Although diabetes can not be cured, early detection enables the blood sugar levels of diabetics can be controlled. This is done in order to keep blood sugar levels within normal limits and the symptoms can be controlled to prevent the complications that might occur.
The doctor will explain the disease in detail, help you to understand the treatment process, as well as monitoring other diseases that can happen to you. The goal of diabetes treatment is to maintain blood sugar levels and minimize the risk of complications.
Patients with type 2 diabetes are encouraged to always maintain health carefully. But you should not feel discouraged because the doctor can help you in the treatment process that you can live. Do not hesitate to ask for help with family or friends.
Starting a Healthy Lifestyle
Initial treatment is generally applied to people with type 2 diabetes is to change the lifestyle. For example, a healthy diet, regular exercise and weight loss for those who are overweight or obese (body mass index of 30 or more).
This initial step will be very effective for patients with type 2 diabetes at an early stage and can help the treatment process if done with discipline and meticulous.
Medications to Lower Blood Sugar Levels
Type 2 diabetes is a progressive disease that generally can get worse. Maintain a regular diet and exercise alone may not be enough to control blood sugar levels of patients completely.
Patients with this type of diabetes will eventually require medications to lower blood sugar levels are high. The treatment process generally begins with the drug in tablet form and sometimes with a combination of more than one type of tablet. Followed by insulin or other drugs are given by injection.
Monitoring Blood Sugar Levels
1. HbA1c tests
People with diabetes are encouraged to undergo a blood sugar concentration in every 2-3 months. This examination will show the level of blood sugar levels in recent months, as well as the effectiveness of your treatment.
When the body is processing the sugar, blood sugar automatically attaches itself to hemoglobin. The higher levels of sugar in the blood, the more hemoglobin linked with glucose and hemoglobin is called HbA1c. HbA1c test measures the amount of hemoglobin that contains glucose.
If you have high blood sugar levels over the past 2-3 months, HbA1c test results will show a high rate as an indication. Because it's kind of your treatment may need to be changed. Normal reference values for HbA1c diabetes is below 6.5%.
2. How do I monitor the blood sugar levels of our own
A healthy diet, exercising and taking medications or insulin therapy will help you to maintain the balance of blood sugar levels. But other diseases and stress can also be influential. Another factor that might have an impact on your blood sugar levels are:
- Consumption of liquor.
- Taking other medications.
- Hormonal changes in the menstrual cycle.
Undergo laboratory examination every 2-6 months, it is essential for people with diabetes type 2. In addition, patients are also recommended to monitor blood sugar levels by testing themselves at home.
Home inspection can be done with a blood sugar test kits are small. This tool can be used to detect fluctuations in blood sugar levels.
Blood sugar levels usually is not always the same throughout the day and can be affected by your treatment process. Then you are recommended to check it several times a day. Routine monitoring will help you to maintain balance.
The unit of measure for blood sugar levels that are used in general in Indonesia is milligrams / deciliter or commonly abbreviated as mg / dL. You should make sure the unit in advance when purchasing a blood sugar test kits.
Blood sugar levels in each person is different, but the normal reference is:
- 72-108 mg / dL before meals.
- 180 mg / dL two hours after eating.
Medications Right for Coping with Diabetes Type 2
Balance blood sugar levels in diabetes sometimes can not be maintained properly only through the adoption of a healthy diet and regular exercise. You also may need drugs to handle it.
There are several types of medications (usually in tablet form) that can be used for type 2 diabetes, you may be given a combination of two types or more drugs to control your blood sugar levels.
1. Metformin to decrease blood sugar levels
Metformin works by reducing sugar content which is distributed to the liver blood flow and make the body more responsive to insulin. This is the first drug that is often recommended for people with type 2 diabetes.
In contrast to other drugs, metformin does not cause weight gain. Therefore this drug is usually given to patients who are overweight.
But metformin can sometimes cause mild side effects, such as nausea and diarrhea. Doctors also would not suggest this drug for diabetics who experience kidney problems.
2. Sulfonylureas to increase insulin production in the pancreas
Sulfonylureas works to increase the production of insulin in the pancreas. People with diabetes who can not take metformin or overweight may be given this drug. If metformin is less effective in controlling your blood sugar levels, your doctor may be combined with sulfonylureas. Examples of these drugs are:
- Glimepiride
- Glibenclamide
- Glipizide
- Gliclazide
- Gliquidone
Sulfonylureas will increase insulin levels in the body so that it can increase the risk of hypoglycemia if any use. In addition, these drugs have side effects as follows:
- Weight gain
- Nausea and vomiting
- Diarrhea
3. Glitazone (thiazolidinedione) as a trigger for insulin
Glitazone (eg, pioglitazone) usually in combination with metformin, a sulfonylurea, or both. This drug functions make body cells more sensitive to insulin so that more glucose is transferred from the blood.
These drugs can cause weight gain and swelling of the ankles. It is not recommended to take pioglitazone if heart failure or at risk of fracture.
