Treatments for Diabetes

For people with type 2 diabetes (T2D), problems with insulin lead to high blood sugar. In some people with T2D, the pancreas does not make enough insulin. In others with T2D, the body does not use insulin effectively.^1,2

High blood sugar increases the risk of serious health problems. This includes heart, kidney, eye, and nerve issues. Treatments for T2D can lower your risk of health problems. The main goal of treatment is to manage blood sugar levels.^1,2

In most cases, the first treatment for T2D is lifestyle changes, such as diet and exercise. But many people with T2D also need prescription drugs to manage blood sugar. You can work with your doctor to monitor your health. They can help find the right treatment for you.¹

Lifestyle changes

A healthy diet and regular exercise are the first steps to manage T2D. Changes in diet can control body weight and blood pressure. Focusing on fruits, vegetables, lean meat, and whole grains can help. Avoiding sugary foods and reducing portion size are also important.^1,3

Regular exercise can control blood sugar, even if you do not lose weight. This is because it improves how your body uses insulin. Even a small amount of physical activity every day can be helpful. Work with your doctor to find activities you enjoy.^1,3

Medications

For many people with T2D, lifestyle changes alone do not control blood sugar. You may also need to take prescription drugs.¹

It may take time to find the best medication or combination of medications for you.^1,3,4

Drugs that stimulate insulin secretion

These drugs trigger the pancreas to release more insulin. This helps reduce blood sugar. Examples of drugs in this category include:¹

• Sulfonylureas
• Meglitinides

Drugs that affect incretin

These drugs increase the action of incretin hormones. Incretin triggers the pancreas to release more insulin. This helps reduce blood sugar, especially after eating. Examples of drugs in this category include:¹

• Dipeptidyl peptidase 4 (DPP-4) inhibitors
• Dual gastric inhibitory polypeptide (GIP)-GLP-1 agonists
• Glucagon-like peptide-1 (GLP-1) agonists

Insulin

Some people with T2D must take insulin to control blood sugar. Different types of insulin work at different speeds to control blood sugar for different amounts of time. These types include:^3,5

• Rapid-acting insulins
• Short-acting insulins
• Intermediate-acting insulins
• Long-acting insulins
• Ultra-long-acting insulins
• Premixed insulin – combines different types of insulin in a single injection

Other medications

Other T2D drugs work in different ways to lower blood sugar. These include:¹

• Alpha-glucosidase inhibitors (AGIs) – slow down the absorption of carbohydrates after eating
• Amylin analogs – slow down how food moves through the stomach
• Biguanides (metformin) – reduce glucose production by the liver
• Bile acid sequestrants (BASs) – reduce glucose production by the liver
• Dopamine agonists – increase dopamine receptor activity in the brain
• Selective sodium-glucose transporter 2 (SGLT2) inhibitors – increase how much glucose is excreted in urine
• Thiazolidinediones (TZDs) – improve how the body uses insulin

Combination treatments contain 2 types of T2D drugs in a single dose. This makes it easier to take multiple medicines. Many options combine metformin with another drug.¹

Complementary and integrative health practices

Some people with T2D try complementary and integrative health practices to help manage symptoms. These treatments should not replace standard treatment with medications, diet, and exercise. They work best when combined with standard treatments.^6,7

Be cautious about any complementary therapy that claims to cure T2D. There is not much evidence that these treatments improve blood sugar. We need more research to understand how to use them to manage T2D.^6,7

If you are thinking about trying complementary therapies, talk to your doctor. They can suggest safe ways to use them. Examples of complementary therapies used by people with T2D include:^6,7

• Yoga
• Meditation
• Massage therapy
• Acupuncture
• Natural treatments

Natural treatments

Natural treatments are a type of complementary health practice. They include vitamins, dietary supplements, and herbal supplements. Some natural treatments may improve blood sugar. They may have other benefits for people with T2D. We need more research to understand how to use them as treatments.^8,9

Talk to your doctor if you are thinking about using natural treatments. Some of them can interfere with T2D medicines. Some natural treatments used by people with T2D include:^8,9

• Alpha-lipoic acid
• Beta-glucan
• Calcium and vitamin D
• Chromium
• Glucomannan
• Guar gum
• Magnesium
• Polyphenols
• Psyllium
• Herbal supplements like berberine, cinnamon, flaxseed, garlic, and ginseng

Before beginning treatment for type 2 diabetes, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.