Type 2 Diabetes: Recently Diagnosed

Overview

Is this topic for you?

This topic provides information for adults who have been diagnosed with type 2 diabetes within the last few months. If this topic does not answer your questions, see:

If you are looking for information about type 1 diabetes, see the topic Type 1 Diabetes.

What is type 2 diabetes?

Type 2 diabetes is a lifelong disease that develops when the pancreas can't make enough insulin or when the body's tissues become resistant to insulin.

Insulin is a hormone that helps the body’s cells use sugar (glucose) for energy. It also helps the body store extra sugar in muscle, fat, and liver cells. Without insulin, this sugar can't get into your cells to do its work. It stays in your blood instead. Your blood sugar level then gets too high.

High blood sugar can harm many parts of the body. It can damage blood vessels and nerves throughout your body. You will have a bigger chance of getting eye, heart, blood vessel, nerve, and kidney disease.

Your weight, level of physical activity, and family history affect how your body responds to insulin. People who are overweight, get little or no exercise, or have diabetes in the family are more likely to get type 2 diabetes.

Type 2 diabetes is usually found in adults, which is why it used to be called adult-onset diabetes. But now more and more children and teens are getting it too.

Type 2 diabetes is a disease that you will always have, but you can live a long and healthy life by learning how to manage it.

What are the symptoms?

Many people have symptoms such as increased thirst and urination, weight loss, and blurred vision. Some people do not have symptoms, especially when diabetes is diagnosed early.

How is type 2 diabetes diagnosed?

Most likely you found out that you have diabetes when you saw your doctor for a regular checkup or for some other problem. Your doctor probably diagnosed type 2 diabetes by examining you, asking about your health history, and looking at the results of blood sugar tests.

How is it treated?

You play a big role in your diabetes treatment. A healthy diet helps keep your blood sugar under control and helps prevent heart disease.

Eating the right amount of carbohydrate at each meal is very important. Carbohydrate is found in:

  • Sugar and sweets.
  • Bread, rice, and pasta.
  • Fruit.
  • Starchy vegetables, such as potatoes and corn.
  • Milk and yogurt.

A dietitian or a certified diabetes educator can help you plan your meals.

Losing weight, eating right, and being more active are enough for some people to control their blood sugar levels. Others also need to take one or more medicines, including metformin (Glucophage) or insulin.

You may need to take other steps to prevent other problems from diabetes. These problems are called complications. You may need medicine for high blood pressure or high cholesterol. If you smoke, quitting smoking may help you avoid having a heart attack and stroke.

People with diabetes are more likely to die from heart and blood vessel problems like heart attack and stroke. Talk to your doctor about whether you should take low-dose aspirin. Daily low-dose aspirin (81 milligrams) may help prevent heart problems if you are at risk for heart attack or stroke.

What kind of daily care do you need?

The key to managing your diabetes is to keep your blood sugar level within your target range. You can do this by:

  • Making healthy food choices. Eat a balanced diet, and try to manage the amount of carbohydrate you eat by spreading it out over the day. Lose weight if you need to.
  • Being active. Walking is a great way to start.
  • Testing your blood sugar levels. You have a better chance of keeping your blood sugar in your target range if you know what it is from day to day.
  • Keeping high blood pressure and high cholesterol under control. This can help lower your risk of other health problems, such as heart disease and stroke.
  • Taking medicines, such as metformin (Glucophage) or insulin, if you need them.
  • Not smoking. Quitting smoking reduces your risk of heart attack and stroke.

It seems like a lot to do at first. You might start with one or two changes. First focus on checking your blood sugar regularly and being active more often. Then work on the other tasks as you can.

It can be hard to accept that you have diabetes, especially if you don't have any symptoms. It's normal to feel sad or angry. You may even feel grief. Talking about your feelings may help. Your doctor or other health professionals can help you cope with your diagnosis.

Cause

Type 2 diabetes occurs when your blood sugar (glucose) levels get too high because:

  • Your body isn't able to use insulin the right way. This makes it hard for your cells to get glucose from blood to make energy. This is called insulin resistance.
  • Your pancreas doesn't make enough insulin to make up for the insulin resistance. As diabetes gets worse, your pancreas may make less and less insulin.

