Type 2 Diabetes Prevention
Adopting a healthy lifestyle can help you lower your risk of diabetes.
- Lose weight. Dropping just 7% to 10% of your weight can cut your risk of type 2 diabetes in half.
- Get active. Thirty minutes of brisk walking a day will cut your risk by almost a third.
- Eat right. Avoid highly processed carbs, sugary drinks, and trans and saturated fats. Limit red and processed meats.
- Quit smoking. Work with your doctor to keep from gaining weight after you quit, so you don’t create one problem by solving another.
What Diabetes Medicines Are There
There are many medicines that can help take care of type 2 diabetes. Each medicine works in a different way to take care of blood sugar levels. How you take the medicine and how often you take it is different for each medicine. Each medicine can also have side effects.
Health professionals are very familiar with these medicines. There is lots of good research to show the best way to use these medicines.
Metformin is the first medicine most people take for type 2 diabetes.
Many people will also need extra medicines to help. They are:
Read on to learn more about these medicines. You can also type the name of your medicine into our Medicine Finder to find out more.
Monitoring For Diabetic Complications
The ADA recommends initiation of complications monitoring at the time of diagnosis of diabetes mellitus. This regimen should include yearly dilated eye examinations, annual microalbumin checks, and foot examinations at each visit.
A study by Cigolle et al found that middle-aged and older adults with diabetes have an increased risk for the development of geriatric conditions . These conditions substantially contribute to morbidity and functional impairment. The authors concluded that adults with diabetes should be monitored for the development of geriatric conditions at a younger age than was previously considered.
The risk for early development of Parkinson disease is 36% higher in patients with diabetes mellitus. However, a systematic review from Cereda et al found no conclusive evidence of this association.
A high overall risk for pancreatic neoplasm is noted in individuals with diabetes mellitus, particularly in those aged 45-65 years.
The incidence of complications widely vary among the Asian subgroups, suggesting the need for an ethnic stratified nuanced approach in evaluation and surveillance. One size does not fit all.
Also Check: What Are The Early Signs Of Type 2 Diabetes
Joint Consensus Statement On Remission
In a 2021 joint consensus statement from the American Diabetes Association, the Endocrine Society, the European Association for the Study of Diabetes, and Diabetes UK, the term remission, as it applies to type 2 diabetes, is defined as the presence of an HbA1c level below 6.5% at least 3 months after glucose-lowering pharmacotherapy has been halted. This applies whether the remission has been achieved by way of lifestyle, bariatric surgery, or other means.
When To Contact A Doctor
If a person experiences persistent side effects from taking diabetes medication, they should make an appointment with a doctor. A doctor may be able to adjust a persons medication or dose to reduce or eliminate adverse effects.
If a person feels very unwell after taking a medication, they should contact a doctor immediately. In rare cases, people can have a severe reaction to a medication. If a person has trouble breathing, collapses, has a seizure, or is unresponsive, someone near them should call 911.
A person must always wear a diabetic identification bracelet to ensure they get the correct treatment in an emergency.
Read Also: Why Do Diabetics Need Insulin
Cost Saving Tips For Diabetes Medications
How Do They Work
There are different types of noninsulin medicines for diabetes. Each type works in a different way to help you control your blood sugar. For example, some types of noninsulin medicines help your body make insulin to lower your blood sugar. Others lower how much insulin your body needs. Some types can slow how quickly your body digests sugars or can remove extra glucose through your urine.
Also Check: What Are The Signs Of Diabetic Kidney Disease
What Should You Know About Side Effects
All medicines can cause side effects. Many people don’t have side effects. And minor side effects sometimes go away after a while.
But sometimes side effects can be a problem or can be serious.
If you’re having problems with side effects, talk to your doctor. Your doctor may be able to lower your dose or change to a different medicine.
Always be sure you get specific information on the medicine you’re taking. For a full list of side effects, check the information that came with the medicine you’re using. If you have questions, talk to your pharmacist or doctor.
Before Taking This Medicine
You should not use metformin if you are allergic to it, or if you have:
severe kidney disease or
metabolic acidosis or diabetic ketoacidosis .
If you need to have surgery or any type of x-ray or CT scan using a dye that is injected into your veins, you may need to temporarily stop taking metformin. Be sure your caregivers know ahead of time that you are using this medication.
Tell your doctor if you have ever had:
high ketone levels in your blood or urine
if you also use insulin, or other oral diabetes medications.
You may develop lactic acidosis, a dangerous build-up of lactic acid in your blood. This may be more likely if you have other medical conditions, a severe infection, chronic alcoholism, or if you are 65 or older. Ask your doctor about your risk.
Follow your doctor’s instructions about using metformin if you are pregnant or you become pregnant. Controlling diabetes is very important during pregnancy, and having high blood sugar may cause complications in both the mother and the baby. Tell your doctor if you become pregnant while taking metformin.
