Diabetes Therapy

Diabetes Therapy

Exams and Tests

If your doctor thinks that you may have diabetes, he or she will order a couple of blood glucose tests. Blood glucose tests are blood tests that measure how much sugar is in your blood. Usually, they are done first thing in the morning, before you eat or drink anything. Sometimes, a glucose tolerance test is also done; however, the American Diabetes Association does not recommend this test because it is expensive and takes time.

To make a diagnosis of type 2 diabetes your physician will compare your blood test results to the American Diabetes Association's criteria. They will also ask you questions about your medical history and do a physical exam.

If your blood sugar level is above normal but below the level for diabetes, you have prediabetes and are at risk for developing type 2 diabetes. For more information on prediabetes, see the topic prediabetes.

Other Diabetes Tests

A home blood sugar test or a urine test for sugar is not the best ways to learn whether you have diabetes. However, after you are diagnosed, you may use home blood sugar tests to monitor your own blood sugar levels.

Along with your home blood sugar tests, your health professional will give you a hemoglobin A1c (glycohemoglobin) test after you start treatment for diabetes. This test finds your average blood sugar level over the previous 2 to 3 months. The A1c test adds to the information from your home blood sugar tests to help you keep track of your blood sugar control.

After you are diagnosed with type 2 diabetes or prediabetes you may need a thorough cardiovascular exam to check for any heart problems.

Early detection

If you are age 45 or older, the American Diabetes Association recommends that you be tested for diabetes every three years. The United States Preventive Services Task Force (USPSTF) recommends testing for diabetes in people who have either high cholesterol or high blood pressure. Talk with your doctor about your risk factors and how often you need to be tested.

The American Diabetes Association recommends that you be tested more often or begin testing at a younger age if you:

• Have a parent, brother, or sister who has type 2 diabetes.
• Are overweight (have a body mass index, or BMI, of 25 or higher).
• Are African-American, Hispanic, Native American, Asian-American, or Pacific Islander.
• Have prediabetes.
• Have high blood pressure.
• Have high cholesterol.
• Have a history of gestational diabetes or have delivered a baby who weighed 9 lb (4 kg) or more.

Treatment Overview

It can be scary to learn that you, your child, a family member, or a friend has type 2 diabetes or is at risk for the disease. Many people are shocked when they find out that they have type 2 diabetes. Others are relieved to know what has been causing their symptoms. Although it is normal to feel angry or depressed about having a serious lifelong disease, it is important to remember that many people who have type 2 diabetes enjoy healthy, active lives when they are able to control their blood sugar. Exercising, eating healthy foods, and taking medicines all help control blood sugar.

There is no cure for type 2 diabetes, but there are ways to treat the disease. Even if you do not feel sick, you still need treatment to prevent more serious health problems in the future.

Some people can control their blood sugar by changing the way they eat and exercising more. Other people also need to take medication either orally and/or by injection. Treatment for type 2 diabetes includes:

• Changing the way you eat to spread carbohydrates throughout the day in order to maintain your blood sugar level.
• Exercising regularly to help your body use insulin better.
• Checking your blood sugar at home to know when the level is above or below your target range.
• Taking pills if eating differently and exercising more do not keep your blood sugar levels within a safe range. You may need one or more medications to help your body make more insulin or to use insulin more efficiently.
• Having insulin injections for a while or for the rest of your life. Insulin can only be given by injection, and it may be used alone or with other oral medications.
• Seeing your doctor regularly to make sure that your treatment is working and that you have not developed any secondary medical conditions such as eye, kidney, cardiovascular, or nerve disease.

Other important issues

If you have type 2 diabetes you also need to:

Preventing type 2 diabetes

You can take steps to prevent type 2 diabetes. Even small changes can make a big difference, and it is never too late to start making healthier choices.

1. Always wear medical identification to let health professionals know in an emergency that you have diabetes. Medical ID necklaces or bracelets are available from your doctor, your local pharmacy, or online.
2. Know how to recognize and quickly treat high blood sugar and low blood sugar.
3. Take extra care of your skin, teeth, feet, and gums.
4. Know how to care for yourself when you are sick.