Symptoms

Not everyone has symptoms before they find out they have type 2 diabetes. But if you did have symptoms, they may go away when your blood sugar level returns to your target range.

Symptoms of high blood sugar

You may not have any symptoms of type 2 diabetes. That's because your blood sugar levels can rise so slowly over time that you don't notice that anything is wrong. Early symptoms of high blood sugar can include:

  • Being very thirsty.
  • Urinating a lot.
  • Losing weight without trying.
  • Having blurry vision.
Photo of a woman

One Woman's Story:

Gloria, 70

About a year ago, Gloria had trouble reading the numbers on some checks she was filing. She cleaned her glasses and put them back on, but it didn't help. "My eyes were all blurry. It was really scary. My doctor tested me for diabetes. He said that the blurriness means my blood sugar is too high."—Gloria

Read more about Gloria and how she manages her diabetes.

The higher your blood sugar rises, the more likely you are to have symptoms. If you have higher-than-normal blood sugar and don't drink enough liquids, you can get dehydrated. This can make you feel dizzy and weak, and it can lead to an emergency called a hyperosmolar state.

Symptoms of low blood sugar

When your blood sugar is too low, it can also cause problems. Low blood sugar can occur suddenly. Symptoms of low blood sugar include:

  • Sweating.
  • Shakiness.
  • Confusion.
  • Loss of consciousness.

You're not likely to get low blood sugar unless you take insulin or some kinds of oral medicines for type 2 diabetes.

Symptoms and signs of complications

Some people already have complications of type 2 diabetes when they are diagnosed. That can happen because high blood sugar can creep up over time and cause problems without your knowing it. It's important to know about possible problems and their symptoms, such as:

If you have kidney damage, you may not notice symptoms. Early damage to your kidneys can only be found by urine tests for protein.

What Happens

Type 2 diabetes is a lifelong disease that affects the way your body uses food for energy. The key to managing your diabetes is keeping your blood sugar within your target range. Controlling your blood sugar will help you prevent or delay other health problems. Learning the skills you need to manage your diabetes will take time, but soon they will become part of your daily routine.

Your treatment will involve eating right, being more active, checking your blood sugar, and possibly taking pills (oral medicines) or insulin. If you are overweight, losing weight may also help you control your blood sugar. For more information, see the Treatment Overview and Medications sections of this topic.

As time goes on, your pancreas may make less and less insulin, which can make it harder to control your blood sugar. It's important to treat your high blood sugar quickly anytime it rises above your target range. Doing so can prevent blood sugar emergencies. For more information, see the Prevention section of this topic.

High blood sugar emergencies

A hyperosmolar state is life-threatening and can occur when your blood sugar level is very high (400 to 500 mg/dL or higher) and you get dehydrated. You are more likely to have this problem if your blood sugar stays above 200 mg/dL.

Hyperosmolar state is treated in a hospital. You'll have 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. You'll get fluids through the IV to get rid of the dehydration. The fluids will make you urinate, removing the excess sugar from your body.

Diabetes complications

Over time, high blood sugar that is not controlled can lead to problems with your:

If you had higher-than-normal blood sugar levels for years, you may already have one or more of these problems.

What Increases Your Risk

Now that you have type 2 diabetes, it's important to know what could increase your risk of complications.

  • Your blood sugar stays high over time. Your risk for complications increases if your blood sugar gets too high and stays high too long.
  • You have had the disease for a long time. The longer you have diabetes, the more likely you are to have some related health problems. This can happen even if your blood sugar levels are controlled.
    • Kidney disease (diabetic nephropathy) occurs in 20 to 30 people out of 100 who have type 2 diabetes.1
    • Eye disease (diabetic retinopathy) occurs within 20 years after diagnosis in more than 60 people out of 100 who have type 2 diabetes.2
    • Most people with diabetes start to get some nerve damage (diabetic neuropathy) over the years. But only about half of the people who get neuropathy have noticeable symptoms.3
  • You already have one complication. If you have one diabetes-related problem, you are at a higher risk for getting another one.
  • You have other risk factors, such as:

For more information, see the Prevention and Home Treatment sections of this topic.

