Treatments for Type 1 and Type 2 diabetes, gestational diabetes and prediabetes require patients to monitor their blood sugar and work to maintain optimal blood sugar levels. Doctors may prescribe medications, recommend safe exercise regimens and outline nutritionally balanced meal plans.
Diabetes Treatments for Type 1, Type 2 and Prediabetes
The key factor in treating diabetes is managing blood sugar levels. For those who have been diagnosed with Type 1 or Type 2 diabetes, daily monitoring of blood sugar will be necessary.
For those with prediabetes and gestational diabetes, consistent diabetes testing will typically be part of a care plan to ensure the condition is managed and does not develop into Type 2. The right comprehensive treatment approach for you will depend on the type of diabetes you have been diagnosed with and your overall health.
Typically treatment plans include quitting smoking, limiting alcohol consumption, safe physical activity, managing stress levels and reducing sugar within a balanced diet. A healthy diabetes diet can be created with the help of a licensed dietitian. It should include a variety of unprocessed foods and recommended portions of complex carbohydrates, which play a critical role in regulating blood sugar.
Research indicates that moderate physical activity helps improve systems critical to regulating insulin and blood sugar. Patients with underlying health conditions will need to take particular care in ensuring any exercise and diet plan is safe and meets their specific needs. Losing weight is not recommended for pregnant women with gestational diabetes and exercise must be approached with care.
While there is no known cure for diabetes, for individuals with prediabetes or who are in high-risk groups for Type 2 diabetes, early intervention to reverse prediabetes and prevent it from worsening can be an effective prevention measure.
Type 1 Diabetes Treatment
Treatment for Type 1 diabetes differs from treatment for Type 2. People with Type 1 diabetes must rely on insulin, while those with Type 2 could have alternative options for treating the condition.
- Insulin delivery: Those with Type 1 diabetes require a perpetual source of bolus (short-term) and basal (long-term) insulin. It is administered via injection with pre-measured dosing, continuously dosed via a pump installed just under the skin, or orally and combined with injectable long-acting insulin.
- Blood sugar testing: Daily blood sugar monitoring is also required to accompany perpetual insulin delivery. The two most common methods are one-time “finger sticks” via a blood glucose meter and longer-term tracking with a continuous glucose monitor.
There is currently no cure for Type 1 diabetes. However, research has made strides in recent years.
In 2020, Penn Medicine reported a breakthrough in islet cell transplantation surgery, which transplants fully functional pancreatic cells into the bodies of Type 1 diabetes patients. The scientists were able to keep these cells alive longer than average.
Until a more reliable and replicable solution is discovered, however, blood sugar control is the main treatment for Type 1 diabetes.
Type 2 Diabetes Treatment
Treatment for Type 2 diabetes typically takes a holistic approach, focusing on the ways in which the body interacts with blood sugar. This can include medication, nutrition planning and engaging in a safe exercise regimen.
Research indicates healthy eating and exercise alone may not be sufficient to control blood sugar levels. Patients may need to supplement these actions with medication.
Like Type 1 diabetes, Type 2 has no cure. However, its effects can be mitigated with oral medication.
- SGLT2 inhibitors, which increase glucose release via frequent urination
- Drugs that stimulate insulin creation and release, such as sulfonylureas and secretagogues
- Biguanides, which increase insulin sensitivity and impede the production of glucose (metformin)
- Alpha-glucosidase, amylin analogues and other means to slow sugar digestion
While all Type 1 diabetes patients require insulin to manage their condition, those with Type 2 may require short- or long-term prescriptions of insulin. Patients with Type 2 diabetes also benefit from regular blood sugar testing. A doctor may advise daily testing when insulin has been prescribed.
Treatment for prediabetes aims to reduce the likelihood of Type 2 diabetes. For some patients, early diagnosis and effective treatment can delay or prevent the onset of Type 2 diabetes through a comprehensive and balanced nutrition plan, a medically approved exercise program and medication.
Effective treatment, in practice, means reversing prediabetes and avoiding Type 2 diabetes. Often, patients will seek guidance from licensed dietitians to create meal plans. Doctors, personal trainers and physical therapists may recommend safe exercise plans for some patients.
Reversing prediabetes is not always easy, especially since the condition often goes undetected. According to estimates by the Centers for Disease Control and Prevention, more than one-third of Americans (96 million) have prediabetes, but less than one-fifth are aware they have it. Treatment is more effective when the disease is caught early.
Gestational Diabetes Treatment
Treatment for gestational diabetes aims to delay or prevent the onset of Type 2 diabetes. Treatment of the mother may also help keep the baby from developing Type 2 diabetes later in life, but there are no known impacts on Type 1 diabetes.
To protect both the mother and her child, blood sugar control is the most critical component of gestational diabetes treatment. Given its importance, regular testing is paramount.
Gestational diabetes typically develops around week 24 of pregnancy, but individuals at increased risk of diabetes may be tested sooner. All who are diagnosed with gestational diabetes should continue to test afterward, as about 50% develop Type 2 diabetes.
