You might need to eat a snack before exercising to help prevent low blood sugar if you take diabetes medications that lower your blood sugar. Depending on your treatment plan, you may need to check and record your blood sugar level every now and then or, if you're on insulin, multiple times a day. Ask your doctor how often he or she wants you to check your blood sugar. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range. Sometimes, blood sugar levels can be unpredictable. With help from your diabetes treatment team, you'll learn how your blood sugar level changes in response to food, exercise, alcohol, illness and medication.
Some people who have type 2 diabetes can achieve their target blood sugar levels with diet and exercise alone, but many also need diabetes medications or insulin therapy. The decision about which medications are best depends on many factors, including your blood sugar level and any other health problems you have. Your doctor might even combine drugs from different classes to help you control your blood sugar in several different ways.
Metformin Glucophage, Glumetza, others. Generally, metformin is the first medication prescribed for type 2 diabetes. It works by improving the sensitivity of your body tissues to insulin so that your body uses insulin more effectively. Metformin also lowers glucose production in the liver.
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Metformin may not lower blood sugar enough on its own. Your doctor will also recommend lifestyle changes, such as losing weight and becoming more active. Nausea and diarrhea are possible side effects of metformin. These side effects usually go away as your body gets used to the medicine. If metformin and lifestyles changes aren't enough to control your blood sugar level, other oral or injected medications can be added. These medications work like sulfonylureas by stimulating the pancreas to secrete more insulin, but they're faster acting, and the duration of their effect in the body is shorter.
They also have a risk of causing low blood sugar, but this risk is lower than with sulfonylureas. Weight gain is a possibility with this class of medications as well. Examples include repaglinide Prandin and nateglinide Starlix. Like metformin, these medications make the body's tissues more sensitive to insulin. This class of medications has been linked to weight gain and other more-serious side effects, such as an increased risk of heart failure and fractures. Because of these risks, these medications generally aren't a first-choice treatment.
These medications slow digestion and help lower blood sugar levels, though not as much as sulfonylureas. Their use is often associated with some weight loss. This class of medications isn't recommended for use by itself. Possible side effects include nausea and an increased risk of pancreatitis. These are the newest diabetes drugs on the market.
They work by preventing the kidneys from reabsorbing sugar into the blood. Instead, the sugar is excreted in the urine. Examples include canagliflozin Invokana and dapagliflozin Farxiga. Side effects may include yeast infections, urinary tract infections, a rare and serious genital infection, increased urination and hypotension. Some people who have type 2 diabetes need insulin therapy as well.
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In the past, insulin therapy was used as a last resort, but today it's often prescribed sooner because of its benefits. Because normal digestion interferes with insulin taken by mouth, insulin must be injected. Depending on your needs, your doctor may prescribe a mixture of insulin types to use throughout the day and night.
Often, people with type 2 diabetes start insulin use with one long-acting shot at night. Insulin injections involve using a fine needle and syringe or an insulin pen injector — a device that looks similar to an ink pen, except the cartridge is filled with insulin. Discuss the pros and cons of different drugs with your doctor.
Together you can decide which medication is best for you after considering many factors, including costs and other aspects of your health. In addition to diabetes medications, your doctor might prescribe low-dose aspirin therapy as well as blood pressure and cholesterol-lowering medications to help prevent heart and blood vessel disease. If you have type 2 diabetes and your body mass index BMI is greater than 35, you may be a candidate for weight-loss surgery bariatric surgery. Blood sugar levels return to normal in 55 to 95 percent of people with diabetes, depending on the procedure performed.
Surgeries that bypass a portion of the small intestine have more of an effect on blood sugar levels than do other weight-loss surgeries. Drawbacks to the surgery include its high cost, and there are risks involved, including a risk of death. Additionally, drastic lifestyle changes are required and long-term complications may include nutritional deficiencies and osteoporosis.
Women with type 2 diabetes may need to alter their treatment during pregnancy. Many women will require insulin therapy during pregnancy. Cholesterol-lowering medications and some blood pressure drugs can't be used during pregnancy. If you have signs of diabetic retinopathy, it may worsen during pregnancy. Visit your ophthalmologist during the first trimester of your pregnancy and at one year postpartum.
Because so many factors can affect your blood sugar, problems sometimes arise that require immediate care, such as:. Hyperglycemic hyperosmolar nonketotic syndrome HHNS. Your blood sugar monitor may not be able to give you an exact reading at such high levels and may instead just read "high. HHNS is caused by sky-high blood sugar that turns blood thick and syrupy.
It tends to be more common in older people with type 2 diabetes, and it's often preceded by an illness or infection. HHNS usually develops over days or weeks. Call your doctor or seek immediate medical care if you have signs or symptoms of this condition. Increased ketones in your urine diabetic ketoacidosis. If your cells are starved for energy, your body may begin to break down fat. This produces toxic acids known as ketones.
Metformin is a type of biguanide and it is currently the only biguanide available in the United States. It is often the first oral medicine prescribed for someone newly diagnosed with diabetes.
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It has the advantage of not causing low blood sugar. Metformin does not cause your pancreas to make insulin, but it helps your body use insulin better. Metformin can cause side effects such as nausea or diarrhea in some people. Your doctor may prescribe metformin in combination with another oral diabetes medicine.
1. Bydureon (exenatide)
Sulfonylureas are the most commonly prescribed diabetes medicines. These medicines help your pancreas make insulin.
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They are inexpensive and have few side effects. There are 3 types of sulfonyureas: Side effects may include weight gain and low level of sodium in the blood. Sulfonylureas can be taken alone or with metformin, pioglitazone a thiazolidinedione , or insulin. This class of medicines includes rosiglitazone and pioglitazone. These medicines help your body respond better to insulin. Rosiglitazone and pioglitazone can be used alone or in combination with other diabetes medicines.
There are two medicines in this group: Both of these lower your blood glucose by prompting the pancreas to release more insulin. These drugs work quickly and do not stay in your system long. So they are a good option if your meal schedule varies or is unpredictable. They also cause less weight gain that other oral diabetes medicines.
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Alpha-glucosidase inhibitors help control blood sugar levels by preventing the digestion of carbohydrates. Carbohydrates include starchy foods like potatoes and corn.
They also include most grains bread, rice, crackers, cereal and sugary sweets. The two medicines in this group are acarbose and miglitol. These medicines may cause bloating, nausea, diarrhea, and flatulence gas. A newer class of diabetes medication, SGLT2 includes three medicines: These drugs remove extra sugar from your body by blocking it from the kidneys.
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