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Conditions in Depth

This page contains the basic information about Type 2 Diabetes Mellitus .

Return to the Type 2 Diabetes Mellitus Main Condition Center

Type 2 Diabetes Mellitus

Treatment

Diet and Exercise

In most cases, type 2 diabetes treatment begins with weight reduction through diet and exercise. A healthy diet for a person with diabetes is:

• Low in saturated fats and cholesterol

• Without any trans fats

• Low in total calories

• Nutritionally balanced with abundant amounts of:

  • Whole-grain foods

  • Monounsaturated oils

  • Fruits and vegetables

A daily multivitamin is recommended for most people with diabetes.

For some people, type 2 diabetes can be controlled just with diet and exercise. Even if medications are required, diet and exercise remain important for controlling diabetes.

Medications: Pills

The medications used for type 2 diabetes include pills and injections. The pills work in many different ways. They include medications that:

• Reduce insulin resistance in the muscles and liver.

• Increase the amount of insulin made and released by the pancreas.

• Cause a burst of insulin release with each meal.

• Delay the absorption of sugars from the intestine.

• Slow your digestion.

• Reduce your appetite for large meals.

• Decrease the conversion of fat to glucose. These medications are called thiazolidinediones. One medication in this group has recently been linked to heart disease. As a result, drugs from this group are not recommended as a first choice in treatment.

Insulins

Because type 2 diabetes develops when the pancreas cannot make enough insulin to overcome insulin resistance, about one of three people with this disease take some form of insulin injection.

In advanced type 2 diabetes, or for people who want to tightly control glucose levels, insulin may be needed more than once per day and in higher doses.

Treatment plans that include both very long-acting insulin and very short-acting insulin are frequently the most successful for controlling blood sugar. Very short-acting insulin is used with meals, to help control the spike in blood sugar levels that occur with a meal. If a person does not eat on a regular schedule, very short-acting insulin can be particularly helpful.

Treatment Side Effects

Medications used to treat type 2 diabetes can have side effects. These vary by medication. Side effects may include:

• Low blood sugar levels (hypoglycemia)

• Weight gain

• Nausea

• Diarrhea

• Life-threatening buildup of lactic acid in the blood (in people with kidney failure)

• Leg swelling

• Worsening of heart failure

• Liver inflammation

• Increased risk of heart attack (with one of the thiazolidinediones medicines)

• Excessive gas and bloating

Fortunately, these side effects are uncommon, so the benefits of treatment far outweigh the risks.

In addition to medicines that help control the level of blood sugar, people with type 2 diabetes often take other medicines that reduce the risk or to slow the onset of the complications of diabetes. These include medications that:

• Slow the worsening of kidney disease.

• Lower cholesterol. All diabetics should consider taking medication to lower their cholesterol.

• Lower blood pressure. Diabetics should use medication to control high blood pressure if it can't be improved by lifestyle changes.

• Protect against heart attacks. Most people with diabetes benefit from a daily aspirin.

Created: 4/27/2004   |   Last Modified: 8/21/2006
From Health A-Z, Harvard Health Publications. Copyright 2006 by the President and Fellows of Harvard College. All rights reserved. Written permission is required to reproduce, in any manner, in whole or in part, the material contained herein. To make a reprint request, contact Harvard Health Publications. Used with permission of StayWell.