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Type 2 Diabetes Treatment Overview

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Care Plan

1

First steps to consider

  • If you have symptoms of type 2 diabetes, like frequent urination or thirst, or your blood test shows high blood sugar levels, see a healthcare provider to get a treatment plan.
  • You may need to take medications, but you can also change your diet and exercise routine to help lower blood sugar levels.
  • Always call your healthcare provider if you think you are developing new symptoms or your blood sugar is not under control.
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Emergency Care

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Go to the ER or call 911 if you have any of the following symptoms:

  • Excessive urination and thirst
  • Fatigue
  • Nausea or vomiting
  • Abdominal pain
  • Difficulty breathing
  • Confusion

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All treatments for type 2 diabetes
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When to see a healthcare provider

Always see a healthcare provider if you have symptoms of type 2 diabetes, like frequent urination or thirst, or if a blood test shows that you have high blood sugar levels. You will work with your provider to create a treatment plan, which includes diet and exercise, and often medications to bring down your blood sugar levels.

You should also contact a provider if your blood sugars remain above your goal after 3 months of lifestyle changes. The provider will review your treatment plan and may add or change a medication to help get your blood sugar levels under control.

You may also be referred to a podiatrist (foot doctor) if you have complications related to your feet. You may also need to see an ophthalmologist or optometrist for regular screening of your retina.

How to diagnose type 2 diabetes

There are several tests used to diagnose diabetes:

  • Random blood sugar testing. The blood test can be done immediately—no fasting required—and may be used if you’re experiencing symptoms of diabetes.
  • Fasting plasma glucose test. This blood test measures your blood glucose (sugar) levels at the time of the test. It’s taken after fasting for 8 hours.
  • Glycated hemoglobin (A1C) test. This blood test provides an average glucose level based on the past 2 to 3 months. It doesn’t require fasting.
  • Oral glucose tolerance test. This involves drinking a sugary drink and then checking blood glucose 2 hours later.

They may also order lab tests for kidney function, liver function, and cholesterol, and check a urine sample to screen for kidney damage.

What to expect from your visit

Your healthcare provider will do testing to confirm your diagnosis and see how severe your diabetes is and whether you have any complications from diabetes, like kidney damage. They will also do a physical examination, including a foot exam to check for damage to blood vessels, nerves, skin, and nails.

They will discuss whether you need to lose weight and how to control your blood sugar levels through diet and exercise. You will also be taught how to monitor your blood sugar levels at home.

They will tell you about the different medication options for you, which depends on how severe your diabetes is. Some medications can increase your body’s production of insulin, a hormone that helps move blood sugars out of your blood and into your cells. Others increase your body’s sensitivity to insulin. You may need oral medications or ones that you inject, depending on how high your blood sugar is.

Prescription medications for type 2 diabetes

Oral medications help control blood sugars

  • Metformin: Increases your body’s sensitivity to insulin and decreases sugar production from the liver.
  • Sulfonylureas and glinides: Increase the production of insulin.
  • Thiazolidinediones: Increase sensitivity to insulin.
  • Di-peptidyl peptidase-4 inhibitors: Reduce the breakdown of insulin.
  • Alpha-glucosidase inhibitors and sodium-glucose co-transporter-2 inhibitors: Eliminate sugar through the gut or urine.

Injectable hormones

  • Glucagon-like peptide 1 agonists: Increase production of insulin, improve insulin sensitivity, and help with weight loss by slowing down the emptying of the stomach. These are for high-risk people, including those with heart or kidney disease and those who need to lose weight.

Insulin

  • Long-acting (basal) insulin: glargine (Lantus, Basaglar), degludec (Tresiba), detemir (Levemir)
  • Rapid acting insulin: lispro (Humalog), aspart (Novolog)

Types of providers

  • A primary care provider can diagnose diabetes and treat mild to moderate symptoms.
  • An endocrinologist (hormone specialist) can create treatment plans for more severe symptoms.
  • An eye care provider (ophthalmologist or optometrist) does annual exams to check for retina damage caused by diabetes.
  • A podiatrist is a foot doctor who can check for nerve or blood vessel damage from diabetes, tell you about preventive care, and treat more complicated conditions like wounds and ulcers.
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