Any nutrition plan for gestational diabetes must take the mother and growing baby’s needs into account. Weight loss is not recommended for pregnant patients.
What to Watch for with Diabetes
Diabetes complications are important to monitor for throughout treatment. Ineffective treatment can cause an onset of complications, and complications can in turn impede treatment. They can also cause potentially fatal side effects if neglected or not treated immediately.
- Low Blood Sugar (Hypoglycemia): Missed meals or overly high insulin dosing can cause hypoglycemia. Glucose levels should be checked regularly. Additional sugar consumption from juice, candy or baked goods may be needed to balance insulin levels.
- High Blood Sugar (Hyperglycemia):Sugar consumption and under-dosing insulin are common causes for high blood sugar levels. Taking fast-acting insulin or exercising will usually help lower high blood sugar levels in the short term.
- Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHS): When hyperglycemia pairs with extreme dehydration, impaired alertness can result.
- Increased Ketones: This is a state in which the liver begins breaking down fat cells for energy because of insufficient insulin. Effective treatment mirrors hyperglycemia treatment.
- Diabetic Ketoacidosis (DKA): This is an extremely serious, potentially fatal condition resulting from excessive ketones. It must be treated immediately in a hospital.
The most efficient way to avoid these complications is to maintain control over blood sugar levels. Consult with your doctor any time your levels are outside your normal range.
Nutrition Tips for Diabetes Patients
Most people with Type 1, Type 2, prediabetes and gestational diabetes will benefit most from working closely with a nutritionist or dietitian to develop a customized personal meal plan.
The CDC, for example, recommends carb counting and the plate method. When preparing a meal using the plate method, half of your plate should be filled with nonstarchy vegetables, a third with lean protein and a third with starch. Additional recommendations include:
- Relatively small portions of carbohydrates, including fewer refined carbs (added sugars, white flours) and more nutritionally dense carbs (sweet potatoes, whole wheat flours)
- Relatively small portions of protein, trending away from fattier sources and cuts of meat (red meat, skin-on cuts) and toward leaner sources (poultry, eggs, legumes, nonfat dairy)
- Relatively large portions of nonstarchy vegetables, such as leafy greens (lettuce and spinach), cruciferous (broccoli and Brussels sprouts), and allium (onions and garlic)
Sources of dietary fiber, which can help control blood sugar, are also typically recommended to protect against heart disease and maintain digestive health. Fiber is also an excellent carbohydrate that helps control appetite and suppress overeating.
Many of these initiatives are most attainable when prioritizing varied meals made from whole ingredients rather than processed foods.
Diabetes and Exercise
Exercise can help prevent or delay the onset of Type 2 diabetes and reduce the severity of symptoms associated with Type 1, gestational and prediabetes. But it’s vital that any exercise plan accounts for other medical conditions, challenges and concerns to ensure safety.
According to a joint study by the American College of Sports Medicine and the American Diabetes Association, the following showed promise for Type 2 diabetes patients:
- Aerobic Training: Moderate cardiovascular exercise undertaken for the equivalent of 150 minutes per week of walking at four miles per hour showed benefits, particularly when each workout was at least 10 minutes long and spread throughout the week.
- Resistance Training: Moderate intensity anaerobic workouts undertaken at least twice per week are recommended. Sessions should comprise five to 10 exercises targeting all major muscle groups. One to two sets of eight to 15 repetitions each, to near fatigue, also demonstrated health benefits.
These are minimum values. Your doctor may recommend greater intensities, durations or combinations thereof. Before embarking on a new exercise regimen on your own, seek guidance from your medical team.
The study also highlights the importance of cumulative daily movement from unstructured activities, such as short walks. Devices that can capture these activities with objective metrics, such as step counters, were shown to significantly increase overall physical activity.
While medication may be prescribed, medications are typically only one part of a comprehensive plan. Studies show that some lifestyle decisions can have a significant impact on diabetes treatment.
- Take care of your teeth to avoid rapid-onset dental disease and potential tooth loss.
- Quit smoking to reduce risks of lung, heart and other diseases. Smoking also is a significant risk factor for diabetes.
- Reduce stress levels to keep blood sugar down and facilitate better overall health.
- Cut back on alcohol, which can raise or lower blood sugar.
Wearing a medical tag to notify personnel of your blood sugar needs in an emergency can also be helpful for diabetes patients. This ensures proper care if you’re unable to communicate your medical history.
Alternative Diabetes Treatment Options
Some patients turn to complementary and alternative medicine approaches. These should be undertaken with caution, and only after careful consultation with trained medical professionals.
- Alpha-lipoic acids, which are found in dark vegetables. These appear to help lower blood sugar.
- Cinnamon may impact glucose uptake in ways similar to alpha-glucosidase inhibitors.
- Chromium, found in whole grains, may boost glucose metabolism in small doses.
Acupuncture or acupressure from a trained professional may provide relief for pain related to diabetes, its complications and comorbidities. It should be noted, though, that the American Diabetes Association does not officially endorse any of these practices.
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