In some countries, risoglitazone which is one of the glitazone drugs have been withdrawn from the market because it is proven to increase the risk of heart disease such as heart attack and heart failure. If consumed, consult potential side effects with your doctor.
4. Gliptin (dipeptidyl peptidase-4 inhibitor) for the prevention of breakdown of GLP-1
Gliptin or DPP-4 inhibitors prevent the breakdown of the hormone GLP-1 (glucagon-like peptide-1). GLP-1 is a hormone that plays a role in the production of insulin when blood sugar is high. Thus, gliptin help raise the level of insulin when blood sugar levels rise.
Gliptin (eg, linagliptin, saxagliptin, sitagliptin and vildagliptin) can inhibit the increase in high blood sugar levels without causing hypoglycemia. These drugs do not cause weight gain and is usually given if the patient can not take a sulfonylurea or a glitazone, or combined with both.
5. GLP-1 agonist as a trigger insulin without the risk of hypoglycaemia
Exenatide is a GLP-1 agonist with a performance similar to the natural hormone GLP-1. The drug is administered by injection twice a day. Exenatide can trigger an increase in the production of insulin when blood sugar levels without the risk of hypoglycaemia.
Most diabetics who take exenatide may also experience weight loss. This drug is generally given to people with diabetes who are taking metformin and sulfonylurea and obese.
Type of other GLP-1 agonist liraglutide is injected once a day. Research shows that these drugs can also lose weight. Liraglutide also commonly given to people with diabetes who are taking metformin and sulfonylurea and obese.
6. Acarbose to slow the digestion of carbohydrates
Acarbose slows the digestion of carbohydrates into sugar in the body. These drugs prevent the increase in blood sugar levels of diabetics too quickly after eating.
These drugs can cause side effects diarrhea and flatulence so rarely used to treat type 2 diabetes, but doctors still would give it if the patient is not fit to take other medications.
7. Nateglinide and repaglinide to release insulin into the bloodstream
Both drugs will stimulate the pancreas to release more insulin into the bloodstream. Function nateglinide and repaglinide can not last long, but effective when taken before meals. So although rarely used, both recommended if the patient has a feeding schedule during the hours are not uncommon.
All drugs have side effects remain, including nateglinide and repaglinide. Side effects of these two drugs are hypoglycemia and weight gain.
8. Insulin therapy as a companion to other drugs
Medicines in tablet form can be less effective for treating diabetes so that you require insulin therapy. This therapy can be given in place of or in conjunction with drugs above, but depending on the dosage and how to use. There are several types of insulin that can be used. Among them:
- Fast-acting insulin that did not last long, but reacted quickly.
- Short-acting insulin that can last up to eight hours.
- Long-acting insulin that can last one day.
Treatment for diabetes is also possible to use a combination of the types of insulin at the top.
9. Insulin injections do for yourself
Giving insulin because insulin injections are generally passed will be digested in the stomach and can not enter into the blood when taken in tablet form.
Your doctor will explain when you need to use insulin. In the early stages of use, doctors will usually help you to inject insulin. Furthermore, you are taught how to inject insulin and store and dispose of needles safely.
There are two methods commonly used to inject insulin, namely through a needle and syringe or pen. Diabetics generally need 2-4 injections per day. The doctor or nurse will also teach how to use the close friends or family.
10. How to cope with hypoglycemia (blood sugar levels are too low)
Patients with type 2 diabetes are generally insulin or certain types of tablet to control blood sugar levels. The treatment method has the risk of causing hypoglycemia.
When your blood sugar is too low, you will experience hypoglycemia. Its symptoms include feeling weak, trembling, and hungry. This condition can be overcome by eating foods or sugary drinks.
Initial treatment for diabetics who experience hypoglycemia is to eat a carbohydrate source (sugar-sweetened drinks or glucose tablets) that can be absorbed quickly. After that the patient should consume carbohydrate source that can last longer as a wafer, a sandwich, or one fruit.
The steps above are generally able to increase blood sugar levels back to normal. But this process can take several hours.
Severe hypoglycemia will result in diabetics feel dazed, sleepy, even loss of consciousness. If you have this condition, people with diabetes should be given an injection of glucagon (a hormone that can increase blood sugar levels quickly) directly on the muscle or vein. The doctor can teach you how inject in your family or close friends.
12. Alternatives in the treatment of patients with type 2 diabetes
Patients with type 2 diabetes have a higher risk to develop complications (heart disease, stroke, or kidney disease). Therefore your doctor will usually suggest the following drugs to reduce the risk of complications, namely:
- Statins (eg, simvastatin) to reduce high cholesterol levels.
- High blood pressure-lowering drugs.
- ACE inhibitor drugs, such as lisinopril, enalapril, or ramipril, if there is an indication of diabetic kidney disease. Developmental disease characterized by the presence of the protein albumin in the urine can be cured if treated immediately.
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