Metformin may stimulate ovulation in a premenopausal woman and may increase the risk of unintended pregnancy. Talk to your doctor about your risk.
You should not breastfeed while using this medicine.
Metformin should not be given to a child younger than 10 years old. Some forms of metformin are not approved for use by anyone younger than 18 years old.
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Type 1 Diabetes Medication
The medication insulin is always needed in type 1 diabetes . This is because, with this disease, the immune system destroys insulin-producing beta cells in the pancreas. Without insulin as an escort, glucose in the bloodstream cant get into the cells and remains stuck in the bloodstream. Too much glucose in the bloodstream is called hyperglycemia, a dangerous health condition with many negative consequences. People who have type 1 diabetes must take insulin to survive.
Important information about insulin:
- It can be taken just once a day or several times per day depending on the individual.
- Some insulin medication is rapid-acting, working immediately.
- Other insulin is long-acting, working more slowly but lasting longer.
- Insulin can be injected with needles via syringe or pen.
- It can also be delivered with an insulin jet injector that sprays the medication into the body using high-pressure air rather than a needle.
- Some people use an insulin pump, a small machine connected to a small tube and needle that delivers insulin when needed.
What Are The Best Drugs To Treat Diabetes
Here are the Top 10 medications in terms of efficacy for lowering A1C and blood sugar levels.
Diabetes is a serious condition that is brought on by decreased insulin secretion from the pancreas and diminished insulin sensitivity in the muscle cells. It is characterized by excessive urination, extreme thirst, high blood sugar, and increased appetite.1
There are a number of medications on the market to help manage this condition, but the following are the top 10 in terms of showing efficacy in lowering A1C and blood sugar levels.
Patients with type 1 diabetes must be treated with insulin, as the beta cells in their pancreas no longer produce it. Insulin plays a vital role in glucose uptake and is required by the muscle and adipose tissue.2 However, insulin is not solely for patients with T1D those with type 2 diabetes may also be placed on insulin but generally only after failing to reach glycemic targets upon being placed on multiple oral agents for some time. Patients with diabetes typically receive multiple injections per day, including bolus insulin administered before meals and the long-acting basal insulin that lowers blood sugar levels over time. Insulin is classified as a high-risk drug because it can cause patients to experience hypoglycemia, but the benefits of this treatment surely outweigh the risks.2
The most common insulins I see prescribed in my daily practice are Basaglar and NovoLog .
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Type 2 Diabetes Diagnosis And Tests
Your doctor can test your blood for signs of type 2 diabetes. Usually, theyâll test you on 2 days to confirm the diagnosis. But if your blood glucose is very high or you have many symptoms, one test may be all you need.
- A1c. It’s like an average of your blood glucose over the past 2 or 3 months.
- Fasting plasma glucose. This is also known as a fasting blood sugar test. It measures your blood sugar on an empty stomach. You won’t be able to eat or drink anything except water for 8 hours before the test.
- Oral glucose tolerance test . This checks your blood glucose before and 2 hours after you drink something sweet to see how your body handles the sugar.
Even If Youre Managing Your Blood Sugar Youre Still At Risk For Heart Failure Hospitalization
Damage from type 2 diabetes can cause heart failure. A type of heart failure happens when the heart is weak and cannot pump enough blood to the rest of the body. This can get worse over time and can lead to hospitalization. Do you have type 2 diabetes and heart disease or other CV risk factors?These additional factors put you at greater risk for landing in the hospital from heart failure:
- High cholesterol
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What Is Type 2 Diabetes
Type 2 diabetes is a chronic disease where the bodys ability to use glucose or sugar as fuel is impaired. Our bodies produce a hormone called insulin which enables sugar from carbohydrates in food we eat to reach the cells and be used as energy. In type 2 diabetes, insulins ability to do its job is compromised, and over time the body actually produces less of it. This means less sugar in the cells for fuel, and more sugar in the blood where it cant be used. Having high levels of blood sugar over time can cause damage to vital organs like the heart, kidneys, nerves, and eyes.
Some risk factors that predispose people to developing type 2 diabetes, such as genetics and age, are not modifiable. Other risk factors, such as being overweight or having obesity, can be altered. This is why losing 5% to 10% of ones baseline weight by healthful eating and physical activity remains the backbone of type 2 diabetes management.
Management Of Coronary Heart Disease
There is contradictory epidemiologic evidence as to whether diabetes is in fact a CHD risk equivalent. For the present, however, that is the position adopted by most groups, such as the National Cholesterol Education Program and the ADA.
Although the risk for CHD is 2-4 times greater in patients with diabetes than it is in individuals without diabetes, control of conventional risk factors is probably more important in event reduction than is glycemic control. Control of hypertension, aspirin therapy, and lowering of LDL cholesterol levels are vitally important in reducing CHD risk.
