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When lifestyle measures no longer control diabetes

The first course of action against type 2 diabetes is always a combination of weight control, meal planning and exercise. This may be all you need for some time. Because diabetes is a progressive disease, however, the time may come when lifestyle changes don’t keep your numbers where they should be.

If this happens, you and your healthcare provider need to discuss your options for better glucose control, which can include:

  • Oral diabetes medications. Many diabetes drugs lower blood glucose, and each type works differently. Some drugs stimulate your pancreas to make more insulin or make it more quickly. Others make your body more sensitive to the insulin it produces, decrease glucose production or affect digestion by slowing starch absorption. Your provider may prescribe more than one drug for optimal sugar control, or you may take both oral medication and insulin. (Warning: Oral medications aren’t safe to use during pregnancy.)
  • Insulin injections. If your pancreas no longer makes insulin, you’ll need insulin injections. You’ll inject the insulin just under the skin with a small, short needle or “insulin pen.” You might start with one injection a day, but most people need at least two. Six main types of insulin work at different speeds, and many people take two variations. Your provider will teach you how to time your meals and exercise with your insulin doses.

Some people achieve better glucose control with an insulin pump, a device that delivers insulin through narrow tubing and a needle inserted just under the skin near the abdomen. The pump may be set to give a steady trickle of insulin or release frequent small doses throughout the day. While it means carrying something akin to a pager, insulin pumps can give you more flexibility in what and when you eat.

Whatever your therapy, good meal planning and physical activity should continue to be musts—they help the medications do their work and keep you feeling your best.