When to Call a Doctor

Call 911 or other emergency services immediately if you are:

Call a doctor immediately if you are vomiting and cannot keep down liquids and:

  • Your blood sugar is 300 mg/dL or higher.

Call a doctor if you:

  • Are sick for more than 2 days (unless it is a mild illness, such as a cold), and you:
    • Have been vomiting or had diarrhea for more than 6 hours.
    • Have followed the doctor's advice but it has not worked. Learn what to do when you are sick and have diabetes.
    • Have blood sugar levels that are often above 300 mg/dL, and urine tests for ketones show more than 2+ or moderate or higher ketones.
  • Have a blood sugar level that stays below the target range after you eat some quick-sugar food.
  • Have a blood sugar level that stays high after you take a missed dose of insulin or oral diabetes medicines or after you take an extra dose of insulin (if prescribed by the doctor).
  • Have frequent problems with high or low blood sugar levels. The insulin dose or schedule may need to be changed.
  • Are having trouble knowing when your blood sugar is low (hypoglycemia unawareness).
  • Have problems following the meal plan or getting physical activity, and you want help.

Who to See

Health professionals who may be involved in your diabetes care include:

If you have signs that a complication of diabetes may be developing or has developed, you may be referred to a specialist.

More Information:

Exams and Tests

Tests to diagnose diabetes

Your diagnosis of type 2 diabetes was based on the American Diabetes Association's (ADA) guidelines.

To help make the diagnosis, your doctor used:

If you are diagnosed as having diabetes but it's not clear whether it is type 2 or type 1 diabetes, your doctor may do a C-peptide level test. The results may be normal or increased if you have type 2 diabetes.

For more information on these tests, see the Exams and Tests section of the topic Type 2 Diabetes.

Tests to check for complications

High blood sugar can creep up over time and cause problems without your knowing it. When you find out that you have diabetes, it's a good idea to check for any complications you may already have. You may need the following tests:

You may also need an exercise electrocardiogram (treadmill EKG test) before you start an exercise program.

Ongoing tests to keep track of diabetes

As part of your treatment, you'll need other tests to monitor your diabetes and help you avoid complications. These include:

  • Home blood sugar tests . You will need to test your blood sugar regularly at home. You have a better chance of keeping your blood sugar in your target range if you know what it is from day to day.
  • Hemoglobin A1c blood test. You'll have this test every 3 to 4 months. It shows how steady your blood sugar levels have been over time. And it can show high blood sugar at times when you might not normally be checking, such as after meals and overnight. With this information, your doctor will know how well your treatment is working.
  • Tests for high blood pressure and high cholesterol.
  • Regular foot exams by your doctor. Diabetes can damage the nerve endings and blood vessels in your feet.
  • Routine eye exams by an ophthalmologist.
  • A yearly urine test for protein, which can be a sign of kidney problems.

For more information, see the Treatment Overview section of this topic.

More Information:

Treatment Overview

The key to treating your type 2 diabetes is keeping your blood sugar as close to your target levels as you can with diet, exercise, and maybe medicines if you need them. This can help you stay healthy and lower your risk of complications. Try to:

Photo of a woman

One Woman's Story:

Gloria, 70

Gloria changed her diet and got more active after she found out she had diabetes. She expected to see results right away, but it took time. "It took me about 6 months to get into my blood sugar range. And I was doing everything right. So I guess the biggest message is that you have to be patient."—Gloria

Read more about Gloria and how she manages her diabetes.

Tests you will need as part of your treatment

See your doctor about every 3 to 6 months to:

  • Have a blood glucose test. Your doctor may check your blood sugar meter to find out if your home blood sugar tests are reliable. He or she may also check your blood sugar levels to see if your treatment needs to be changed since your last visit.
  • Check your blood pressure and start or adjust treatment if it's high.
  • Check your feet for signs of foot problems.
  • Have a hemoglobin A1c or similar test. If your blood sugar levels are stable and your treatment hasn't changed, this test may be done every 6 months.

