The treatment of type 2 diabetes

The treatment of type 2 diabetes is essentially different from the treatment of diabetes 1. While type 1 diabetes maintains blood sugar levels by administering insulin, the treatment of type 2 diabetes mainly uses modified nutrition, of the side effects of the condition and taking medication.

The treatment of type 2 diabetes

The treatment of type 2 diabetes has different goals than the treatment of type 1 diabetes:

  • Keeping blood glucose levels as normal as possible
  • Achieving or maintaining a healthy weight
  • Lowering or keeping the cholesterol level in the blood low
  • Lowering or keeping blood pressure low

This is quite demanding for a diabetic patient. It will certainly take some getting used to to fit life with diabetes into your life as you were used to before. However, if you carry out the treatment properly, you will have (almost) no problems with diabetes .

Power supply

Nutrition plays an important role in the treatment of type 2 diabetes. Healthy nutrition reduces the risk of later complications and the risk of obesity. In addition, food increases blood glucose .
Food contains carbohydrates , and carbohydrates are converted into glucose in the body. Diet therefore indirectly influences blood glucose. To prevent your blood glucose from becoming too high, a diet with few but sufficient carbohydrates is recommended.

Obesity and losing weight

Many people with diabetes type are overweight or have a hereditary predisposition to this. Being overweight makes it more difficult for the body to produce insulin with sufficient effect, causing blood glucose to become too high. In addition, being overweight increases the risk of high cholesterol and high blood pressure , which in turn significantly increases the risk of cardiovascular disease.


Unfortunately, in most cases it is not possible to get and keep blood sugar levels under control with an adapted diet alone. Losing weight is also not always possible. The blood glucose level can often be controlled when the adjusted diet is combined with tablets that lower blood glucose. However, this medication only has an effect if you follow an adjusted diet at the same time. These medications can only be used when the body is still producing insulin itself.

The choice of medication

The choice of the type of medication depends primarily on whether one is overweight or not.
Not overweight
If you are not overweight, the first choice is usually a drug that contains a sulfonylurea derivative . One starts with a low dose which is slowly increased. However, some people do not benefit from sulfonylurea. The effect may also diminish after a few years.
If you do not benefit or do not benefit enough from a sulfonylurea derivative, you often switch to a combination of a sulfonylurea derivative and metformin or acarbose .
Being overweight
Sulfonylurea derivatives can have weight gain as a side effect . In people who are overweight, metformin is therefore first started. This medicine has the side effect of weight gain to a much lesser extent.


Tablets containing sulfonylurea derivatives ensure that the pancreas is stimulated to produce more insulin. The condition for medication with a sulfonylurea derivative is that the pancreas still produces insulin. These tablets should be taken shortly before or during a meal . Common brand names of sulfonylurea medications include:

  • Rastinon
  • Tolbutamide
  • Daonil
  • Glibenclamide
  • Diamicron
  • Glibenese
  • Amaryl

The most common side effect is a hypo : the blood glucose level becoming too low . This side effect is mainly observed in older people or people who have drunk alcohol around taking the tablets.


The effect of metformin is not exactly known. Metformin probably ensures, among other things, that glucose can be better absorbed by the body . Metformin falls under the group of biguanides , which reduce the insulin resistance of the body’s cells, allowing the body to respond better to insulin. In addition, it ensures that the liver releases less glucose between meals .
Metformin is mainly used by overweight people . Metformin ensures that the insulin can still be used, despite the fact that it is often of poorer quality due to obesity. In addition , metformin reduces appetite . Metformin is often issued under the brand name Glucophage .
The most serious possible side effect is severe acidification of the body , which is called lactic acidosis or lactic acidosis . However, this side effect is rare. The risk of such acidification increases if you have a poor general condition or have problems with the liver or kidneys. Alcohol also increases the risk.


Arcorbose is an alpha-glucosida inhibitor , which ensures that blood glucose fluctuates less after a meal . The substance ensures that glucose from food enters the blood less quickly because it slows down the breakdown of carbohydrates. The tablets are taken just before eating. A well-known brand name of medication containing acarbose is Glucobay .

Type 2 diabetes and still insulin?

Some people with type 2 diabetes have high blood glucose in the morning before breakfast . In these people it is difficult to maintain optimal blood glucose levels with only dietary adjustments and tablets. These people then benefit from insulin, which unfortunately often has to be administered for the rest of their lives. This is the case with approximately 30% of diabetics .
Due to fever or an operational procedure, the blood sugar level can suddenly rise sharply, making it necessary to administer insulin.

Treating high cholesterol levels

People with type 2 diabetes often have high cholesterol levels. Because high cholesterol levels increase the risk of cardiovascular disease, it is important to keep it low enough.

Treating high blood pressure

Type 2 diabetes is often accompanied by high blood pressure. High blood pressure can result in problems with the eyes, kidneys, heart and blood vessels.

Increased blood pressure

Blood pressure refers to the pressure that the blood exerts on the walls of the arteries. This pressure varies with the heart rate . When the heart contracts and pumps blood into the arteries, this is called systolic pressure . When the heart muscle relaxes, the pressure decreases, this is called negative pressure or diastolic pressure .
The average blood pressure fluctuates around 120 upper pressure and 80 lower pressure. Blood pressure automatically rises when we exert ourselves strongly. This is not bad. It only becomes a problem when blood pressure is consistently higher than normal. The limit for people under 60 is a blood pressure of 150/85. The limit for people over 60 is 160/90.

Lowering high blood pressure

Many cases of high blood pressure are caused by unhealthy diet (with too many harmful fats), smoking and insufficient exercise. Adjusting lifestyle can help a lot. In addition, one can be supported with blood pressure-lowering medication .

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