How Is Type 2 Diabetes Treated?

Jenna Fletcher
·7 min read

Medically reviewed by Do-Eun Lee, MD

Type 2 diabetes is a metabolic condition in which your pancreas does not process sugar properly, limiting your body’s ability to turn food into energy.

When your blood sugar rises after eating food, it signals your pancreas to create insulin. Insulin enables your body to convert this sugar into energy. If you have type 2 diabetes, your body either doesn’t make enough insulin or doesn’t process it correctly. This can lead to an excess of sugar in the blood that, over time, can lead to a variety of health conditions and concerns.

Type 2 diabetes often requires you to take an active role in your treatment. Treatment typically involves a combination of lifestyle changes, such as diet and exercise modifications, and taking medications, such as insulin. You will also likely need to take additional steps such as monitoring your blood sugar levels.

Lifestyle Changes

The primary treatment for type 2 diabetes is to make lifestyle changes. This mostly refers to modifications to your diet and exercise or activity levels.

Dietary changes, or changes to what you eat every day, can include:

  • Eating whole grains, vegetables, fruits, lean proteins, and healthy fats, like olive oil

  • Reducing the number of calories you consume each day, particularly if you are overweight or obese

  • Choosing water or low-calorie drinks over sugary soft drinks, juices, and sports drinks

Exercise plays another important part in lifestyle changes you can make. The American Heart Association (AHA) recommends getting at least 150 minutes of moderate cardio exercise (such as brisk walking) each week. This can break down into five days of 30-minute sessions.

You also do not have to choose traditional exercises like running on a treadmill or riding a stationary bike. You can get active through hiking, walking, playing a recreational sport, or other physically demanding activities.

The AHA also recommends two days of resistance training. This can include lifting weights, body weight exercises like push-ups, and working with fitness machines.



Balancing Medications With Lifestyle Changes

When you make changes to your diet and exercise, keep in mind it can affect your treatment regimen. For example, if you take insulin, sudden or drastic changes to either diet or exercise can affect how much you need. Keep your healthcare provider informed of your lifestyle changes so they can change your treatment as needed.



Changes in exercise and diet can affect your blood sugar levels. For example, a sudden increase in exercise and a decrease in caloric intake could lead to an unsafe drop in blood sugar levels.

Medications

Though diet and exercise changes can generally help everyone live a healthier life, you may also need to take medications to help manage your blood sugar levels. Taking medications does not mean you are not doing what you are supposed to, it just means you need a bit more help to keep you healthy.

Medications for type 2 diabetes come in two forms: oral and injectable.

Oral Medications

Oral medications are any medication you swallow with water or other drink. The majority of people living with type 2 diabetes will start with Glucophage (metformin). This medication helps your liver produce less glucose, which regulates your blood sugar. It also helps your body process insulin better.

Metformin is just one of many different types of type 2 diabetes medications that your endocrinologist (a medical doctor who specializes in the care of endocrine conditions such as diabetes) or healthcare provider may prescribe or recommend.

Other oral medications used to regulate blood sugar can include, but are not limited to, the following drugs:

  • Prandin (repaglinide)

  • Precose (acarbose)

  • Avandia (rosiglitazone)

  • Tradjenta (linagliptin)

  • Diabeta (glyburide)

  • Tolinase (tolazamide)

Injectable Medications

Injected medications are available to help treat type 2 diabetes. Injected medications require you to insert a needle into your arm or another area of the body to administer the medication.

Injected medications can help prevent your blood glucose from rising too high. They can either be glucagon-like peptide 1 (GLP-1) receptor agonists, or dual GLP-1 and gastric inhibitory polypeptide (GIP) receptor agonists (known as GLP-1/GIP). These medications help suppress your appetite and may help you lose weight.

Insulin

Because a hallmark of type 2 diabetes is either not making insulin or not processing it correctly, many people need to take it in the form of medication. However, not everyone living with type 2 diabetes will need insulin. You may also only need insulin at particular times, such as during pregnancy or when admitted to the hospital for treatment.

Insulin is typically injected. But you can also use it in different forms, such as:

  • Injection pen: Uses a needle to inject insulin into the subcutaneous tissue (the tissue between your muscle and your skin)

  • Pump: A computerized device that delivers insulin through a thin tube under the skin

  • Inhaler: A breathing device that allows you to inhale insulin

  • Jet injector: A syringe that quickly injects insulin into the subcutaneous tissue

There are several different types of insulin. Types are based on how quickly they start acting. The types include:

  • Rapid-acting/ultra rapid-acting: 15 minutes

  • Rapid-acting, inhaled: 10 to 15 minutes

  • Regular (also called short-acting): 30 minutes

  • Intermediate-acting: two to four hours

  • Long-acting: two hours

  • Ultra long-acting: six hours

Your healthcare provider will help you determine the best options for you.

If you take more insulin than you need or do not eat enough food, you can have a potentially dangerous drop in blood sugar levels. This can cause signs such as:

  • Shaking

  • Sweating

  • Hunger

  • Dizziness

  • Irritability or confusion

  • Fast heartbeat

  • Nervousness or anxiety

Finding the Right Treatment

Everyone responds differently to medications, which means you may not respond well to a particular medication or combination. This just means you will need to speak to your healthcare provider about making changes to your medications if they do not work for you.

Some possible reasons you may need to switch can include:

  • Your blood sugar levels are not under control.

  • You notice side effects when taking the medication.

  • You experience an allergic reaction.

You will need to take medications regularly, often for the remainder of your life, to help manage your blood sugar levels. It is important to take the medication as prescribed because taking too much can lead to unsafe drops in blood sugar levels, while taking too little can lead to spikes in blood sugar levels.

Living With and Managing Type 2 Diabetes

If you are living with type 2 diabetes, you can take several steps to help manage the condition. In addition to changes to diet and exercise, you may find that making the following changes can help:

  • Check your blood sugar levels regularly. This is particularly important if you take insulin, have a difficult time controlling your blood sugar levels, or do not have the regular signs or symptoms associated with too low or high blood sugar levels. You should follow your healthcare provider’s recommendations on when and how often you should check.

  • Schedule regular doctor appointments. Regular checkups can help you and your doctor better monitor your blood sugar levels, check for signs of complications, and provide overall better care.

  • Take steps to manage your stress. Stress can worsen blood sugar levels and cause potential other complications. Regular exercise, getting enough sleep, and learning relaxation techniques such as meditation, can be helpful for stress reduction.

  • Keep diabetes supplies on hand and in stock at home.

  • Take steps to learn more about your care and include family members and friends as much as possible.

  • Monitor your eyes, feet, and skin for signs of possible complications or issues.

  • Learn about your own signs and symptoms of high or low blood sugar levels and develop a plan of how to deal with it when it occurs.

  • Mental health care may help you cope with any related anxiety, depression, or stress related to treating a lifelong condition.

Frequently Asked Questions

The Benefits of Using a CGM

The biggest tool in my diabetes management toolkit is my continuous glucose monitor. I went from manually recording fingersticks—which was hard to maintain for accurate A1C readings—to being armed with so much more data. I was able to use the graphs to see patterns and make more informed decisions.

A Quick Review

Living with type 2 diabetes means you will likely need to make some lifestyle changes, take medications, and take an active role in your treatment to manage the condition. Medications, including insulin, can help you manage your blood sugar levels. Exercise and dietary changes can also play a major role in your treatment.

Along with these methods, you will likely find monitoring your blood sugar regularly, regular checkups with your endocrinologist or another healthcare provider, and managing your stress can help.

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