Type 2 Diabetes Treatment: Management, Medications and Side Effect

Introduction

According to the International Diabetes Federation (IDF), in 2021, approximately 537 million adults (20-79 years) were living with diabetes worldwide. This number is expected to rise, with projections estimating that by 2045, around 783 million people may have diabetes. The majority of people with diabetes have type 2 diabetes, which is often associated with lifestyle factors, genetics, and ageing. A significant concern is the number of undiagnosed cases. Many individuals may have diabetes without being aware of it, leading to delayed intervention and potential complications. Regular health check-ups and screenings are essential for early detection.

Importance of Type 2 Diabetes Treatment and Management

Once diagnosed, careful attention and proactive measures for effective treatment and management of diabetes mellitus are extremely important. The significance of these efforts extends far beyond controlling blood sugar levels.

1. Prevention of Complications:

The complications include heart disease, kidney disease, eye problems, and nerve damage. For every 1% reduction in HbA1c, the risk of heart failure decreases by 16%, myocardial infarction by 14%, and microvascular complications by 25%.

2. Quality of Life:

Proper treatment improves symptoms such as excessive thirst, frequent urination, fatigue, and blurred vision, contributing to a better quality of life for individuals with type 2 diabetes.

3. Healthy Weight Management:

Type 2 diabetes treatment at home includes lifestyle modifications that promote healthy weight management, reducing the risk of obesity-related complications.

4. The Economic Impact:

The importance of treating diabetes mellitus goes beyond individual health, extending to substantial economic implications marked by healthcare costs, productivity loss, and the burden of managing complications. It poses challenges for both developed and developing nations.

In India, the prevalence of type 2 diabetes has been steadily rising. According to recent statistics, an estimated 77 million adults in India are living with diabetes, with the numbers expected to increase. While a type 2 diabetes diagnosis may initially seem daunting, it’s crucial to understand that it doesn’t have to be devastating. Education is a powerful tool in managing the condition. Learning about insulin resistance, recognising the signs of diabetes, and making informed choices about diet and lifestyle are empowering steps toward leading a fulfilling and healthy life. Let’s start by understanding hyperglycemia in type 2 diabetes.

Read More: Top 10 Homeopathic Medicine For Diabetes.

Understanding Hyperglycemia in Type 2 Diabetes

Hyperglycemia occurs when the body struggles to regulate blood sugar levels, either due to insufficient insulin production or poor insulin utilisation. In type 2 diabetes, the cells become resistant to insulin, leading to an accumulation of glucose in the bloodstream. This persistent elevation can result in a range of symptoms and, if left uncontrolled, contribute to long-term health complications. The treatment of hyperglycemia in type 2 diabetes involves a comprehensive approach, including medication management, lifestyle modifications, and regular monitoring of blood glucose levels. Some people also prefer to include homoeopathic treatment for managing type 2 diabetes. Let’s take a closer look at its effectiveness.

Type 2 Diabetes Treatment Medications

If you have Type 2 Diabetes, you’ve likely encountered the oral medication metformin (Glucophage). This type 2 diabetes first line treatment is a stalwart in managing blood sugar levels by reducing glucose production in the liver and enhancing insulin sensitivity. However, the pharmacological toolkit for Type 2 Diabetes extends beyond metformin, offering a range of medications tailored to individual needs and responses. Let’s take a look at them:

1. Sulfonylureas and Meglitinides (Marketed as Diabinese, Glucotrol, DiaBeta and Amaryl:
   • These drugs stimulate the pancreas to produce more insulin, aiding in the regulation of blood sugar levels.
2. Alpha-glucosidase Inhibitors (Sold as Acarbose- Precose, Glucobay, Miglitol – Glyset and Voglibose:
   • Slowing down the digestion of certain carbohydrates, these drugs prevent rapid blood sugar spikes after meals. They exert their effect by delaying the absorption of glucose from the digestive tract.
3. Thiazolidinediones (TZDs) (Sold as Actos and as Avandia):
   • This group of drugs increases insulin sensitivity, helping stabilise blood sugar levels.
4. GLP-1 Agonists (marketed as Dulaglutide, Bydureon, Byetta):
   • These drugs mimic the action of a hormone called glucagon. GLP-1 Agonists increase insulin secretion in response to glucose and slow down glucose absorption in the gut. This can be administered through injection and may contribute to weight loss.
5. GLP-1 Receptor and GIP Agonists (e.g., Tirzepatide – Mounjaro):
   • Tirzepatide activates both GLP-1 and GIP receptors, increasing insulin secretions and improving blood sugar control.
6. DPP-4 Inhibitors (sitagliptin, saxagliptin, linagliptin, and alogliptin):
   • These drugs block the action of the enzyme DPP-4, preventing the breakdown of GLP-1, a hormone that increases insulin secretion and slows glucose absorption. This treatment is generally well-tolerated, with a lower risk of hypoglycemia.
7. SGLT-2 Inhibitors (Dapagliflozin, Empagliflozin, Canagliflozin, Ertugliflozin Invokana, Jardiance):
   • These relatively new drugs facilitate the release of glucose through the urine by slowing the kidney’s reabsorption of glucose. It can contribute to weight loss and may have cardiovascular benefits.
8. Insulin treatment:
   • Insulin treatment for type 2 diabetes may be recommended when other medications or lifestyle changes are insufficient to control blood sugar levels. While type 2 diabetes is often initially managed with oral medications, some individuals may eventually require insulin therapy to achieve optimal glucose control. Insulin can be administered through injections or, in some cases, an insulin pump.

