Treatments for Type 2 diabetes
Treatments for Type 2 diabetes
The list of treatments mentioned in various sources
for Type 2 diabetes
includes the following list.
Always seek professional medical advice about any treatment
or change in treatment plans.
Type 2 diabetes: Is the Diagnosis Correct?
The first step in getting correct treatment is
to get a correct diagnosis.
Differential diagnosis list for Type 2 diabetes may include:
Hidden causes of Type 2 diabetes may be incorrectly diagnosed:
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Drugs and Medications used to treat Type 2 diabetes:
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or change in treatment plans.
Some of the different medications used in the treatment of Type 2 diabetes include:
Hospital statistics for Type 2 diabetes:
These medical statistics relate to hospitals, hospitalization and Type 2 diabetes:
- 0.2% (25,174) of hospital consultant episodes were for non-insulin-dependent diabetes mellitus in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 74% of hospital consultant episodes for non-insulin-dependent diabetes mellitus required hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 55% of hospital consultant episodes for non-insulin-dependent diabetes mellitus were for men in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 45% of hospital consultant episodes for non-insulin-dependent diabetes mellitus were for women in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
- 57% of hospital consultant episodes for non-insulin-dependent diabetes mellitus required emergency hospital admission in England 2002-03 (Hospital Episode Statistics, Department of Health, England, 2002-03)
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Medical news summaries about treatments for Type 2 diabetes:
The following medical news items
are relevant to treatment of Type 2 diabetes:
Discussion of treatments for Type 2 diabetes:
Diabetes Overview: NIDDK (Excerpt)
Healthy eating, physical activity, and blood glucose testing are the
basic management tools for type 2 diabetes. In addition, many people with
type 2 diabetes require oral medication and insulin to control their blood
glucose levels.
(Source: excerpt from Diabetes Overview: NIDDK)
Diabetes Statistics in the United States: NIDDK (Excerpt)
Treatment of type 2 diabetes: Treatment typically includes
diet control, exercise, home blood glucose testing, and, in some cases,
oral medication and/or insulin. Approximately 40 percent of people with
type 2 diabetes require insulin injections. (Source: excerpt from Diabetes Statistics in the United States: NIDDK)
Medicines for People With Diabetes: NIDDK (Excerpt)
Healthy eating, exercise, and losing weight may help you lower your
blood glucose (also called blood sugar) when you find out you have type 2
diabetes. If these treatments do not work, you may need one or more types
of diabetes pills to lower your blood glucose. After a few more years, you
may need to take insulin shots because your body is not making enough
insulin. (Source: excerpt from Medicines for People With Diabetes: NIDDK)
Medicines for People With Diabetes: NIDDK (Excerpt)
Many types of diabetes pills can help people with type 2 diabetes lower
their blood glucose. Each type of pill helps lower blood glucose in a
different way. The diabetes pill (or pills) you take is from one of these
groups. You might know your pill (or pills) by a different name.
- Sulfonylureas (SUL-fah-nil-YOO-ree-ahs). Stimulate
your pancreas to make more insulin.
- Biguanides (by-GWAN-ides). Decrease the amount of
glucose made by your liver.
- Alpha-glucosidase inhibitors (AL-fa gloo-KOS-ih-dayss
in-HIB-it-ers). Slow the absorption of the starches you eat.
- Thiazolidinediones(THIGH-ah-ZO-li-deen-DYE-owns).
Make you more sensitive to insulin.
- Meglitinides (meh-GLIT-in-ides). Stimulate your
pancreas to make more insulin.
- D-phenylalanine (dee-fen-nel-AL-ah-neen)
derivatives. Help your pancreas make more insulin
quickly.
- Combination oral medicines. Put together different kinds of
pills.
(Source: excerpt from
Medicines for People With Diabetes: NIDDK)
Medicines for People With Diabetes: NIDDK (Excerpt)
Your doctor might prescribe one pill. If the pill does not lower your
blood glucose, your doctor may
- ask you to take more of the same pills, or
- add a new pill or insulin, or
- ask you to change to another pill or insulin.
