There is no cure yet for diabetes. However, a combination of diet, exercise and medication can be effective in controlling blood sugar and preventing related conditions. The goal of treatment is to keep your blood glucose as close to a normal range as possible. Your treatment team will develop a self-care plan for you, but you will need to play a major role in managing your diabetes. With good treatment and management, you can lead a long and healthy life.
Your treatment will be determined by a number of factors, including the type of diabetes you have:
- If you have type 1 diabetes, you will need to take insulin.
- If you have type 2 diabetes, your treatment may start with diet and exercise. You may need to take an oral diabetes medication, insulin or another injectable medication. You may need a combination of treatments, and your treatment may change over time.
- If you have gestational diabetes, treatment may start with diet and exercise, but you also may need an oral medication or insulin.
Your treatment team will help you set up a self-care diabetes management plan. Your plan may help you:
- Get your A1C tested every three months.
- Work with your doctor to control your blood pressure and cholesterol.
- Stop smoking and limit alcohol to one drink a day.
- Follow a diabetes meal plan. This may include controlling portion sizes and limiting fat, cholesterol, salt and added sugar.
- Set a goal for weight loss and physical activity.
- Learn how to take your medications.
- Check your blood glucose with a glucose monitor. You will learn when to check and what your target levels are. You will learn what to do if your glucose is too high or too low.
- Check your urine for proteins called ketones. You will learn when to check and what to do if you have ketones in your urine.
- Learn how to manage stress and help you find a diabetes education or support program.
There are many options when it comes to insulin. Your doctor will help you find the option that works best for you. Types of insulin include rapid, short, intermediate and slow-acting. You may need a mix of types. Insulin can be taken by:
- Injecting it with a syringe
- Using a self-injecting insulin pen
- Wearing an insulin pump that gives you programmed amounts of insulin
- Having an insulin port inserted through your skin so you can inject into it
- Using an insulin jet, which forces insulin through your skin
- Using an insulin powder inhaler
If you have type 2 diabetes or gestational diabetes and you need an oral medication, you will probably start with metformin. It lowers blood glucose by decreasing the amount of glucose made in your liver. There are other options, if needed, and you might take a combination. Oral medications include drugs that:
- Stimulate cells in your pancreas to make more insulin (sulfonylureas, meglitinides)
- Help insulin work better in muscle and fat cells (thiazolidinediones)
- Help insulin survive longer in the body (DPP-4 inhibitors)
- Help glucose be removed by your kidneys (SGLT2 inhibitors)
- Help reduce glucose in your body by blocking digestion of glucose in foods (alpha-glucosidase inhibitors)
- Help lower levels of bad cholesterol in your blood along with glucose (bile acid sequestrants)
Other Injectable Medications
Two injectable medications that are not insulin may be used to treat type 2 diabetes. These drugs are injected under your skin.
- GLP1 receptor agonists stimulate insulin production and also decrease glucose made in the liver.
- Amylin analogs slow down the movement of food through the stomach. This helps keep glucose levels from peaking. It also reduces glucose made in the liver.
Bariatric surgery is weight-loss surgery, also called gastric bypass surgery. If you have type 2 diabetes and you are very overweight, this surgery may help by causing you to lose a large amount of weight. Studies show that bariatric surgery may help control blood glucose. In some people, it may lower or eliminate the need for medication.
Recent research also shows that this surgery may help some people who are obese and have type 1 diabetes. However, long-term results are still being studied.