Have these exams and tests every year:

You can print out a list of tests to monitor diabetes to help you remember what to do and when.

Why treatment and testing are important

Untreated type 2 diabetes can lead to serious health problems. People with diabetes have a higher risk of dying from heart and blood vessel diseases than people who don't have the disease.5 That's why it's important to take charge of your diabetes as soon as you find out you have it—even if you feel fine.

With diabetes, you're in charge. It's up to you to eat right, get active, and keep your blood sugar levels on target. It seems like a lot to do at first. Start with one or more changes. Your might first focus on checking your blood sugar regularly and being active more often. Then work on the other tasks as you can.

For help and how-tos, see the Home Treatment section of this topic.

To take charge, you need to test

Photo of a woman

Rhonda O'Brien, certified diabetes educator

"A lot of people who find out they have type 2 diabetes think, 'Well, at least it's not the "bad kind" of diabetes [type 1].' But they still need to test. Type 2 diabetes is just as serious as type 1." —Rhonda

Learn blood sugar testing tips from Rhonda O'Brien.

Prevention

Prevent complications

You can prevent or delay complications of type 2 diabetes by controlling your blood sugar levels. And it's just as important to keep high blood pressure and high cholesterol under control.

Managing your blood sugar, cholesterol, and blood pressure can help prevent other health problems with your eyes, kidneys, and heart.

To keep blood sugar at your target range and avoid complications:

  • Make healthy food choices.
  • Be active.
  • Test your blood sugar levels.
  • Take medicines, such as metformin (Glucophage) or insulin, if you need them.
  • Don't smoke.

To manage your blood pressure and cholesterol, eat a heart-healthy diet, get active, and take medicines if you need them.

Prevent blood sugar emergencies

It's also important to avoid high and low blood sugar problems that can lead to medical emergencies.

  • High blood sugar. A hyperosmolar state is life-threatening and can occur when your blood sugar level is very high (400 to 500 mg/dL or higher) and you get dehydrated. You are more likely to have this problem if your blood sugar stays above 200 mg/dL. Your blood sugar may rise when you are ill, so follow the guidelines for when you are sick to help prevent a high blood sugar emergency.
  • Low blood sugar. It's unlikely that you will have low blood sugar unless you take insulin or some kinds of oral medicines for type 2 diabetes that can cause it. But if you are at risk for low blood sugar, know your symptoms and how to treat them. Low blood sugar can lead to a life-threatening emergency if it is not treated quickly. Don't drive if your blood sugar level is below 70 milligrams per deciliter (mg/dL). Take precautions when you are driving.

For more help controlling your blood sugar and avoiding complications of diabetes, see the Home Treatment section of this topic.

Set a Goal to Manage Diabetes

Losing weight, getting active, eating better, and quitting smoking are all important changes you can make for your health when you have type 2 diabetes. But you don't have to do them all at once. Just pick one to start. Maybe it's losing weight or adding more activity to your life. Three steps can help you get started.

1. Know your reason. Before you set a goal, think about why you want to make a change. If your reason comes from you—and not from someone else—it will be easier for you to make a healthy change for good.

Maybe you want to prevent your diabetes from getting worse. Perhaps you know someone who had serious problems from diabetes, and you want to prevent that from happening to you. You might simply want to enjoy your life and have more energy for all the things you enjoy doing. Your reason for wanting to change is important.

2. Set long-term and short-term goals. Start by setting a big, or long-term goal. Maybe you want to lose 10% of your body weight to reduce your risk of health problems tied to type 2 diabetes. If you weigh 200 pounds, that means losing 20 pounds. Break down your big goal into smaller, short-term ones. These are the steps you'll take to reach your big goal.

