Treatment Overview
Your treatment for
type 2 diabetes will change over time to meet your
individual needs. But the focus of your treatment will always be to keep your
blood sugar levels within a
normal or near-normal range to prevent complications
from diabetes, such as eye, kidney, heart, blood vessel, and nerve disease. You
play an important role in managing your condition. By learning about diabetes
and working with your health professional to create a plan for treatment, you
can improve your health and quality of life.
How can you manage your diabetes?
Follow your diet
It is important to follow a
healthy, balanced diet that includes whole grains, lean meat, fish, and
vegetables. To help control your blood sugar and reduce your risk for
complications from diabetes, limit alcohol. And reduce calories if you need to
lose weight.
Of the three major nutrients (carbohydrate, protein,
and fat),
carbohydrate has the greatest effect on blood sugar.
Because you have diabetes, it's important that you include the proper amount of
carbohydrate in your daily diet and that you space carbohydrate evenly
throughout the day. You can use one of the following approaches:
Diabetes: Counting carbs if you don't use
insulin (preferred)
Diabetes: Counting carbs if you use
insulin (preferred)
Diabetes: Using a food guide
Diabetes:
Using a plate format for eating
Planning meals to manage diabetes often means looking
at food in a new way. Some people may have trouble accepting the changes they
need to make in their lifestyle. You may find it helpful to read about how
emotions influence what we eat, when we eat, and how much we eat:
Diabetes: Coping with your feelings about your
diet
Take an aspirin daily
If you are age 30 or
older, talk to your health professional about taking a low-dose aspirin daily
to help prevent
heart attack,
stroke, and other large blood vessel disease (macrovascular disease). People with diabetes are 2 to
4 times more likely than people who don't have diabetes to die from heart and
blood vessel diseases.1
Exercise regularly
Exercise helps control your
blood sugar, because you use glucose for energy during and after activity. It
also helps you stay at a healthy weight; lower
high cholesterol; raise
high-density lipoprotein (HDL), or "good,"
cholesterol; and lower
high blood pressure. These benefits help prevent
cardiovascular
disease. Try to do activities that
raise your heart rate. Exercise for at least 30 minutes on most, preferably
all, days of the week. It may help to keep track of your exercise on an
activity
log
(What is a PDF document?). The American Diabetes Association suggests that you include
resistance exercises in your exercise program.2
Resistance exercises can include activities like weight lifting or even yard
work. See the topic
Fitness for ideas on how to add daily activity to your
life. Work with your health professional to develop a
safe exercise program.
Maintain blood sugar control
Diabetes: Checking your blood
sugar
Diabetes: Preventing high blood sugar
emergencies
Lower high blood pressure and high cholesterol
It's important to keep your blood pressure and cholesterol at recommended
levels to reduce your risk of heart disease and large blood vessel
disease.
- Blood pressure should be less than 130/80
millimeters of mercury (mm Hg) in people with
diabetes. Moderate exercise, such as 30 to 45 minutes of brisk walking most
days of the week, can help lower blood pressure. But you may need to take one
or more medicines, such as
angiotensin-converting enzyme (ACE) inhibitors or
thiazide diuretics, to achieve your goal.8
- A low-fat diet, exercise, and weight loss can lower your
cholesterol. Your body needs insulin to process fats, as it does with
carbohydrate. If your diabetes is poorly controlled, the fats in your blood
(particularly
triglycerides) can rise significantly. You should
strive for a goal of less than 100
milligrams per deciliter (mg/dL) or aim for keeping it
at 70 mg/dL, for
low-density lipoprotein (LDL), or "bad," cholesterol.
Adults with diabetes need to keep their HDL cholesterol level more than 40
mg/dL for men and more than 50 mg/dL for women. Triglycerides should be less
than 150 mg/dL. You may need to take lipid-lowering medicines, such as statins,
to reach your goals. Statins reduce LDL levels and the risk of heart disease in
people with diabetes.9 They also have been shown to
reduce the risk of heart attack and stroke by one-third in people with
diabetes, even those who do not have high LDL levels or existing heart
disease.10
Take care of yourself in other ways
Diabetes: Taking care of your
feet.
- Limit your alcohol intake to no more than 1
drink a day for women (none if you are pregnant) and 2 drinks a day for
men.
- See your health professional regularly. For more information,
see the Exams and Tests section of this topic.
If you take oral diabetes medicine
Take your
medicine as directed. If you take one of the medicines with low blood sugar as
a side effect, learn to deal with low blood sugar. For information, see:
Diabetes: Dealing with low blood sugar from
medicines.
If you need to take insulin
If you become severely
ill, have surgery, become pregnant, or breast-feed, you may need insulin
injections temporarily even though you normally take only oral medicine. You
should be able to return to your usual treatment after the situation is
over.
As type 2 diabetes progresses, your
pancreas may produce less and less insulin. This means
that you have to take
insulin for the rest of your life, usually by giving
yourself a shot several times a day for the rest of your life.
If
you take insulin, learn how to deal with low blood sugar and give yourself an
insulin shot. See:
Diabetes: Dealing with low blood sugar from
insulin.
Diabetes: Giving yourself an insulin
shot.
Also, learn how to:
Other issues
Talk with your health professional if
you want to know about:
What to Think About
The
United Kingdom Prospective Diabetes Study (UKPDS)
showed that keeping blood sugar levels within a normal or near-normal range
helps decrease a person's chances of developing complications from diabetes.
Every effort you make to get your blood sugar level closer to a normal or
near-normal range leads to some lowering of your risk for complications.