.0%after initiation of dual oral therapy. The preferred regimen for insulin therapy is in type 2 diabetes is basal insulin once daily. [4]

Bariatric Surgery

In terms of type 2 diabetes treatments, bariatric surgery also treats one of the major symptoms, which is excessive weight gain. Extensive research supports the use of bariatric surgery in type 2 diabetic patients whose body mass index (BMI) is 35 kg /m2 or higher. [5]

This surgery can also help blood glucose levels return to normal if the small intestine is shortened, reducing the potential uptake of sugar and putting less strain on the pancreas’ production of insulin. However, there are always risks attached to going under the knife, so this surgery is often seen as a last resort.

In most of the obese cases with type 2 diabetes, about more than three- fourth in particular, bariatric surgery has resulted in diabetes remission (also known as normoglycaemic control that does not require the use of medications).

However, data on the effects of this surgery also varied amongst the type of method used in the procedure. More randomized trials are warranted comparing the types of therapy and the various types of bariatric surgery in diabetes patients with less-complex obesity.

Natural Type 2 Diabetes Treatments

For those who are only at risk of diabetes, or want to treat their symptoms more naturally, there are plenty of home remedies and natural type 2 diabetes treatments to choose from. They include changing the exercise habits, losing weight, altering the diet and making key lifestyle changes.

Physical Activity

Staying active is a key component of fighting off type 2 diabetes and lowering your risk of spiking blood sugar. Even 30 minutes of physical activity each day, just enough to raise your heart rate, will lower your blood sugar levels and prevent the effects of a sedentary lifestyle. This will help your body’s metabolism increase, prevent excessive weight gain, and reduce the levels of stress hormones in your body. All of these are linked to reduced symptoms of diabetes. If you are obese and struggling to undergo physical activities or getting to the gym, try low-impact exercises like swimming or biking, or simply go for a walk around the block a few times every day. Overweight patients with prediabetes as well should try and achieve a 7 percent loss of initial body weight and increase moderate-intensity physical activity (such as brisk walking) to at least 150 min/week. [6]

Monitoring Blood

If you want to control your blood sugar levels, it is essential to pay attention when they begin to change. Throughout the day, a type 2 diabetic person should check their blood sugar levels multiple times. This should be done particularly after a large meal, to ensure that the blood sugar isn’t climbing. If you find that it is, you can take immediate steps to suppress your blood sugar or stimulate your insulin production. Furthermore, you will learn a bit more about your dietary boundaries, helping to prevent spikes in glucose levels in the future. [7]

Self-monitoring blood glucose levels (SMBG) is an effective tool to evaluate short-term glycaemic control by providing a more actual estimate of blood glucose levels. It helps patients as well as their health care providers to assess the effect of factors such as food, medications, stress and any kind of physical activity on blood glucose levels.

It is recommended for people with diabetes under the following conditions:

  • For patients with type 1 diabetes or insulin-dependent type 2 DM. Clinical trials have shown that SMBG plays an important role in helping patients refine and adjust insulin doses by monitoring for asymptomatic hypoglycemia as well as pre-prandial and postprandial hyperglycemia
  • Patients who are prone to ketosis / recurrent hypoglycemia
  • Hypoglycemia unawareness
  • Whenever rigid control is indicated as in conditions like pregnancy, acute illness, and complications.

Patients with diabetes are recommended to self – monitor their glucose levels at least three times a day

Weight

Obesity is one of the most common factors in type 2 diabetes. Being overweight increases your risk of developing the condition significantly, and it is also a frequent side effect in those who have been diagnosed. Increasing obesity can further damage your body’s ability to regulate blood sugar by speeding up the long-term effects of this disease. Therefore, being conscious of your dietary intake and actively trying to keep your BMI at normal levels is important. [8]

Alcohol

It is important to remember that alcohol can have a rapid effect on your blood sugar since there are carbs in beverages like beer and wine coolers. These natural sugars are needed to be handled by insulin, just like the carbs in your food. Before you go out for a drink, check your blood sugar, and don’t overdo it in terms of consumption. [9]

Chronic heavy consumption of alcohol has a detrimental effect on metabolic control and may even be related to impaired glucose tolerance (i.e. a combination of impaired insulin secretion and reduced insulin sensitivity or insulin resistance).

The B- cells of the islets of the pancreas increase the release of insulin to overcome the reduced efficiency of insulin. Thereby maintaining normal glucose tolerance. However, excessive alcohol intake disrupts the process resulting in glucose intolerance, a transition phase between normal glucose tolerance and diabetes, also referred to as pre-diabetes.

Alcohol can also increase your weight due to the surprisingly high amount of calories it contains, so be conscious about staying within your calorie limits.

  • For men: No more than 2 drinks per day.
  • For women: No more than 1 drink per day.
  • For people over 65 years: No more than 1 drink per day.

Smoking

The short and long-term effects of diabetes include many different bodily systems, from your vision to the integrity of your blood vessels. Smoking can also exacerbate many of these symptoms and secondary health conditions. Nicotine has been shown to directly alter glucose homeostasis suggesting an important role in the development of type 2 diabetes mellitus. Glucose homeostasis is a process by which blood glucose levels are maintained by the body with the help of hormones like insulin and glucagon in a rigid manner. [10]

By eliminating smoking, you will lessen the speed at which diabetic symptoms will appear. Cutting out smoking will also make it easier for you to exercise, stay in shape and lose weight.

Stress

When you are anxious or stressed for an extended period, it will cause inflammation in the body, and demand resources and energy that the body simply cannot afford. This can make your diabetic symptoms even worse, and lead to weight gain, a poor diet, and the use of alcohol and tobacco. All of these are negative indicators for type 2 diabetes. [11]

Dietary Changes

As you know, most of the sugar in your body comes from carbohydrates, so they will always play an important role in your diet as basic fuel. However, there are more complex carbohydrates, such as those you find in beans, legumes, whole grains, fruits, and vegetables. These carbohydrates will be digested slowly by the body, giving the pancreas enough time to keep up with insulin production. Do your best to avoid simple sugars, such as those found in white bread, snack foods, and pastries. Also, increase your fiber intake, as it is known to regulate the levels of insulin and glucose in the body. Lean meats and those containing good fats (omega-3 etc.) are highly recommended. [12]

People with diabetes should aim to drink a minimum of 10- 12 glasses of water every day. High blood sugar levels compel the kidney to eliminate some of the excess sugars through increased urination. Hyperglycaemia may, therefore, increase the risk of dehydration. Be watchful of the carbohydrate intake of the beverages chosen. Beverages such as juices, sports drinks, and carbonated drinks can exacerbate hyperglycemia. [13]

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About the Author

John Staughton is a traveling writer, editor, publisher and photographer with English and Integrative Biology degrees from the University of Illinois in Champaign-Urbana (USA). He co-founded the literary journal, Sheriff Nottingham, and now serves as the Content Director for Stain’d Arts, a non-profit based in Denver, Colorado. On a perpetual journey towards the idea of home, he uses words to educate, inspire, uplift and evolve.

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