• Maintain a healthy weight. To find out if you are overweight, you can use the body mass index (BMI) chart for adults. If you need to lose weight, losing as few as 10 lb (4.5 kg) to 20 lb (9.1 kg) can help reduce your risk of developing diabetes.
• Exercise regularly. Regular exercise decreases your risk of developing type 2 diabetes. Try to do activities that raise your heart rate. Exercise for at least 30 minutes on most, preferably all, days of the week. The American Diabetes Association suggests that you include resistance exercises in your exercise program.
• Resistance exercises can include activities like weight lifting or even yard work. This does not mean that you have to do strenuous activities or join an expensive gym—anything that increases your heart rate counts. Walking groups or programs where you use a pedometer to count the number of steps you take in a day are great ways to start exercising and to stay motivated. If you are at risk for type 2 diabetes, using an exercise planning form may help you and your doctor or other health professional to create a personalized exercise program.
• Eat healthy foods. Eating more vegetables, whole grains, and nuts can lower your risk for developing type 2 diabetes. Eating sugary foods, fast foods, and red meat (especially processed red meat) and drinking soft drinks can increase your risk for developing type 2 diabetes.

Preventing complications from diabetes

You can help prevent or delay the development of problems with your heart, eyes, kidneys, and nerves if you:

1. Keep your blood sugar levels within a safe range.
2. Talk to your doctor about taking a low-dose aspirin to prevent a heart attack, a stroke, or other large blood vessel diseases (macro vascular disease).
3. Take medication for high blood pressure and high cholesterol.
4. Take an angiotensin-converting enzyme (ACE) inhibitor or angiotensin II receptor blocker (ARB) medicine at the first sign of diabetic nephropathy (kidney disease), even if you do not have high blood pressure.
5. Get regular eye exams.
6. Take good care of your feet.
7. Quit smoking. If you smoke cigarettes, talk with your doctor about ways to quit. Smoking contributes to the early development of diabetes complications.

Home Diabetes Treatment

Making healthy choices is a large part of treating type 2 diabetes. The more you learn about the disease, the more motivated you may be to make good choices and to follow your treatment plan. By understanding what is happening in your body, you may also feel more in control of your disease.

If you have type 2 diabetes, your daily routine will include:

• Eating healthy foods and spreading carbohydrates throughout the day.
• Getting some physical activity that raises your heart rate, including resistance exercises like weight lifting or even yard work.
• Checking your blood sugar levels regularly.
• Taking oral medication for type 2 diabetes and insulin injections if prescribed.
• Drinking enough fluids to avoid dehydration.
• Taking a low-dose aspirin if your doctor tells you to do so.

Other Important Diabetes Issues

If you have type 2 diabetes, you also need to:

• Always wear medical identification to let health professionals know in an emergency that you have diabetes. Medical ID necklaces or bracelets are available from your doctor, your local pharmacy, or online.
• Know how to recognize and to quickly treat high blood sugar and low blood sugar.
• Take extra care of your skin, teeth, feet, and gums.
• Know how to care for yourself when you are sick.

Diabetes Medications

Some people with type 2 diabetes need medication to help their bodies make more insulin, to decrease insulin resistance, or to slow down how quickly their body absorbs carbohydrates.

You may not need to take any medication, may need to take one medication, or a few medications. Some people need medication for short periods of time, while others will always need it. How much you need depends on how well you can keep your blood sugar within a safe range with diet and exercise.

Some people who have type 2 diabetes take medication for high blood pressure or high cholesterol. They may also take aspirin to prevent a heart attack, a stroke, or other large blood vessel diseases (macro vascular disease).

Other Diabetes Treatment

You may be tempted to try products or pills that promise to cure your type 2 diabetes. But these products and remedies can be harmful and expensive. If you are considering taking any medication or herbal remedies without a prescription, talk to your doctor first. We can recommend to you alternative therapies that may prove beneficial.

Begin Your Journey to Wellness with Patients Medical

Our job at Patients Medical is to listen, to connect the dots between a patient's medical history, symptoms, and their underlying causes. Patients Medical is a superb place for women and men to secure integrative and holistic health care from providers who give personalized care, partner with the patient to focus on the root cause of their illness, support their recovery, and help them maintain good health.

To make an appointment with one of our physicians, please call us at 1-212-794-8800. We look forward to hearing from you.

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