Diabetes: An Overview

Diabetes Treatment

How do you Treat Diabetes?

For all types of diabetes, the focus of treatment is to manage blood glucose levels to avoid diabetic complications. Generally, the goal is to keep daytime glucose levels between 80 and 120 milligrams per deciliter (mg/dL) and bedtime levels between 100 and 140 mg/dL. Type 1 diabetes treatment involves the use of insulin, dietary controls, exercise and weight control.^[12] If you have type 2 diabetes, your doctor is likely to see if you can control blood glucose levels through diet, exercise and weight control as a first step.^[13] It may be necessary, however, to control glucose levels with medicine.

Type 1 Diabetes

The use of insulin is essential for control of type 1 diabetes.^[12] There are numerous types of insulin ranging from rapid-acting to long-acting forms. Your doctor may recommend a mixture of these types of insulin. Insulin can not be taken orally. Insulin may be injected instead using a needle and syringe or an insulin pump. An insulin pump is a small pump worn on the outside of the body that carefully injects rapid-acting insulin.

Other forms of medicine may be necessary including pramlintide (Symlin), an injection taken before eating, low-dose aspirin to prevent heart disease, high blood pressure medicines and cholesterol-lowering statins.

With respect to diet, you will need to control caloric intake, avoid fatty foods and sweets and eat more fruits, vegetables, and whole grains. You will also need to learn to manage how much carbohydrates you eat. A dietitian can help you design a meal plan, plus you can find handy recipes in this article to help you manage sweets and calories.

Exercise is important, but check with your doctor before starting an exercise program to make sure you're healthy enough. Pick activities you enjoy when exercising. Be sure to make them a regular part of your daily activities. Try to exercise at least 30 minutes most days of the week. You will need to carefully monitor your glucose levels when you exercise.

Type 2 Diabetes

Typically, the first steps to treat type 2 diabetes involve diet, exercise and weight control.^[13] If these steps are not adequate to control your blood sugar, then medicine will be necessary. One medicine may be enough; if not, you may need to take a combination of medicines. There are several medicines that can be taken orally in addition to injectable medicines. Drugs that can be taken orally include:

• Glipizide (Glucotrol). This medicine can cause low blood sugar and weight gain.

• Metformin (Fortamet, Glucophage and others). This medicine doesn't cause weight gain and may reduce LDL cholesterol (bad cholesterol) and triglycerides. It can cause diarrhea.

• Glimepiride (Amaryl). This can cause low blood sugar and weight gain.

• Rosiglitazone (Avandia). This drug may cause a slight increase in HDL cholesterol, the good cholesterol. It can cause swelling and weight gain and may lead to or worsen heart failure. It may increase LDL cholesterol and triglycerides and increase the risk of heart attack.

• Pioglitazone (Actos). This drug may decrease triglycerides and increase LDL cholesterol. It can cause swelling and weight gain. It may lead to or worsen heart failure.

• Sitagliptin phosphate (Januvia). This drug does not cause weight gain. It can cause upper respiratory tract infection, sore throat and diarrhea.

Injectable medicines for type 2 diabetes include:

• Pramlintide (Symlin). This medicine may promote weight loss. It can not be taken with other diabetes medicines and may cause nausea.

• Exenatide (Byetta). This drug may promote weight loss. It can cause nausea.

This Elder Health Guide was published on October 13, 2009 and was updated on October 28, 2009.