Diabetes is a condition in which the body does not produce a sufficient amount insulin, this often leads to poor blood sugar control.
Let's take a look at the best treatments for type 1 diabetes, type 2 diabetes, prediabetes and gestational diabetes.
- Treatment for Prediabetes
- Treatment for Type 1 Diabetes
- Treatment for Type 2 Diabetes
- Treatment for Gestational Diabetes
Treatment for Prediabetes
Healthy lifestyle choices can help you bring down blood sugar level back to normal, or keep it from rising toward the levels seen in type 2 diabetes.
Eat healthy foods
Choose foods low in fat and calories and high in fiber. Focus on fruits, vegetables and whole grains. Strive for variety to help you achieve your goals.
Be more active
Aim for 30 to 60 minutes of moderate physical activity at least 5 days of the week.
Lose excess weight
If you're overweight, losing just 5 to 10 percent of your body weight — about 10 to 20 pounds (4.5 to 9 kilograms) if you weigh 200 pounds (91 kilograms) — can reduce the risk of developing type 2 diabetes. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits
Take medications as needed
If at high risk for diabetes Metformin (Glucophage) is recommended. Medications to control cholesterol and high blood pressure might also be prescribed.
Treatment For Type 1 Diabetes
The treatment for type 1 diabetes involves multiple daily injections or continuous insulin infusion.
Anyone who has type 1 diabetes needs lifelong insulin therapy which include:
Short-acting (regular) insulin- (regular) insulin include Humulin R and Novolin R.
Rapid-acting insulin- insulin glulisine (Apidra), insulin lispro (Humalog) and insulin aspart (Novolog)
Intermediate-acting (NPH) insulin- insulin NPH (Novolin N, Humulin N)
Long-acting insulin- insulin glargine (Lantus, Toujeo Solostar), insulin detemir (Levemir) and insulin degludec (Tresiba)
Insulin requirements can be estimated based on weight typical doses ranging from 0.4 to 0.1 units/kg/day
Insulin pumps can be programmed to dispense specific amounts of rapid-acting insulin automatically. This steady dose of insulin is known as your basal rate, and it replaces whatever long-acting insulin you were using. When you eat, you program the pump with the amount of carbohydrates you're eating and your current blood sugar, and it will give you what's called a bolus dose of insulin to cover your meal and to correct your blood sugar if it's elevated.
Non-insulin treatments include oral glucose-lowering drugs
- Surgical treatment for Type 1 diabetes such as pancreas and islet transplantation which normalizes glucose levels but requires lifelong immunosuppression
Treatment For Type 2 Diabetes
There are a number of different medications prescribed to treat type 2 diabetes.
Metformin (Glucophage, Glumetza, others)
Generally, metformin is the first medication prescribed for type 2 diabetes it works by lowering glucose production in the liver and improving your body's sensitivity to insulin so that your body uses insulin more effectively.
Nausea and diarrhea are the possible side effects of metformin. These side effects may go away as your body gets used to the medicine or if you take the medicine with a meal. If metformin and lifestyle changes aren't enough to control your blood sugar level, other oral or injected medications can be added.
Sulfonylureas-glyburide (DiaBeta, Glynase), glipizide (Glucotrol) and glimepiride (Amaryl)
hese medications help your body secrete more insulin. Possible side effects include low blood sugar and weight gain.
Meglitinides-repaglinide (Prandin) and nateglinide (Starlix)
These work like sulfonylureas by stimulating the pancreas to secrete more insulin, but they're faster acting, and the duration of their effect in the body is shorter. They also have a risk of causing low blood sugar and weight gain.
Thiazolidinediones- rosiglitazone (Avandia) and pioglitazone (Actos)
They make the body's tissues more sensitive to insulin. These drugs have been linked to weight gain and other more-serious side effects, such as an increased risk of heart failure and anemia. Because of these risks, these medications generally aren't first-choice treatments.
