In order to treat your type 2 diabetes, you need to monitor your blood sugar, eat healthy, get regular exercise, and oftentimes take medication or insulin therapy. If you are committed to doing these steps, you can delay or prevent complications and stabilize your blood sugar levels.
Blood Sugar Monitoring
One of the primary ways to treat type 2 diabetes is by monitoring your blood sugar. This is done by measuring and recording your blood sugar once a day or several times a week, depending on your doctor’s counsel. This is done to ensure that your glucose levels are within a healthy range.
Your blood sugar levels can change in response to:
Food- The foods you eat determine low or high blood sugar. Blood sugar is generally high for type 2 diabetics 1 to 2 hours after a meal.
Physical activity- Exercise increases insulin sensitivity, uses your glucose, and lowers your blood sugar.
Medication- Diabetes medications may be needed to help control your blood sugar. Consult with your doctor about which medications will help stabilize your glucose levels.
Alcohol- Alcohol intake can cause high or low blood sugar, depending on how much you consume and what you eat while drinking.
Stress- If you experience high stress for a long duration, the hormones secreted can prevent insulin from working properly.
Illness- During an illness, your body may produce hormones that raise your blood sugar levels.
Female Hormone Changes- In women, hormone fluctuation during menstrual cycles can disrupt stable blood sugar levels, especially in the week before your period. Menopause can also cause a change in blood sugar.
There is no actual diabetes diet—there’s not a “one diet fits all” type of regimen that all doctors prescribe for type 2 diabetics. Each diet is individual, but you do need to make sure that you’re eating enough fruit, vegetables, and whole grains. To keep your blood sugar within your target range, lower your intake of refined carbohydrates, refined sugars and animal products. Also eat low-glycemic foods such as foods that are high in fiber.
The most important factor of maintaining a healthy diet is consistency. Work with a registered dietitian to make a meal plan and have your meals at the same time every day with the same amount of carbohydrates, proteins, and fats.
For treating your diabetes and possibly reversing it, regular exercise is key. However, ask your doctor before you start an exercise program. Incorporate physical activity into your daily routine with at least 30 minutes most days of the week. This physical activity should be mostly aerobic exercise, but strengthening and stretching are important as well. Build up the intensity of your workouts gradually—don’t start out with routines that are too difficult. Make sure to do exercises you enjoy! Check your blood sugar before exercising. If it’s low, eat a snack before and after your activity.
Medication and Insulin
When type 2 diabetes medication or insulin therapy are prescribed, they are intended to supplement exercise and healthy eating to treat type 2 diabetes—not replace them. Your doctor may combine different medications to help control your blood sugar. The type of medication you’re prescribed largely depends on your blood sugar levels and any other health problems you may have.
Many type 2 diabetics are prescribed metformin (Glucophage, Glumetza, others), which is a diabetes medication that improves insulin sensitivity and lowers glucose production in the liver. When metformin is not enough to control your glucose level, your doctor may prescribe other medications, either to be taken orally or through injection. Some diabetes medications stimulate the pancreas to produce and release more insulin while others block enzymes that break down carbs in the intestine or make tissues more sensitive to insulin.
Oral drugs besides metformin include sitagliptin (Januvia), saxagliptin (Onglyza), repaglinide (Prandin) and nateglinide (Starlix). New type 2 diabetes medications that are injected include Exenatide (Byetta) and Liraglutide (Victoza).
If recommended by your doctor, insulin therapy is another way you can treat your type 2 diabetes. Insulin is taken through injections using a fine needle and syringe or insulin pen injector. This injector is a device that looks similar to an ink pen, except it is filled with insulin instead of ink. There are many different kinds of insulin including fast-acting, long-acting and intermediate forms. Some insulin medications include insulin lispro (Humalog), insulin aspart (Novolog), insulin glargine (Lantus), insulin detemir (Levemir) and insulin isophane (Humulin N, Novolin N).
Women who have type 2 diabetes will most likely need to change treatment during pregnancy. No study has proven metformin is safe for pregnant women, so you will be advised not to take it while pregnant. Because of this, you will be moved from oral medication to injected insulin. You also may have to stop blood pressure or cholesterol-lowering medication during pregnancy. If have you have diabetic retinopathy, it may worsen from pregnancy. Visit the ophthalmologist during your first trimester or one year postpartum.
Trouble with Treatment
If you have any of the following, see your doctor immediately. If left untreated, these conditions may lead to seizures and comas.
High blood Sugar (Hyperglycemia)
Your blood sugar may rise for many different reasons including being ill, not taking a large enough dose of glucose-lowering medication, or eating too much. Check your blood sugar often to measure if you are running high. You may have high blood sugar if you experience frequent urination, heightened thirst, dry mouth, blurred vision, nausea, or fatigue.
Increased Ketones in the Urine (Diabetic Ketoacidosis)
Your body may begin to break down fat if your cells are not getting the energy they need. This breakdown creates toxic acids or ketones. Symptoms of this include weakness, loss of appetite, fever, stomach pain, vomiting, or fruity-smelling breath. You can check your urine for an increase in ketones with an over-the-counter ketone test kit from a local grocery store or pharmacy. If you are high in ketones, see your doctor immediately.
Hyperglycemic Hypersmolar Nonketotic Syndrome (HHNS)
You may have HHNS if your blood sugar reading is higher than 600 mg/dL (33.3 mmol/L), or if you have a fever, extreme thirst, dry mouth, confusion, hallucinations, or dark urine. HHNS is a life-threatening condition caused by extremely high blood sugar that makes your blood thick and even syrupy. HHNS typically occurs in older people with type 2 diabetes, normally following an illness. It can develop over days or weeks. Go to urgent care if you are experiencing the symptoms of HHNS.
Low Blood Sugar (Hypoglycemia)
Low blood sugar occurs when your blood sugar drops below your target range. Your blood sugar can drop from skipping a meal or exercising more than normal, but it is most likely from glucose-lowering medication that makes your body secrete insulin. Watch for sweating, shakiness, hunger, dizziness, slurred speech, confusion, heart palpitations, headache, or blurred vision. If you have nighttime hypoglycemia, you may wake up sweaty or with a headache. Nighttime hypoglycemia may cause a very high blood sugar reading in the morning, so pay close attention to those first-in-the-morning blood sugar calculations.
To combat moments of low blood sugar, eat or drink high-glucose foods like hard candy, soda, fruit juice, or another source of sugar. Fifteen minutes after eating this sugar, retest your blood glucose levels and to see if they’re back to normal. If they’re not, eat more sugar and retest in another 15 minutes. If you lose consciousness, a loved one may need to give you an emergency injection of glucagon. This hormone prompts a sugar release into the bloodstream.