Understanding these common medications available allows for more personalised treatment plans. Your healthcare provider will consider your unique health profile, preferences, and potential side effects when selecting the most suitable medication for your Type 2 Diabetes management.

Read More: HbA1c (Hemoglobin A1c) A1c Chart, Test, Levels, & Normal Range

Type 2 Diabetes Treatment Side Effects

The treatment of type 2 diabetes may come with certain side effects. Individual responses to these treatments may vary, and not everyone will experience the same side effects. Here are some potential side effects associated with common type 2 diabetes treatments:

1. Metformin:

   • Common side effects: Gastrointestinal issues such as nausea, diarrhoea, or stomach upset.
   • Rare side effects: Lactic acidosis (a serious but rare complication).

2. Sulfonylureas:

   • Common side effects: Hypoglycemia (low blood sugar), and weight gain.

3. Thiazolidinediones:

   • Common side effects: Fluid retention, weight gain.
   • Rare side effects: Increased risk of fractures, and liver issues.

4. Insulin:

   • Common side effects: Hypoglycemia, weight gain, injection site reactions.
   • Rare side effects: Allergic reactions, lipodystrophy (changes in fat distribution).

5. GLP-1 Receptor Agonists:

   • Common side effects: Nausea, vomiting, diarrhoea.
   • Rare side effects: Pancreatitis, thyroid tumors.

Adjustments to the treatment plan can often be made to minimise side effects while effectively managing diabetes.

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Permanent Treatment of Diabetes Mellitus

Diabetes requires lifelong management. Although there isn’t a definitive permanent treatment for diabetes type 2,  several promising approaches are being explored. Here are some treatments that show potential.

Bariatric Surgery:

Bariatric surgery is a medical procedure that involves the alteration of the digestive system to help with weight loss, particularly for those with severe obesity. The primary goal of bariatric surgery is to limit food intake, leading to weight loss and improvement in obesity-related health conditions. This procedure has shown promising outcomes in achieving long-term remission for some individuals with Type 2 Diabetes. The surgery not only aids in significant weight loss but also influences hormonal changes that positively impact insulin sensitivity and blood sugar regulation.

Islet Cell Transplantation:

This treatment involves transplanting insulin-producing cells into the pancreas, aiming to restore normal insulin function. While still an experimental approach, research in islet cell transplantation continues, and it holds potential as a long-term solution.

Gene Therapy:

Emerging research in gene therapy aims to address the underlying genetic factors contributing to Type 2 Diabetes. Gene therapy holds promise for correcting genetic abnormalities related to insulin production and sensitivity.

Read More: 15 Ways To Lower Your Insulin Levels Naturally

Considerations for Long-term Management 

1. Healthy Eating Habits: Adopting and maintaining a balanced diet that aligns with personal preferences ensures long-term dietary sustainability.
2. Regular Physical Activity: Incorporating enjoyable physical activities into daily routines promotes lasting fitness and helps manage blood sugar levels.
3. Regular Monitoring and Check-ups: Continuous monitoring of blood sugar levels allows individuals to stay proactive in managing their condition. Regular visits to healthcare providers help assess overall health, monitor medication effectiveness, and make necessary adjustments to the diabetes mellitus type 2 treatment plan.
4. Medication Adherence: A comprehensive understanding of prescribed medications, their mechanisms, and potential side effects contributes to effective long-term management.
5. Education and Support: Staying informed about the latest treatment for type 2 diabetes contributes to informed decision-making. Engaging with support networks, including healthcare professionals, support groups, and online communities, provides emotional and informational support.
6. Holistic Well-being: Addressing not only physical but also emotional and mental well-being contributes to a comprehensive long-term management strategy.

Conclusion

The journey of managing Type 2 Diabetes is unique for everyone. Beyond medications, the best treatment for type 2 diabetes is the one that adopts a holistic approach that includes dietary modifications, regular physical activity, and stress management. By embracing a comprehensive strategy, people can lead fulfilling lives while effectively managing their diabetes. Remember, every step you take towards a healthier and happier life is a commendable achievement. With personalised care, lifestyle adjustments, and a positive mindset, you have the tools to lead a fulfilling life despite the challenges.

Read More: How Intermittent Fasting Helps in Diabetes?

FAQ’s (Frequently Asked Questions)