The Progression of Type 2 Diabetes Treatments

Medically Reviewed By William C. Lloyd III, MD, FACS
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Each year, about 1.4 million people are diagnosed with type 2 diabetes and must embark on a lifelong journey to manage this chronic condition. Diabetes develops when your body doesn’t respond well to insulin, which is a hormone made in your pancreas. Insulin is responsible for helping your body properly use sugar (glucose) from your food—your body typically uses glucose for energy, but when you have diabetes, this process doesn’t work. To treat the condition, you’ve got to take steps to get things functioning well again. There are many ways to do this—first, you’ll need to make some lifestyle changes, and then your doctor will likely prescribe medications, before finally turning to insulin injections. Everyone’s path is different, and it might take a few tries to find the right treatment for you, but keep in mind that your doctor will be with you every step of the way.

Lifestyle Changes

Not everyone diagnosed with diabetes needs medication at first. It might be that you just need to make healthy lifestyle changes. Your doctor will likely connect you with a certified diabetes educator, who can work with you to make these changes and get control of your diabetes. This may mean an overhaul of your typical diet, making sure you get plenty of high-fiber, low-fat foods like fruits, vegetables, and whole grains. You’ll also want to eat fewer refined carbohydrates (like white bread and rice), less meat, and fewer sweets. You’ll start on a fitness routine to get your body more active and promote weight loss, and you’ll also want to try some stress relief techniques, like yoga or meditation, to keep blood pressure down and promote good overall health.

Oral Medications

However, often lifestyle changes aren’t enough to help you gain control of your diabetes, so your doctor will turn to oral medications. These pills work in different ways to get your blood sugar levels balanced. Keep in mind, though, that the combination of oral medications and lifestyle changes is the most effective way to manage your diabetes—just because you’re prescribed medication doesn’t mean you should quit going to the gym or stop watching what you eat.

There are several different types of oral diabetes medications your doctor can prescribe. The most common medication is called metformin, and it works by limiting how much sugar your liver releases into your bloodstream. Other types of diabetes pills stimulate your pancreas to release more insulin, so it can regulate your blood sugar levels. And there are some drugs that manage your blood sugar levels by both limiting the amount of glucose your body makes and stimulating insulin production.

Sometimes, diabetes pills stop working after a period of time—they may stop being effective after just a few months or a few years. Often, we’re not sure exactly why they don’t work anymore, but it doesn’t mean your diabetes has gotten worse. In the past, when this happened, doctors would put patients on insulin right away. However, today we have many more options to try before insulin. In these cases, your doctor may prescribe you more than one oral medication to take; this is called combination therapy. There are even medications available that combine two oral drugs in one pill, so you’re not taking lots of pills every day. Many people take two or three kinds of oral diabetes pills to manage their condition, and some even take pills and insulin together, or pills and non-insulin injections together. It all depends on your specific case, and your doctor will work to find the right fit for you.

Non-Insulin Injectable Medications

In recent years, a new type of diabetes drug has come onto the market—the non-insulin injectable. If oral drugs aren’t helping you stay in control of your diabetes, your doctor might prescribe you a non-insulin injectable medication. They work by increasing the amount of insulin your body makes and decreasing the amount of sugar your body sends into your bloodstream. If you have a hard time remembering to take your pills several times a day, non-insulin injectables can be a good option; it depends on the specific medication, but some are injected once a week, once a day, or twice a day.

These injectable drugs have some benefits in addition to lowering blood sugar levels: they’ve also been found to reduce blood pressure and some can cause weight loss.

Insulin

Eventually, many people with diabetes require insulin injections to manage their diabetes properly. Over time, the pancreas might not be able to produce enough insulin—a common side effect of aging. Sometimes, people stop responding to their natural insulin because of weight gain or chronic emotional or physical stress. When this happens, pills or non-insulin injectables aren’t enough to keep the body functioning well. When that happens, your doctor will prescribe the right dosage and type of insulin for you. You might need a combination of short-acting and long-acting insulins to control your blood sugar levels and stay healthy. It’s important to remember that needing to take insulin doesn’t mean you’ve failed—your body just needs manufactured insulin since your natural process isn’t working anymore.

No matter what medication you take for your type 2 diabetes, it’s crucial to commit to an exercise plan, a healthy diet, and a low-stress lifestyle. Living a healthy life and taking your prescribed medications is key to managing diabetes and staying in control.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jan 18
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THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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