Do what works best for you. It's important to set goals you can reach. For example:

  • Week 1: Set a goal to walk 15 minutes, 5 days a week.
  • Week 2: Continue to walk 15 minutes, 5 days a week. And this week, when you reach for a snack, make it carrot or celery sticks instead of potato chips or crackers.
  • Week 3: Keep up your walking program and eating healthy snacks. Pay attention to your hunger levels when eating meals. Stop eating when you feel full.

For help, see:

Click here to view an Actionset. Fitness: Adding activity to your life.
Click here to view an Actionset. Fitness: Walking for wellness.
Click here to view an Actionset. Healthy eating: Starting a plan for change.
Click here to view an Actionset. Healthy eating: Recognizing your hunger signals.

3. Prepare for slip-ups and barriers. Plan for setbacks. Use a personal action plan(What is a PDF document?) to write down your goals, any possible barriers, and your ideas for getting past them. By thinking about these barriers now, you can plan ahead for how to deal with them if they happen.

For help, see:

Click here to view an Actionset. Quitting smoking: Preventing slips and relapses.
Click here to view an Actionset. Healthy eating: Overcoming barriers to change.

Tips for staying on track

  • Get support. Tell family and friends your reasons for wanting to change. Tell them that their encouragement makes a big difference to you in your goal, whether it's losing weight or quitting smoking. Your doctor or a professional counselor can also provide support.
  • Pat yourself on the back. Don't forget to give yourself some positive feedback. If you slip up, don't waste energy feeling bad about yourself. Instead, think about how much closer you are to reaching your goal than when you started.

Home Treatment

You play a major role in managing your diabetes. The more you know about your disease, the better you can care for yourself.

For the best chance at a long, healthy life, you need to set goals for your treatment, including:

Make a healthy eating plan

If you're overweight, losing 5% to 10% of your weight may help you reach normal blood sugar levels. For example, if you weigh 200 pounds, losing 10 to 20 pounds may lower your blood sugar.

Managing the amount of carbohydrate you eat is an important part of a healthy diet for diabetes. Carbohydrate is found in:

  • Sugar and sweets.
  • Bread, rice, and pasta.
  • Fruit.
  • Starchy vegetables, such as potatoes and corn.
  • Milk and yogurt.

The best diet is a balanced one. A healthy eating plan doesn't have to be complicated. Try to:

  • Limit how much fat you eat. Eat foods low in saturated fat and high in fiber.
  • Cut down on foods that are high in calories but low in nutrition, such as soda.
  • Limit sweets.

You may want to work with a dietitian or certified diabetes educator to help you plan menus that spread carbohydrate throughout the day. This will keep your blood sugar from rising sharply after meals.

It can be hard to make big changes in the way you eat. And if you don't have any symptoms, you might not think it's all that important.

It's normal to have some negative feelings about diabetes and how it's affecting your life, especially the way you eat. But try not to let those feelings get in the way of taking care of yourself. For help, see:

Click here to view an Actionset. Diabetes: Coping with your feelings about your diet.

For more ideas about healthy eating, try:

Quick Tips: Smart Snacking When You Have Diabetes.
Click here to view an Actionset. Diabetes: Using a plate format for eating.
Click here to view an Actionset. Diabetes: Counting carbs if you don't use insulin.
Click here to view an Actionset. Diabetes: Using a food guide.

Healthy eating is the key

Photo of a woman

Rhonda O'Brien, certified diabetes educator

"Healthy eating is the key to your diabetes diet. There's no 'good food' or 'bad food' for diabetes. But you do need to count your carbohydrates. And you need to test so that you know the foods that affect your blood sugar."—Rhonda

Learn blood sugar testing tips from Rhonda O'Brien.

Get active

The more active you are, the more sugar (glucose) your body uses for energy. This keeps the sugar from building up in your blood. Being active also:

How to start

Don't worry. You don't have to sign up for a gym membership or train for a marathon to get the activity you need to control your blood sugar. Even everyday activities can help.

Try to do moderate activity at least 2½ hours a week. Or try to do vigorous activity at least 1¼ hours a week. It's fine to be active in blocks of 10 minutes or more throughout your day and week.

Moderate activity is safe for most people, but it's always a good idea to talk to your doctor before you start an exercise program.