(Source: excerpt from
Medicines for People With Diabetes: NIDDK)
Medicines for People With Diabetes: NIDDK (Excerpt)
Your doctor may ask you to take more than one diabetes medicine at
a time. Some diabetes medicines that lower blood glucose work well
together. Here are examples:
(Source: excerpt from Medicines for People With Diabetes: NIDDK)
Medicines for People With Diabetes: NIDDK (Excerpt)
Your doctor might ask you to take insulin and one of these diabetes
pills:
- a sulfonylurea
- metformin
- pioglitazone
(Source: excerpt from
Medicines for People With Diabetes: NIDDK)
Noninvasive Blood Glucose Monitors: NIDDK (Excerpt)
In March 2001, the U.S. Food and Drug Administration (FDA) approved a
noninvasive blood glucose monitoring device for adults with diabetes.
Noninvasive monitoring means checking blood glucose levels without
puncturing the skin for a blood sample. The GlucoWatch Biographer,
manufactured by Cygnus Inc., was approved to detect glucose level trends
and patterns in adults age 18 and older with diabetes. It must be used
along with conventional blood glucose monitoring of blood samples. The
device, which looks like a wristwatch, pulls body fluid from the skin
using small electric currents. It checks blood glucose levels every 20
minutes. (Source: excerpt from Noninvasive Blood Glucose Monitors: NIDDK)
Dealing With Diabetes - Age Page - Health Information: NIA (Excerpt)
Early in the disease, many people with type 2 diabetes can
keep their blood glucose levels near normal by controlling their
weight, exercising, and following a sensible diet. Often, people
with type 2 diabetes must take oral anti-diabetic medications
to control their glucose. For some people, insulin may also be
needed. (Source: excerpt from Dealing With Diabetes - Age Page - Health Information: NIA)
Dealing With Diabetes - Age Page - Health Information: NIA (Excerpt)
Diabetes cannot be cured, but it can be controlled. Good control
requires a careful blend of diet, exercise, blood sugar monitoring,
and medication. People with type 1 diabetes control their
blood sugar with insulin injections and frequent self-monitoring of
blood glucose. People with type 2 diabetes generally control
their blood sugar with oral medications. In some cases, insulin
injections are needed to keep type 2 diabetes under
control.
Diet is very important to lowering blood glucose levels.
In planning a diet, the doctor considers the patient's weight and
daily physical activity. For overweight patients, a weight loss plan
is a must for proper blood glucose control. Food exchange lists to
help with meal planning are available from your doctor and the
American Diabetes Association.
Exercise is very important because it helps the body burn
off some of the excess glucose as energy. Taking part in a regular
fitness program has been shown to improve blood glucose levels in
older people with high levels. A doctor can help plan an exercise
program that balances the diet and medication needs and your general
health.
Drugs may not be needed for type 2 diabetes if good
control can be achieved through diet and exercise. But when these
measures fail, oral drugs, insulin, or a combination of the two may
be prescribed. A person who normally does well without drugs will
need to take medication during acute illnesses.
Foot care is very important for people with diabetes. The
disease can lower blood supply to the limbs and reduce feeling in
the feet. People with diabetes should check their feet every day and
watch for any redness or patches of heat. Sores, blisters, breaks in
the skin, infections or buildup of calluses should be reported right
away to a podiatrist or family doctor.
Skin care is very important. Because people with diabetes
may have more injuries and infections, they should protect their
skin by keeping it clean, using skin softeners to treat dryness, and
taking care of minor cuts and bruises.
Teeth and gums need special attention to avoid serious
infections. People with diabetes should tell their dentist about
their condition and schedule regular checkups. (Source: excerpt from Dealing With Diabetes - Age Page - Health Information: NIA)
Buy Products Related to Treatments for Type 2 diabetes
Book Excerpts: Treatment of Type 2 diabetes
Treatments of Type 2 diabetes: Online Medical Books
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for more information about the treatments of Type 2 diabetes.
