Diabetes > Diabetes Treatments > Treating Type 2 Diabetes

Treating Type 2 Diabetes

Treatment of type 2 diabetes typically includes eating a healthy diet, taking regular exercise and losing weight if you are overweight or obese, and home blood glucose testing.

People who have type 2 diabetes must take good care of their health for the rest of their life. As soon as you are diagnosed with this type of diabetes you should put together a treatment plan with the help of a qualified diabetes care team.

These measures will help regulate your blood glucose levels. However, over time your condition may get worse and you may find that diet and exercise are not enough to keep your blood glucose at a healthy level. In this case, you will be given oral medication and/or insulin. Approximately 40% of people with type 2 diabetes require insulin injections.

What medicines are used to treat type 2 diabetes

There are several different types of oral (tablet) medicines that are used to help type 2 diabetics lower the level of sugar in their blood and maintain this level. You may be asked to take a combination of two or more of these glucose-lowering medicines.

Metformin

In the UK, doctors usually start by prescribing metformin to treat type 2 diabetes. Metformin helps the body to control blood sugar in several ways. It lowers the amount of glucose that your liver sends into your bloodstream, makes the cells in your body more responsive to insulin and decreases the amount of sugar absorbed by the intestines.

This type of medicine is often recommended for people with diabetes who are overweight as it is unlikely to cause weight gain, unlike some other type 2 diabetic drugs. However, it may cause weight gain if taken in conjunction with insulin or a sulfonylurea, and can also cause mild side effects such as nausea and diarrhoea.

Sulphonylureas

Sulphonylureas are glucose lowering medicines that increase insulin production in the pancreas. They may be prescribed as a single treatment for diabetics who cannot take metformin and are not overweight, or they may be taken in conjunction with metformin. Because sulphonylureas boost the amount of insulin in your body they can increase the risk of Hypoglycemia (low blood glucose). Other possible side effects include weight gain, nausea and diarrhoea.

Exenatide

Exenatide is an injectable drug that mimics the action of the naturally occurring hormone GLP-1, i.e. it helps to lower high blood glucose levels by boosting the production of insulin in the pancreas. It also helps reduce appetite which often results in a modest weight loss.

Exenatide is mainly prescribed to patients with type 2 diabetes who cannot achieve stable blood glucose through the use of metformin, or metformin and sulphonylurea. Side effects can include nausea, diarrhoea, headache and stomach pain.

Other medicines for type 2 diabetes

Other medicines for type 2 diabetes include:

Glitazones (thiazolidinediones, TZDs)

These medicines work by making your body’s cells more reactive to insulin so that the insulin works effectively in moving glucose from your blood to your cells. They are usually used alongside metformin or sulphonylureas, or both. Possible side effects include weight gain and ankle swelling.

Gliptins (DPP-4 inhibitors)

Gliptins work by preventing the rapid breakdown of a hormone called GLP-1, which naturally occurs when there is too much glucose in your blood and helps boost the production of insulin in your body.

These relatively new drugs may be taken in conjunction with metformin or sulphonylureas to help bring blood glucose under control.

Acarbose

This medicine prevents your level of blood glucose from rising too much after eating a meal. It does this by slowing down the speed at which the carbohydrates from your food are broken down into glucose by your digestive system. Acarbose causes bloating and diarrhoea which is why it is normally only prescribed to help treat people with type 2 diabetes if they are unable to take other types of diabetes drugs.

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