Here are some ideas for starting to get activity into your daily routine:

Quick Tips: Getting Active at Home
Click here to view an Actionset. Fitness: Adding more activity to your life
Click here to view an Actionset. Fitness: Walking for wellness

Try to include resistance exercises in your program 3 times a week. 4 These activities can include things like weight lifting or yard work. See the topic Fitness for more ideas.

Your blood sugar levels change when you are active. For some people, the change is the same every time they exercise. For other people, how their blood levels change will be different each time they exercise. It's a good idea to check your blood sugar before and after you're active, and talk to your doctor about it.

Test your blood sugar

Everything in your life can affect your blood sugar levels, from what you eat, to how you feel, to how much activity you get. You may not like having to check your blood sugar regularly and keep track of the results over time. But it can really help you keep your diabetes under control.

  • Checking how your blood sugar rises or falls in response to certain foods, exercise, and other things can help you reduce symptoms, prevent blood sugar emergencies, and prevent serious complications.
  • Having a record of your blood sugar over time can help you and your doctor know how well your treatment is working and whether you need to make any changes.

For more information, see:

Click here to view an Actionset. Diabetes: Checking your blood sugar.
Photo of older man

One Man's Story:

Andy, 52

"Probably the biggest thing I've learned is to test, don't guess. That's something my doctor told me, and it's really true. You can't know what your numbers are unless you test."—Andy

Read more about Andy and his diabetes routine.

Take medicines if you need them

You may need to take medicines, such as metformin (Glucophage) or insulin, to help keep your blood sugar levels on target.

Click here to view an Actionset. Diabetes: Dealing with low blood sugar from medicines.
Click here to view an Actionset. Diabetes: Giving yourself an insulin shot.

For more information, see the Medications section of this topic.

Daily aspirin

People with diabetes have a higher risk of dying from heart and blood vessel diseases than people who don't have diabetes.4 Talk to your doctor about whether you should take low-dose aspirin. Daily low-dose aspirin (81 milligrams) may help prevent heart problems if you are at risk for heart attack or stroke.

Take care of yourself in other ways

Check your feet every day to look for cuts or other signs of injury. (If you have poor eyesight, have someone else check your feet.) Diabetes can damage the nerve endings and blood vessels in your feet, making you less likely to notice when they are injured.

Diabetes also makes it harder for your body to fight infection. If you get a minor foot injury, it could turn into an ulcer or a serious infection.

With good foot care, you can prevent most of these problems. For more information on foot care, see the topic Type 2 Diabetes: Living With the Disease or see:

Click here to view an Actionset. Diabetes: Taking care of your feet.

Wear medical identification at all times. If you have an accident or are taken to a hospital, identification lets people know that you have diabetes so they can give you the right care.

You can buy medical identification as bracelets, necklaces, or other kinds of jewelry at your local drugstore.

How to cope with your feelings

Finding out that you have diabetes can be hard to accept. You may feel sad, angry, and confused. You may want to deny that you have it. And you may wonder how you are going to manage all the changes you need to make.

It's normal to feel sad when your health changes. It can be hard to adjust to the idea of treating diabetes for the rest of your life. Give yourself time to grieve your losses. If you start to feel overwhelmed, try to focus on one day at a time. See:

Click here to view an Actionset. Depression: Using positive thinking.

If you're having trouble coping with your feelings, you may want to talk with a counselor. A professional may make it easier to say things you wouldn't talk about with friends or family.

If you have symptoms of depression, such as a lack of interest in things you enjoy, a lack of energy, or trouble sleeping, talk with your doctor. For more information, see the topic Depression.

You can also:

  • Talk to your doctor. He or she can help you deal with your feelings.
  • Talk with friends and family about how you feel and any help you need.
  • Ask a friend or family member to come to counseling with you.
  • If you belong to a church or spiritual group, talk to your spiritual advisor. He or she will have experience helping people deal with their feelings.
  • Join a support group. You can find one through your doctor, your local hospital, or the American Diabetes Association.
Photo of a woman

One Woman's Story:

Gloria, 70

Gloria meets once a month with her support group—women she met in her diabetes education class. "It's not a formal group. We get together for coffee, talk about how we're doing, what we're eating. And we swap recipes. It's really fun, and I learn a lot from them."—Gloria

Read more about Gloria and how she manages her diabetes.