Hyperglycemia:
Treatment
(In a Page: Signs and Symptoms)
-
IV fluids
-
Acute treatment includes insulin administration (IV or subcutaneous) or oral hypoglycemic medications
-
Remove offending medications if possible
-
Treat the underlying etiology
-
Acute treatment of diabetic ketoacidosis involves fluid repletion, correction of electrolyte disturbances, insulin administration, and very frequent monitoring of glucose and electrolytes (intensive care admission is often necessary for initial stages of treatment)
-
Long-term management includes regular testing of HbA1C, glucose (home readings), blood pressure, lipid profile, renal function, and regular podiatric and ophthalmology examinations
'>
» READ BOOK EXCERPT ONLINE »
Source: In a Page: Signs and Symptoms, 2004
Hyperglycemia:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Initial management
–Fluid to correct dehydration
–Insulin to correct hyperglycemia and acidosis
–Intravenous therapy required if patient in DKA
-
Long-term management: Goal is to normalize blood glucose and HbA1c to decrease risk of acute and chronic complications
-
Type II diabetes
–Absolute daily insulin requirement
–Monitor blood glucose (metabolic control)
–Attention to dietary intake (carbohydrate counting)
-
Type II diabetes
–Weight management via diet changes and exercise
–Most require medication (insulin and/or metformin)
-
Prognosis
–Chronic hyperglycemia increases long-term risk of microvascular (retinopathy, nephropathy, neuropathy) and macrovascular (atherosclerosis and ischemic heart disease) complications
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Polydipsia:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Insulin and/or oral medications for DM
-
Central DI
–Desmopressin treatment for older children
–Not in immediate post-op period
–Free water replacement
–Desmopressin may lead to hyponatremia in infants and in postoperative cases that may also involve SIADH
-
Nephrogenic DI
–Thiazide diuretics
–Mild salt depletion
–Prostaglandin synthesis inhibitors
-
Behavioral modification for compulsive water drinking
-
Surgical intervention for tumor
-
Strict measurement of input and output
-
Must assess presence or absence of intact thirst mechanism for central DI
>>
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Diabetes insipidus:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Mild cases require no treatment other than fluid intake to replace fluid lost. Until the cause of more severe cases of diabetes insipidus can be identified and eliminated, administration of various forms of vasopressin or of a vasopressin stimulant can control fluid balance and prevent dehydration. Vasopressin injection is an aqueous preparation that’s administered S.C. or I.M. several times a day because it’s effective for only 2 to 6 hours; this form of the drug is used in acute disease and as a diagnostic agent.
Desmopressin acetate can be given by nasal spray that’s absorbed through the mucous membranes, or by injection given S.C. or I.V.; this drug is effective for 8 to 20 hours, depending on the dosage. It’s also available in tablet form, to be given at bedtime or in divided doses. Hydrochlorothiazide can be used in both central and nephrogenic diabetes insipidus. Indomethacin and amiloride are also used for nephrogenic diabetes insipidus. If nephrogenic diabetes insipidus is caused by medication (such as lithium), stopping the medicine leads to kidney recovery.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Diabetes mellitus:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Effective treatment normalizes blood glucose and decreases complications using insulin replacement, diet, and exercise. Current forms of insulin replacement include single-dose, mixed-dose, split-mixed dose, and multiple-dose regimens. The multiple-dose regimens may use an insulin pump. Insulin may be rapid acting, intermediate acting, long acting, or a combination of rapid acting and intermediate acting; it may be standard or purified, and it may be derived from beef, pork, or human sources. Purified human insulin is used commonly today. Pancreas transplantation is experimental and requires chronic immunosuppression.
Successful treatment requires an extensive dietary education. The patient’s diet is specifically tailored to include the right amount and combination of foods. Almost all foods may be eaten occasionally. The diet should address dietary prescriptions as well as personal and cultural preferences to improve adherence and control. For the obese patient with type 2 diabetes, weight reduction is a goal. In type 1 diabetes, the calorie allotment may be high, depending on growth stage and activity level.
Type 2 diabetes may require oral antidiabetic drugs to stimulate endogenous insulin production, increase insulin sensitivity at the cellular level, and suppress hepatic gluconeogenesis.
Five types of drugs have been used to treat diabetes. Sulfonylureas stimulate pancreatic insulin release, increase tissue sensitivity to insulin, and require insulin’s presence to work. Meglitinides cause immediate, brief release of insulin and are taken immediately before meals. Biguanides decrease hepatic glucose production and increase tissue sensitivity to insulin. Alpha-glucosidase inhibitors slow the breakdown of glucose and decrease postprandial glucose peaks. The thiazolidinediones enhance the action of insulin; however, insulin must be present for them to work. These drugs also reduce insulin resistance by decreasing hepatic glucose production and increasing glucose uptake. They have also been shown to lower blood pressure in diabetic hypertensive patients. Cholesterol and triglyceride levels may also be reduced.
Treatment of long-term diabetic complications may include transplantation or dialysis for renal failure, photocoagulation for retinopathy, and vascular surgery for large-vessel disease. Meticulous blood glucose control is essential.
Alert Any patient with a wound that has lasted more than 8 weeks and who has tried standard wound care and revascularization without improvement should consider hyperbaric oxygen therapy. This treatment may speed healing by allowing more oxygen to get to the wound and may therefore result in fewer amputations.
