Glucose is a type of sugar. It comes from food, and is also created in the liver. Glucose travels through the body in the blood. It moves from the blood to cells with the help of a hormone called insulin. Once glucose is in those cells, it can be used for energy.
Diabetes is a condition that makes it difficult for the body to use glucose. This causes a buildup of glucose in the blood. It also means the body is not getting enough energy. Type 2 diabetes is one type of diabetes. It is the most common type.
Medication, lifestyle changes, and monitoring can help control blood glucose levels.
Type 2 diabetes is often caused by a combination of factors. One factor is that your body begins to make less insulin. A second factor is that your body becomes resistant to insulin. This means there is insulin in your body, but your body cannot use it effectively. Insulin resistance is often related to excess body fat.
The doctor will ask about your symptoms and medical history. You will also be asked about your family history. A physical exam will be done.
Diagnosis is based on the results of blood testing. American Diabetes Association (ADA) recommends diagnosis be made if you have one of the following:
Symptoms of diabetes and a
random blood test
with a blood sugar level greater than or equal to 200 mg/dL (11.1 mmol/L)
- Fasting blood sugar test—Done after you have not eaten for eight or more hours—Showing blood sugar levels greater than or equal to 126 mg/dL (7 mmol/L) on two different days
- Glucose tolerance test—Measuring blood sugar two hours after you eat glucose—Showing glucose levels greater than or equal to 200 mg/dL (11.1 mmol/L)
- HbA1c level of 6.5% or higher—Indicates poor blood sugar control over the past 2-4 months
mg/dL = milligrams per deciliter of blood; mmol/L = millimole per liter of blood
Treatment aims to:
- Maintain blood sugar at levels as close to normal as possible
- Prevent or delay complications
- Control other conditions that you may have, like high blood pressure and high cholesterol
Food and drinks have a direct effect on your blood glucose level. Eating healthy meals can help you control your blood glucose. It will also help your overall health. Some basic tips include:
If you are overweight, weight loss will help your body use insulin better. Talk to your doctor about a healthy weight goal. You and your doctor or dietitian can make a safe meal plan for you.
These options may help you lose weight:
Physical activity can:
- Make the body more sensitive to insulin
- Help you reach and maintain a healthy weight
- Lower the levels of fat in your blood
exercise is any activity that increases your heart rate. Resistance training helps build muscle strength. Both types of exercise help to improve
long-term glucose control. Regular exercise can also help reduce your risk of heart disease.
Talk to your doctor about an activity plan. Ask about any precautions you may need to take.
Certain medicines will help to manage blood glucose levels.
Medication taken by mouth may include:
- Metformin—To reduce the amount of glucose made by the body and to make the body more sensitive to insulin
Medications that encourage the pancreas to make more insulin such as sulfonylureas (glyburide,
tolazamide), dipeptidyl peptidase-4 inhibitors (saxagliptin,
Insulin sensitizers such as
pioglitazone—To help the body use insulin better
Starch blockers such as
miglitol—To decrease the amount of glucose absorbed into the blood
Some medicine needs to be given through injections, such as:
Incretin-mimetics such as
stimulate the pancreas to produce insulin and decrease appetite (can assist with weight loss)
Amylin analogs such as
replace a protein of the pancreas that is low in people with type 2 diabetes
Insulin may be needed if:
- The body does not make enough of its own insulin.
- Blood glucose levels cannot be controlled with lifestyle changes and medicine.
Insulin is given through injections.
Blood Glucose Testing
You can check the level of glucose in your blood with a blood glucose meter. Checking your blood glucose levels
during the day can help you stay on track. It will also help your doctor determine if your treatment is working. Keeping track of blood sugar levels is especially important if you take insulin.
Regular testing may not be needed if your diabetes is under control and you don't take insulin. Talk with your doctor before stopping blood sugar monitoring.
may also be done at your doctor's office. This is a measure of blood glucose control over a long period of time. Doctors advise that most people keep their HbA1c levels below 7%. Your exact goal may be different. Keeping HbA1c in your goal range can help lower the chance of complications.
Decreasing Risk of Complications
Over a long period of time, high blood glucose levels can damage vital organs. The kidneys, eyes, and nerves are most affected. Diabetes can also increase your risk of heart disease.
Maintaining goal blood glucose levels is the first step to lowering your risk of these complications. Other steps include:
- Take good care of your feet. Be on the lookout for any sores or irritated areas. Keep your feet dry and clean.
- Have your eyes checked once a year.
- Don't smoke. If you do, look for programs or products that can help you quit.
- Plan medical visits as recommended.