Lifestyles in the treatment of type 2 diabetes
Type 2 diabetes is a highly inherited disease that is affected by lifestyle outbreaks. The same lifestyle changes are suitable for the prevention of type 2 diabetes as for the treatment of type 2 diabetes.
You can start with these three right away:
Medication in addition to lifestyle changes
Low blood sugar medication should be started when fasting blood sugar in a type 2 diabetic is:
repeatedly above 7 millimoles per liter (mmol / l)
and/or more than 11.1 mmol / l 2 hours after a meal.
After starting medication - and whenever it is intensified - it is important to monitor your weight carefully. If weight gain begins, the medication should be checked.
Various tablets or tablets and insulin injections or insulin alone can be used to treat high blood sugar. There are also injectable intestinal hormone-like medicines that affect blood sugar.
Medication does not diminish the importance of drug-free treatment but remains the basis for the treatment of type 2 diabetes. Drug-free treatment means a healthy diet, regular exercise, weight management, and non-smoking.
Drugs that affect blood sugar except for insulin
Tablets There are several different tablets you can use to treat your blood sugar - either alone or in combination with other tablets or insulin.
The tablets can reduce the production of sugar in the liver, increase the effect of the body's own insulin, increase the secretion of insulin by the pancreas, or speed up the release of insulin from the pancreas.
The appropriate medication is always chosen individually. The dosage is also individual.
The tablets are taken regularly as directed.
Metformin is a liver sugar barrier
Metformin reduces liver sugar production. Metformin is a long-used and common drug that is recommended for type 2 diabetics as the primary blood glucose drug. It is effective and inexpensive, and there is a lot of experience in using it.
Metformin suppresses appetite and has a beneficial effect on blood fat levels. It doesn’t usually lower your blood sugar too much. It is a good idea to take metformin with a meal, as there will be less potential stomach upset. You should start taking the medicine gradually by increasing the dose.
Metformin is not suitable for people with kidney or liver problems, heavy drinkers, or people with severe general conditions.
There are several preparations for metformin. Examples of trade names are Diformin Retard, Glucophage, Metformin, Metformin Actavis, Metgol, and Oramet-Hexal.
Gliptins
Sitagliptin, vildagliptin, saxagliptin, and linagliptin stimulate pancreatic insulin secretion and inhibit hepatic glucose production by affecting gastrointestinal hormones, incretins. The drugs are new and there is no long experience with their use.
Gliptins lower blood sugar only when it is elevated and thus do not increase the risk of low blood sugar. They do not lift weights.
The drugs are suitable for use with metformin or an insulin sensitizer. Sitagliptin is sold under the trade names Januvia and Xelevia, vildagliptin is called Galvus, saxagliptin is called Onglyza, and linagliptin is called Trajenta.
A combination of sitagliptin and metformin (Janumet, Velmetia) and a combination of vildagliptin and metformin (Eucreas), and a combination of linagliptin and metformin (Jentadueto) are also available.
Gluclocins
Gliflocins, SGLT2 inhibitors, increase the urinary excretion of sugar from the kidneys. This will lower your blood sugar and your weight may fall somewhat.
Glyphlocins can be used in combination with other medicines to lower blood sugar and insulin. It is not suitable if you have kidney problems.
Excess sugar in the urine slightly increases the susceptibility to the urinary tract and yeast infections. Dapagliflozin is sold under the trade name Forxiga and empagliflozin under the name Jardiance.
Meal
tablets Meal tablets (repaglinide) are fast-acting medicines that increase insulin secretion. Meal tablets are suitable when the problem is a sharp rise in blood sugar after a meal. Medicines are taken just before a meal. If you miss a meal, the medicine will not be taken. Meal tablets may be combined with metformin or insulin sensitizers or long-acting insulin. A meal tablet can lower your blood sugar too much if taken with a meal that is very low in carbohydrates. Meal tablets are usually taken with main meals.
Insulin
sensitizer Pioglitazone (Actos) is an insulin sensitizer that improves the action of insulin on cells. This medicine is used alone or in combination with other tablets and insulin. A combination of pioglitazone and metformin (Competact) is also available.
Insulin sensitizer increases the insulin sensitivity of the liver, adipose tissue, and muscles. In addition, it reduces fatty liver. Its disadvantages include weight gain and swelling, as well as an increased risk of fractures in women.
Insulin sensitizer is generally suitable for type 2 diabetics who have not had diabetes for a very long time and who have insulin resistance and metabolic syndrome. Insulin sensitizers are not suitable for people with heart failure or liver disease.
Sulphonylureas
Sulphonylureas increase insulin secretion and release from the pancreas. They lower both postprandial blood sugar and fasting blood sugar. Sulphonylureas may lower your blood sugar too much, for example during exercise or with a longer meal interval. Therefore, sulphonylureas should be taken with food. Weight gain can also be a disadvantage. Sulphonylureas can be used in combination with metformin, an insulin sensitizer, or insulin. Glimepiride, a sulphonylurea, is available in a number of different concomitant products.
Subcutaneous use, including insulin
Intestinal hormone derivatives exenatide and liraglutide
Exenatide (trade name Byetta) and liraglutide (Victoza) act as incretin effects such as sitagliptin and vildagliptin.
Exenatide is injected twice a day, liraglutide once a day under the skin. There is also a weekly form of exenatide (Bydureon). Exenatide and liraglutide have a weight-loss effect and do little to increase the risk of low blood sugar. The disadvantages are an upset stomach.
Liraglutide is suitable for use with metformin, a sulphonylurea or an insulin sensitizer, or a combination thereof. Exenatide can be used in combination with metformin and sulphonylurea.
Insulin treatment is part of an effective, modern treatment for type 2 diabetes. The need for insulin therapy is always decided individually. Type 2 diabetes is characterized by a decrease in pancreatic insulin production over the years. As a result, tablet therapy alone may not be enough to achieve a good sugar balance. Usually, the first switch to combination therapy is to add insulin to the tablets. If necessary, type 2 diabetes can be treated with insulin alone.
Initiating insulin therapy can sometimes feel like a treatment failure or a frightening new thing. Knowledge of the nature of type 2 diabetes and the importance of insulin therapy, as well as familiarization with injection equipment, clarifies thoughts and dispels potential fears.
The form of treatment is chosen individually. There are several different options. This could be, for example, evening insulin treatment (tablets during the day, basal insulin in the evening) or, in the absence of insulin, multi-injection therapy (mealtime with meals, basal insulin once a day).
Blood glucose measurement required
Initiating insulin therapy usually means measuring your blood sugar more often. This will be agreed upon with your doctor or nurse.
Weight monitoring
Insulin therapy may be associated with weight gain. The reason is an improvement in blood sugar balance. As a result, no more sugar is excreted in the urine, and all the energy is left for the body to use. Insulin use may also increase appetite. When starting insulin treatment, it is good to check that the amount of food (energy intake) corresponds to the consumption. If necessary, eating should be reduced, sometimes by a fair amount.
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