Keeping glucose at near-normal levels for 5 years or more reduces both the onset and progression of retinopathy, nephropathy, and neuropathy. In type 2 diabetes, blood pressure control as well as smoking cessation reduces the onset and progression of complications, including cardiovascular disease.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Diabetic complications during pregnancy:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment of both the newly diagnosed and the established diabetic is designed to maintain blood glucose levels within acceptable limits through dietary management and insulin administration. Many females with overt diabetes mellitus require hospitalization at the beginning of pregnancy to assess physical status, check for cardiac and renal disease, and regulate diabetes.
For pregnant patients with diabetes, therapy includes:
❑ bimonthly visits to the obstetrician and the internist during the first 6 months of pregnancy; weekly visits may be necessary during the third trimester
❑ maintenance of fasting blood glucose levels at or below 100 mg/dl and 2-hour postprandial blood glucose levels at or below 120 mg/dl during the pregnancy
❑ frequent monitoring for glycosuria and ketonuria (ketosis presents a grave threat to the fetal central nervous system)
❑ weight control (gain not to exceed 3 to 3½ lb [1.4 to 1.6 kg] per month during the last 6 months of pregnancy)
❑ high-protein diet of 2 g/day/kg of body weight, or a minimum of 80 g/day during the second half of pregnancy; daily calorie intake of 30 to 40 calories/kg of body weight; daily carbohydrate intake of 200 g; and enough fat to provide 36% of total calories (however, vigorous calorie restriction can cause starvation ketosis)
❑ exogenous insulin if diet doesn’t control blood glucose levels. Be alert for changes in insulin requirements from one trimester to the next and immediately postpartum. Oral antidiabetic drugs are contraindicated during pregnancy because they may cause fetal hypoglycemia and congenital anomalies.
Generally, the optimal time for delivery is between 37 and 39 weeks’ gestation, although with reassuring antenatal testing and no evidence of macrosomia, 40 weeks or later is also feasible. The insulin-dependent diabetic may require hospitalization before delivery for frequent monitoring of blood glucose levels and prompt intervention if complications develop.
Depending on fetal status and maternal history, the obstetrician may induce labor or perform a cesarean delivery. During labor and delivery, the patient with diabetes should receive continuous I.V. infusion of dextrose with regular insulin in water. Maternal and fetal status must be monitored closely throughout labor. The patient may benefit from half her prepregnancy dosage of insulin before a cesarean delivery. Her insulin requirement will fall markedly after delivery.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Diabetic ketoacidosis:
Treatment (Tx)
(Professional Guide to Diseases (Eighth Edition))
Insulin, I.V. fluids, sodium bicarbonate
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Hereditary fructose intolerance:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment of hereditary fructose intolerance consists of exclusion of fructose and sucrose (cane sugar or table sugar) from the diet. Otherwise, treatment is supportive as the patient’s progress is monitored.
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Source: Professional Guide to Diseases (Eighth Edition), 2005
Diabetes insipidus:
Treatment
(Handbook of Diseases)
Until the cause of diabetes insipidus can be identified and eliminated, administration of various forms of vasopressin can control fluid balance and prevent dehydration.
Vasopressin injection
This aqueous preparation is administered S.C. or I.M. several times a day because it’s effective for only 2 to 6 hours. This form of the drug is used as a diagnostic agent and, rarely, in acute disease.
Desmopressin acetate
This drug can be given orally, by nasal spray that’s absorbed through the mucous membranes or by S.C. or I.V. injection. Desmopressin acetate is effective for 8 to 20 hours, depending on the dosage.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Diabetes mellitus:
Treatment
(Handbook of Diseases)
Effective treatment for both types of diabetes normalizes blood glucose and decreases complications.
Type 1 diabetes
Treatment includes insulin replacement, diet, and exercise. Current forms of insulin replacement include single-dose, mixed-dose, split-mixed dose, and multiple-dose regimens. The multiple-dose regimens may use an insulin pump.
Human insulin may be rapid-acting (Regular), intermediate-acting (NPH or Lente), long-acting (Ultralente, Lantus), or a combination of rapid-acting and intermediate-acting (70/30, 75/25, or 50/50 of NPH and Regular).
Clinical tip Insulin Lispro or Novalogue may be used in place of Regular insulin. It’s rapid in onset (15 minutes) and makes waiting to eat after injection unnecessary. It has a short duration of action (4 hours), which decreases between-meal and nocturnal hypoglycemia.
