Type 2 Diabetes Treatment and Tablets

In people who are prone to develop diabetes, putting on weight, especially around the waistline can precipitate the development of diabetes. Diabetes is not infectious. People with type 2 diabetes can still produce insulin but they are either not making enough to meet their body's needs, or they are unable to use the insulin, which is provided efficiently.

How is Type 2 diabetes treated?

The primary treatment for Type 2 diabetes is A healthy diet, which is low in sugar, low in fat and high in fiber.  Exercise, to keep weight and blood glucose under control.  Tablets are often added;  they are not a substitute for healthy eating! Insulin is sometimes necessary for some people when tablets are not sufficient to keep blood glucose under control.

People with type 2 diabetes can develop the complications of diabetes, especially if blood glucose is not kept under control. For this reason, Type 2 diabetes must be taken seriously and treated correctly. Type 2 diabetes should never be regarded as 'mild diabetes.' The main aim of treatment is to achieve near-normal blood glucose levels which, together with a healthy life-style, will help to improve well-being and protect against long-term damage to the heart, eyes, nerves, kidneys,  and major arteries.

Diabetes and Tablets

Tablets are sometimes started if sugar levels do not come under control with a healthy diet; however, they are not a substitute for healthy eating.

Metformin

Metformin is usually the first choice for people who are overweight.It helps the insulin already present to work more efficiently, but does not cause hypoglycemia (low blood sugar). Metformin can cause stomach upset, e.g. sickness, vomiting, diarrhea; if any of these symptoms happen, please inform your GP or Diabetes team. The side effects can be helped by taking the drug with or after food.

Sulphonylureas

These tablets are usually the first choice for people who are of average weight. They encourage the pancreas to produce more insulin; because of this they can cause hypoglycemia (a low blood sugar). Examples include Glipizide, Gliclazide or Glimepiride. They should be taken before food.

Alpha-Glucosidase Inhibitors

These work by delaying the rate at which sugars are digested and enter the bloodstream after eating. The most common one is Acarbose. The drug must be taken with the first mouthful of food to be effective. It may cause stomach upset, e.g., rumbling stomach, wind, diarrhea or soft, smelly stools. If any of these happen, discuss with your GP or Diabetes team.

Hypoglycaemia 

This happens if the level of glucose in the blood drops down too low It is unlikely in people controlled by diet or on Metformin Symptoms include trembling, sweating, dizziness and a feeling of hunger Confusion can also occur. The most common causes of hypoglycemia are missed or delayed meals, excessive exercise or too large a dose of tablets. If this happens, discuss your treatment with one of your diabetes team. How to achieve good blood glucose control Attend the clinic, either the hospital or your general practice regularly. Regular check-ups mean that you will receive advice on how to avoid complications of diabetes. It also says that if problems develop, they can be picked up and treated at an early stage.

Glitazones

These drugs also help insulin to work more efficiently. They may be prescribed as an alternative to Metformin in overweight people with type 2 diabetes, especially when Metformin has caused side effects, or they may be used in combination with Metformin. Examples are Pioglitazone and Rosiglitazone. These drugs cannot be used alone or combined with insulin, and they are not suitable for some patients, including those with heart failure or liver problems. Patients taking either of these drugs should have blood tests to check their liver function every two months for the first year of treatment.

Some people take a combination of tablets, or even tablets combined with insulin, to control blood sugar levels. Since the requirements for tablets can change over a period; it is necessary to have regular check-ups with the Diabetes team or your GP. Other Medications Steroids and some water tablets (diuretics) can cause higher blood sugar levels. Your diabetes treatment may need to be altered if you are on either of these. If you need a cough, cold or indigestion remedies, please obtain sugar-free varieties.

Diet: it is essential to keep to a healthy diet which is low in fiber, low in sugar and high in fat.

Self-testing: testing either urine or blood for glucose is a way for you to monitor how well you are controlling your diabetes. The diabetes nurse or practice nurse will show you how to do this.

Exercise: regular exercise is an ideal way to keep fit and healthy. Any form of exercise is beneficial, e.g., swimming, keep fit classes or walking. Exercise also helps to reduce blood glucose levels.