What treatments are there for Type two diabetes?

There isn't a cure for Type 2 diabetes (although in some overweight patients acute weight loss can bring blood glucose levels back to normal) but it can be controlled. Some people can control their condition with lifestyle changes alone. Others need to take medicines or use insulin injections.

Self-help

By making the following lifestyle changes, you can help control your blood glucose levels.

  • Eat a healthy balanced diet with regular meals, three times a day. Include carbohydrates, such as pasta or potatoes in each meal.
  • Try to do at least half an hour of moderate physical activity on at least three days a week. This will help you to stay a healthy weight and control your blood glucose levels.
  • Only drink alcohol in moderation and stick within the recommended limits.
  • If you smoke, give up. Smoking is unhealthy for everyone, but it's especially important to stop if you have diabetes because you already have an increased risk of developing circulatory problems and cardiovascular disease.

Oral medicines

If lifestyle changes alone do not keep the blood glucose levels under control, prescribed medicines may be needed.
For example:

  • Metformin works by reducing the amount of glucose that gets released into your bloodstream from your liver. It also improves the way glucose is used by your muscles.
  • Gliclazide, glipizide, glimepiride and tolbutamide help your pancreas to produce more insulin.
  • Repaglinide and nateglinide also help your pancreas to produce more insulin, but work more quickly and last for a shorter time.
  • Acarbose lowers your blood glucose by slowing down the rate at which some carbohydrates are absorbed by your body.
  • Pioglitazone reduces your body's resistance to insulin.
  • Sitagliptin, saxagliptin and vildagliptin help your body to produce more insulin at mealtimes.

These medicines are usually taken between one and three times a day.

Injections

 Other medicines which may be prescribed are exenatide or liraglutide. These are given by injection and work by helping the body to make more insulin when it’s needed. They can also reduce the appetite and help weight loss.

If lifestyle changes and medicines do not keep the blood glucose levels under control, then insulin injections may be needed as well as, or instead of, tablets.

Usually self injection with insulin once or twice a day, using either a small needle or a pen-type syringe with replaceable cartridges. There are several different types of insulin that work at different rates and for different lengths of time.

It is important that whichever of these treatments are followed, that the blood sugar is monitored on a regular basis with a home test kit. This involves taking a pinprick of blood from the finger and putting a drop on a testing strip. A meter will read the result automatically.

The GP or diabetes nurse should also check  HbA1C levels at least twice a year. The test is done by taking blood from a vein in the arm or sometimes a drop of blood from a fingerprick. It’s used to see how well the blood sugar levels are being controlled.