Islet cell or pancreas transplantation is available and requires chronic immunosuppression.
Type 2 diabetes
Patients may require oral antidiabetic drugs to stimulate endogenous insulin production, increase insulin sensitivity at the cellular level, suppress hepatic gluconeogenesis, and delay GI absorption of carbohydrates.
UNDER STUDY: Studies have shown that treatment with a lipase inhibitor (such as orlistat) combined with a low-calorie diet significantly decreases the weight of overweight patients with type 2 diabetes. Patients following this therapy also displayed improvements in glycemic control and cardiovascular risk profile; levels of glycosylated hemoglobin, fasting glucose, and postprandial glucose improved significantly.
Both types
Treatment of both types of diabetes requires a diet planned to meet nutritional needs, to control blood glucose levels, and to reach and maintain appropriate body weight.
For the obese patient with type 2 diabetes, weight reduction is a goal. In type 1, the calorie allotment may be high, depending on growth stage and activity level. For success, the diet must be followed consistently and meals eaten at regular times.
UNDER STUDY: Vitamin E is under investigation for its cellular effects that can possibly reduce the risk of macrovascular disease in patients with type 2 diabetes mellitus. The antioxidant effects of vitamin E were supported, and it was found that, in high doses, vitamin E acts as an anti-inflammatory. It’s postulated that heart disease and stroke risk can be decreased because vitamin E reduces plaque formation at the endothelial level. Vitamin E may also have an effect on the metabolic syndrome that causes diabetes mellitus and may prevent the disease from occurring.
Complications
Treatment of long-term diabetic complications may include transplantation or dialysis for renal failure, photocoagulation for retinopathy, and vascular surgery for large-vessel disease. Meticulous blood glucose control is essential.
The Diabetes Control and Complications Trial has proved that intensive insulin therapy that focuses on keeping glucose at near-normal levels for 5 years or more reduces both the onset and progression of retinopathy (up to 63%), nephropathy (up to 54%), and neuropathy (up to 60%).
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Diabetic complications during pregnancy:
Treatment
(Handbook of Diseases)
Both the newly diagnosed and the established diabetic need dietary management and insulin administration to maintain blood glucose levels within acceptable limits. Most women with overt diabetes mellitus require hospitalization at the beginning of pregnancy to assess physical status, check for cardiac and renal disease, and regulate diabetes.
For pregnant patients with diabetes, therapy includes:
❑ frequent visits to the obstetrician and the internist during the first 6 months of pregnancy; weekly visits may be necessary during the third trimester, an internist may be consulted as necessary.
❑ maintenance of blood glucose levels at or below 95 mg/dl during the third trimester
❑ frequent monitoring for glycosuria and ketonuria (Ketosis presents a grave threat to the fetal central nervous system.)
❑ a high-protein diet of 2 g/day/kg of body weight (a minimum of 80 g/day during the second half of pregnancy), a daily calorie intake of 30 to 40 calories/kg of body weight, a daily carbohydrate intake of 200 g, and enough fat to provide 36% of total calories (However, vigorous calorie restriction can cause starvation ketosis.)
❑ exogenous insulin if diet doesn’t control blood glucose levels. Oral antidiabetic agents are generally contraindicated during pregnancy because they may cause fetal hypoglycemia and congenital anomalies.
Delivery
Generally, the optimal time for delivery is no different from a normal pregnancy, as long as blood sugars are controlled and no fetal compromise is present.
Depending on fetal status and maternal history, labor may be spontaneous induced or a cesarean section performed. During labor and delivery, the patient with diabetes should receive a continuous I.V. infusion of dextrose with regular insulin in water. Maternal and fetal status must be monitored closely throughout labor.
The patient may benefit from half her prepregnancy dosage of insulin before a cesarean delivery. Her insulin requirement will fall markedly after delivery.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Polydipsia:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Teach the patient about his underlying disorder and its treatment. Discuss such self-care measures as diet, exercise, and home blood glucose monitoring. Explain the importance of reporting any significant weight gain or loss to his health care provider.
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Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Polydipsia:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Monitor the patient's intake and output.
▪ Weigh the patient daily.
▪ Check the patient's blood pressure and pulse in the supine and standing positions to detect orthostatic hypotension, which may indicate hypovolemia.
▪ Encourage adequate fluid intake, if appropriate.
Patient teaching
▪ Explain the underlying disorder and its treatments.
▪ Teach the patient about diet, exercise, and home blood glucose monitoring, if indicated.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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