Also Check: What Can Lead To Type 2 Diabetes
Comparison Of Oral Antidiabetic Agents
In 2007, the AHRQ compared the effectiveness and safety of oral diabetes medications for adults with type 2 diabetes, with a 2011 update. The AHRQ found little evidence to support predictions as to whether a particular medication is more likely to be effective in a given patient subgroup or to cause adverse effects in a particular patient.
The AHRQ concluded that although the long-term benefits and harms of diabetes medications remain unclear, the evidence supports the use of metformin as a first-line agent. On average, monotherapy with many of the oral diabetes drugs reduces HbA1c levels by 1 percentage point , and 2-drug combination therapies reduce HbA1c about 1 percentage point more than do monotherapies.
Other AHRQ findings included the following:
Metformin decreased LDL cholesterol levels relative to pioglitazone, sulfonylureas, and DPP-4 inhibitors
Unfavorable effects on weight were greater with TZDs and sulfonylureas than with metformin
Risk of mild or moderate hypoglycemia was 4-fold higher with sulfonylureas than with metformin alone this risk was more than 5-fold higher with sulfonylureas plus metformin than with a TZD plus metformin
Risk of heart failure was higher with TZDs than with sulfonylureas
Risk of bone fractures was higher with TZDs than with metformin
Diarrhea was more common with metformin than with glitazones.
If Your Body Weight Goes Down Or Your Level Of Physical Activity Goes Up You May Find The Medication You Are On For Blood Glucose Or Blood Pressure Will Need To Be Reduced
Recent research has proved that having healthy blood glucose and blood pressure levels greatly reduces the chance of you getting diabetes complications. Developing the complications of diabetes is a process. If you have the early signs of diabetes complications, achieving healthy blood glucose and blood pressure levels may slow down or even halt the progress.
Sometimes people feel as though they have failed in their diabetes management if they need to go onto medication. However, Type 2 diabetes is a process. Virtually everyone with Type 2 diabetes at some stage needs medication to help them manage their diabetes.
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Other Medications That Lower The Risk Of Cardiovascular Disease
Type 2 diabetes increases the risk of cardiovascular disease. People with diabetes often have other risk factors as well, like high blood pressure. It is then quite likely that treating those other factors with medication may lower the risk of a heart attack or stroke more effectively than keeping blood sugar levels down. The main types of medication are:
- Blood-pressure-lowering drugs
- Statins for lowering
All of these medications can have side effects and also interact with other medications. So it’s important to talk to your doctor before taking any of them. This is also true for any over-the-counter medicine that you take.
The United Kingdom Prospective Diabetes Study
The care of patients with type 2 diabetes mellitus has been profoundly shaped by the results of the United Kingdom Prospective Diabetes Study . This landmark study confirmed the importance of glycemic control in reducing the risk for microvascular complications and refuted previous data suggesting that treatment with sulfonylureas or insulin increased the risk of macrovascular disease. Major findings of the UKPDS are displayed in the images below.
Significant implications of the UKPDS findings include the following:
Microvascular complications are reduced by 25% when mean HbA1c is 7%, compared with 7.9%
A continuous relationship exists between glycemia and microvascular complications, with a 35% reduction in risk for each 1% decrement in HbA1c a glycemic threshold below which risk for microvascular disease is eliminated does not appear to exist
Glycemic control has minimal effect on macrovascular disease risk excess macrovascular risk appears to be related to conventional risk factors such as dyslipidemia and hypertension
Sulfonylureas and insulin therapy do not increase macrovascular disease risk
Metformin reduces macrovascular risk in patients who are obese
Vigorous blood pressure control reduces microvascular and macrovascular events beta blockers and angiotensin-converting enzyme inhibitors appear to be equally effective in this regard
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Type 2 Diabetes Complications
Over time, high blood sugar can damage and cause problems with your:
- Heart and blood vessels. Youâre up to five times more likely to get heart disease or have a stroke. Youâre also at high risk of blocked blood vessels and chest pain .
- Kidneys. If your kidneys are damaged or you have kidney failure, you could need dialysis or a kidney replacement.
- Eyes. High blood sugar can damage the tiny blood vessels in the backs of your eyes . If this isnât treated, it can cause blindness.
- Nerves. This can lead to trouble with digestion, the feeling in your feet, and your sexual response.
- Skin. Your blood doesnât circulate as well, so wounds heal slower and can become infected.
- Pregnancy. Women with diabetes are more likely to have a miscarriage, a stillbirth, or a baby with a birth defect.
- Sleep. You might develop sleep apnea, a condition in which your breathing stops and starts while you sleep.
- Hearing. Youâre more likely to have hearing problems, but itâs not clear why.
- Brain. High blood sugar can damage your brain and might put you at higher risk of Alzheimerâs disease.
- Depression. People with the disease are twice as likely to get depressed as people who donât have it.
The best way to avoid these complications is to manage your type 2 diabetes well.
- Take your diabetes medications or insulin on time.
- Eat right, and don’t skip meals.
- See your doctor regularly to check for early signs of trouble.