Treatment Overview
Treatment for
type 2 diabetes involves using diet, exercise, and
often medicines to keep your blood sugar within a
normal or near-normal range, reducing your risk of
complications.
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.5 If you are 40 or older, talk to your doctor
about taking a low-dose aspirin daily to help prevent
heart attack,
stroke, or other large blood vessel (macrovascular) disease. You also can reduce your risk
by lowering
high blood pressure and
high cholesterol.
If you smoke, quitting may also lower your risk of diabetes
complications.
Treatment to keep your blood sugar in a normal or
near-normal range involves:
- Limiting and spreading
carbohydrate throughout the day to prevent high blood
sugar levels after meals. A
registered dietitian can help you make a meal plan
that fits your lifestyle. You likely will use one of several methods to plan
your diet, such as the
plate format, the food guide for diabetes, or
carbohydrate counting. For more information on diet, see the Treatment section
of the topic
Type 2 Diabetes: Living With the Disease.
Diabetes: Using a plate format for eating
Diabetes: Counting carbs if you don't use insulin
- Doing
moderate activity at least 2½ hours a week. One way to
do this is to be active 30 minutes a day, at least 5 days a week. It's fine to
be active in blocks of 10 minutes or more throughout your day and week. Also
include resistance exercises in your exercise program.6, 7 Resistance exercises can include
activities like weight lifting or yard work. Some
tips for exercising safely may be helpful. See the
topic
Fitness for ideas on how to add daily activity to your
life. Work with your doctor to plan a safe exercise program. It may also help
to keep track of your exercise on an
activity log
(What is a PDF document?). - Testing your blood sugar to monitor your progress
and find out how exercise and various foods affect your blood sugar. For more
information, see:
Diabetes: Checking your blood sugar.
- Taking oral diabetes medicine or
insulin. For more information, see the Medications
section of this topic.
Taking steps to prevent complications
People over
the age of 40 who have diabetes should consider taking a low-dose aspirin every
day to reduce the risk of
cardiovascular
complications.5
You should also control your blood pressure and
reach and keep healthy cholesterol and triglyceride levels.
High blood pressure and
high cholesterol can increase your risk of developing
complications of diabetes.
If you smoke, quitting may lower your risk of diabetes
complications.
How often should I see my doctor?
See your doctor
about every 3 to 6 months for the rest of your life
to:
- Review your blood sugar levels since your
last checkup and evaluate whether your treatment needs to be
changed.
- Check your blood pressure and start or adjust treatment if
it's high.
- Check your feet for signs of diabetic foot
problems.
- Have a hemoglobin A1c or similar test (glycosylated hemoglobin or glycohemoglobin). If your
blood sugar levels are stable and your treatment hasn't changed, this test may
be done every 6 months.
- Have a
blood glucose test. Check the accuracy of your blood
sugar meter at this time to see whether your
home blood sugar tests are reliable.
Have these exams and tests yearly:
What happens if my blood sugar level is very high?
If you have a severe infection or other illness, or become severely
dehydrated, or do not take your diabetes medicine
(pills or insulin), your blood sugar level may rise very high and cause a
dangerous condition called a
hyperosmolar state. Hyperosmolar state is usually
treated in a hospital, often in the intensive care unit. There you are closely
observed and receive frequent blood tests for glucose and
electrolytes. Insulin will be given to you through a
vein (intravenous, or IV) to lower your blood sugar level. Fluids will be given
through the IV to correct the dehydration. The fluids will make you urinate,
removing the excess glucose from your body.
What to Think About
You have just been diagnosed
with a disease that requires daily attention for the rest of your life. You may
feel angry or resentful about having diabetes, or you may want to deny that you
have it. These feelings are normal, because you are experiencing the loss of
what your life was like before you were diagnosed. Allow yourself time to
grieve your losses. For more information, see the
topic
Grief and Grieving.
Feeling angry,
resentful, or frightened can prevent you from following your treatment plan.
You may benefit from seeing a professional counselor to help you cope with
having diabetes.
If you have signs of heart and blood vessel
complications from diabetes, you may need a thorough heart exam, including an
electrocardiogram (ECG, EKG) or an
exercise electrocardiogram (treadmill EKG test),
before beginning a vigorous exercise program.