Medications

How medicine helps manage diabetes

Some people with type 2 diabetes need pills (oral medicines) to help their bodies make insulin, decrease insulin resistance, or slow down how quickly their bodies absorb carbohydrate.

You may take no medicine, one medicine, or a few medicines. Some people need to take medicine for a short time, while others always need to take medicine. How much medicine you need depends on how well you can keep your blood sugar within normal levels.

Taking two or more medicines may work better to lower your blood sugar level than taking one medicine alone. Also, taking two or more medicines may mean fewer side effects because you are taking a lower dose of each.

Medicine choices

  • Oral medicines that help your body make insulin. These include:
    • Sulfonylureas, such as glipizide (Glucotrol), glyburide (DiaBeta, Glynase, and Micronase), glimepiride (Amaryl), and other medicines that work in combination (Glucovance, Metaglip).
    • Meglitinides, such as repaglinide (Prandin), nateglinide (Starlix), and a combination medicine (Prandimet).
    • DPP-4 inhibitors, such as sitagliptin (Januvia) and a combination medicine (Janumet).
  • Oral medicines that lower insulin resistance. These include:
    • Biguanides, such as metformin (Glucophage), and other medicines that are combined with metformin (Prandimet, Avandamet).
    • Thiazolidinediones, such as pioglitazone (Actos) and rosiglitazone (Avandia).
  • Oral medicines that slow down absorption of carbohydrates. These include:
  • Medicines that help lower blood sugar. If you are having trouble controlling your blood sugar with pills, your doctor may suggest that you try one of these medicines:
    • Incretin mimetics, such as exenatide (Byetta). You take this medicine as a shot 2 times a day.
    • Amylinomimetics, such as pramlintide (Symlin). This medicine works with insulin and glucagon to help control blood sugar. It is given as a shot before meals.
  • Insulin . Insulin lets sugar (glucose) in the blood enter cells, where it is used for energy. Without insulin, the blood sugar level rises above what is safe for the body. Most of the time, people who take insulin use a combination of short-acting and long-acting insulin. This helps keep blood sugar within the recommended range. You may also want to learn more about when insulin is needed for type 2 diabetes.

What to Think About

You may also need to take:

Surgery

There are no surgeries to treat type 2 diabetes.

Studies show that the large weight loss provided by stomach surgery (bariatric surgery) improves blood sugar control in people who are very overweight.4 But this surgery can be risky. And it's not a good choice for everyone with diabetes. Keep in mind that there is more than one kind of weight-loss surgery, and it's not clear which one is best.

If you are very overweight, talk with your doctor about whether stomach surgery would be right for you. For more information, see the topic Obesity.

Other Treatment

Avoid products that promise a “cure” for diabetes. There is no cure.

If you have questions about a diet or product for diabetes, check with your local American Diabetes Association office, your doctor, or a diabetes educator. Talk with a dietitian before choosing a meal plan for your diabetes diet.

Complementary therapies

Some complementary therapies, such as acupuncture or biofeedback, may help relieve stress and muscle tension. They might also improve your well-being and quality of life. But they should not be used alone to treat diabetes.

Talk with your doctor if you are using any complementary or alternative therapies, including chiropractic therapy and osteopathy.

Herbal medicines and natural substances, such as antioxidants, vanadium, magnesium, and chromium, may help you feel better. But they should be taken only under your doctor's supervision. Talk with your doctor about any herbal or natural products that you are taking or that you want to take.