DPP-4 inhibitors-sitagliptin (Januvia), saxagliptin (Onglyza) and linagliptin (Tradjenta)
These medications help reduce blood sugar levels, but tend to have a very modest effect. They don't cause weight gain, but may cause joint pain and increase your risk of pancreatitis.
GLP-1 receptor agonists
These injectable medications slow digestion and help lower blood sugar levels. Their use is often associated with weight loss. Possible side effects include nausea and an increased risk of pancreatitis.
Exenatide (Byetta, Bydureon), liraglutide (Victoza) and semaglutide (Ozempic) Recent research has shown that liraglutide and semaglutide may reduce the risk of heart attack and stroke in people at high risk of those conditions.
These drugs prevent the kidneys from reabsorbing sugar into the blood. Instead, the sugar is excreted in the urine. Examples include canagliflozin (Invokana), dapagliflozin (Farxiga) and empagliflozin (Jardiance).
Medications in this drug class may reduce the risk of heart attack and stroke in people with a high risk of those conditions. Side effects may include vaginal yeast infections, urinary tract infections, low blood pressure, and a higher risk of diabetic ketoacidosis. Canagliflozin, but not the other drugs in the class, has been associated with an increased risk of lower limb amputation.
Some people who have type 2 diabetes need insulin therapy. In the past, insulin therapy was used as a last resort, but today it's often prescribed sooner because of its benefits. Low blood sugar (hypoglycemia) is a possible side effect of insulin.
Normal digestion interferes with insulin taken by mouth, so insulin must be injected. Depending on your needs, your doctor may prescribe a mixture of insulin types to use throughout the day and night. There are many types of insulin, and they each work in a different way.
Often, people with type 2 diabetes start using insulin with one long-acting shot at night, such as insulin glargine (Lantus) or insulin detemir (Levemir).
Types of insulin
There are several types of insulin. These types are classified according to how quickly the insulin begins to work and how long it remains active:
- Insulin lispro (brand name: Humalog)
- Insulin aspart (brand name: NovoLog)
- Insulin glulisine (brand name: Apidra)
- Insulin regular (brand name: Humulin R)
- Insulin NPH (brand name: Humulin N)
- Insulin lispro protamine (mixed with rapid acting insulin lispro [brand name: Humalog Mix])
- Insulin glargine (brand name: Lantus)
- Insulin detemir (brand name: Levemir; intermediate to long acting; may be needed twice daily)
Very long acting:
- Insulin degludec (brand name: Tresiba)
- Insulin glargine 300 units/mL (brand name: Toujeo)
Initial insulin dose
When insulin is started for type 2 diabetes, health care providers usually recommend "basal" insulin; this means taking intermediate-acting and/or long-acting forms of insulin to keep blood sugar controlled throughout the day. You will likely need to take basal insulin once per day, either in the morning or at bedtime.
Treatment For Gestational Diabetes
Monitoring your blood sugar
While you're pregnant, your health care team may ask you to check your blood sugar four to five times a day, first thing in the morning and after meals — to make sure your level stays within a healthy range. This may sound inconvenient and difficult, but it'll get easier with practice.
Eating the right kinds of food in healthy portions is one of the best ways to control your blood sugar and prevent too much weight gain, which can put you at higher risk of complications
Regular physical activity plays a key role in every woman's wellness plan before, during and after pregnancy. Exercise lowers your blood sugar by stimulating your body to move glucose into your cells, where it's used for energy. Exercise also increases your cells' sensitivity to insulin, which means your body will need to produce less insulin to transport sugar.
If diet and exercise aren't enough, you may need insulin injections to lower your blood sugar
- A fast-acting insulin that you take before a meal, or an intermediate- or long-acting (basal) insulin that you take at bedtime or upon waking
- Oral medications such as glyburide and metformin do appear to be effective and safe for gestational diabetes
Written by Dr. Chitrali Sood | Edited by Hannah Kingston