Other Places To Get Help

Organizations

American Diabetes Association (ADA)
1701 North Beauregard Street
Alexandria, VA  22311
Phone: 1-800-DIABETES (1-800-342-2383)
E-mail: AskADA@diabetes.org
Web Address: www.diabetes.org
 

The American Diabetes Association (ADA) is a national organization for health professionals and consumers. Almost every state has a local office. ADA sets the standards for the care of people with diabetes. Its focus is on research for the prevention and treatment of all types of diabetes. ADA provides patient and professional education mainly through its publications, which include the monthly magazine Diabetes Forecast, books, brochures, cookbooks and meal planning guides, and pamphlets. ADA also provides information for parents about caring for a child with diabetes.


National Diabetes Education Program (NDEP)
1 Diabetes Way
Bethesda, MD  20814-9692
Phone: 1-800-438-5383 to order materials
(301) 496-3583
E-mail: ndep@mail.nih.gov
Web Address: http://ndep.nih.gov
 

The National Diabetes Education Program (NDEP) is sponsored by the U.S. National Institutes of Health (NIH) and the U.S. Centers for Disease Control and Prevention (CDC). The program's goal is to improve the treatment of people who have diabetes, to promote early diagnosis, and to prevent the development of diabetes. Information about the program can be found on two Web sites: one managed by NIH (http://ndep.nih.gov) and the other by CDC (www.cdc.gov/team-ndep).


National Diabetes Information Clearinghouse (NDIC)
1 Information Way
Bethesda, MD  20892-3560
Phone: 1-800-860-8747
Fax: (703) 738-4929
TDD: 1-866-569-1162 toll-free
E-mail: ndic@info.niddk.nih.gov
Web Address: http://diabetes.niddk.nih.gov
 

This clearinghouse provides information about research and clinical trials supported by the U.S. National Institutes of Health. This service is provided by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK), a part of the National Institutes of Health (NIH).


National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Building 31, Room 9A06
31 Center Drive, MSC 2560
Bethesda, MD  20892-2560
Phone: (301) 496-3583
Web Address: www.niddk.nih.gov
 

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) provides information and conducts research on a wide variety of diseases as well as issues such as weight control and nutrition.


References

Citations

  1. American Diabetes Association (2004). Nephropathy in diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S79–S83.
  2. American Diabetes Association (2004). Retinopathy in diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S84–S87.
  3. American Diabetes Association (2005). Diabetic neuropathies. Position statement. Diabetes Care, 28(4): 956–962.
  4. American Diabetes Association (2009). Standards of medical care in diabetes. Clinical Practice Recommendations 2009. Diabetes Care, 32(Suppl 1): S13–S61.
  5. American Diabetes Association (2004). Aspirin therapy in diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S72–S73.

Other Works Consulted

  • American Diabetes Association (2008). All About Diabetes. Available online: http://www.diabetes.org/about-diabetes.jsp.
  • American Diabetes Association (2008). Nutrition recommendations and interventions for diabetes. Diabetes Care, 31(Suppl 1): S61–S78.
  • Amorosa LF, Swee DE (2007). Diabetes mellitus. In RE Rakel, ed., Textbook of Family Medicine, 7th ed., pp. 989–1020. Philadelphia: Saunders Elsevier.
  • Dixon JB, et al. (2008). Adjustable gastric banding and conventional therapy for type 2 diabetes. JAMA, 299(3): 316–323.
  • Gray DS (2006). Diabetes mellitus, type 2. In MR Dambro, ed., Griffith's 5-Minute Clinical Consult, pp. 322–323. Philadelphia: Lippincott Williams and Wilkins.
  • Saenz A, et al. (2007). Metformin monotherapy for type 2 diabetes mellitus. Cochrane Database of Systematic Reviews (4).
  • Sigal RJ, et al. (2006). Physical activity/exercise and type 2 diabetes: A consensus statement from the American Diabetes Association. Diabetes Care, 29(6): 1433–1438.

Credits

Author Caroline Rea, RN, BS, MS
Editor Susan Van Houten, RN, BSN, MBA
Associate Editor Pat Truman, MATC
Primary Medical Reviewer Caroline S. Rhoads, MD - Internal Medicine
Specialist Medical Reviewer Matthew I. Kim, MD - Endocrinology & Metabolism
Last Updated June 16, 2008

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