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Best Treatment of type 2 diabetes mellitus

Overview

Treatment of type 2 diabetes mellitus: Treating type 2 diabetes requires patience and commitment by both a clinician and the patient. This is because  type 2 diabetes treatment  goes for life provided the cause of diabetes in that patient cannot be eliminated.There is medical and lifestyle and diet modification in order to make a full set of DMT2 management.

Medical treatment of type 2 diabetes mellitus

Here treatment is by using drugs. Different anti diabetic drugs work differently but the whole aim is to achieve required level of blood glucose.

Drug classes used for the treatment of type 2 diabetes include the following:

Sulfonylureas

These drugs improve the secretion of insulin into the blood by the pancreas. People use the following newer medicines most often, as they are less likely to cause adverse effects:

Sulfonylureas include:

  • glimepiride (Amaryl)
  • glipizide (Glucotrol)
  • glyburide (DiaBeta, Micronase, Glynase)

The older, less common sulfonylureas are:

  • chlorpropamide (Diabinese)
  • tolazamide (Tolinase)
  • tolbutamide (Orinase)

Today, doctors prescribe sulfonylureas less often than they did in the past. This is because they can cause very low blood sugar, which causes other health problems.treatment of type 2 diabetes mellitus

Meglitinides

Meglitinides also enhance insulin secretion. These might also improve the effectiveness of the body in releasing insulin during meals, and include:

  • nateglinide (Starlix)
  • repaglinide (Prandin)

Biguanides

Biguanides boost the effect of insulin. They reduce the amount of glucose the liver releases into the blood.

They also increase the uptake of blood glucose into the cells.

Metformin is the only licensed biguanide in the United States, in the form of Glucophage, Glucophage XR, Glumetza, Riomet, and Fortamet.

Thiazolidinediones

Thiazolidinediones reduce the resistance of tissues to the effects of insulin. They have been associated with serious side effects, so they need monitoring for potential safety issues. People with heart failure should not use these medications, which include.

  • pioglitazone (Actos)
  • rosiglitazone (Avandia)

Alpha-glucosidase inhibitors

Alpha-glucosidase inhibitors cause carbohydrates to be digested and absorbed more slowly. This lowers glucose levels in the blood after meals.

  • acarbose (Precose)
  • miglitol (Glyset)

Dipeptidyl peptidase inhibitors

Dipeptidyl peptidase (DPP-4) inhibitors slow the rate of the stomach contents emptying further along the gut, and so slow down glucose absorption.

  • alogliptin (Nesina)
  • linagliptin (Tradjenta)
  • sitagliptin (Januvia)
  • saxagliptin (Onglyza)

Sodium-glucose co-transporter 2 inhibitors

Sodium-glucose co-transporter 2 (SGLT2) inhibitors cause the body to expel more glucose into the urine from the bloodstream. They might also lead to a modest amount of weight loss, which can be a benefit for type 2 diabetes.

  • canagliflozin (Invokana)
  • dapagliflozin (Farxiga)
  • empagliflozin (Jardiance)
  • ertugliflozin (Steglatro)

Incretin mimetics

Incretin mimetics are drugs that mimic the hormone incretin, which stimulates insulin release after meals. These include:

  • exenatide (Byetta, Bydureon)
  • liraglutide (Victoza)
  • dulaglutide (Trulicity)
  • lixisenatide (Adlyxin)
  • semaglutide (Ozempic)

Oral combination drugs

A variety of products that combine some of the drugs mentioned above is available. These include:

  • alogliptin and metformin (Kazano)
  • alogliptin and pioglitazone (Oseni)
  • glipizide and metformin (Metaglip)
  • glyburide and metformin (Glucovance)
  • linagliptin and metformin (Jentadueto)
  • pioglitazone and glimepiride (Duetact)
  • pioglitazone and metformin (Actoplus MET, Actoplus MET XR)
  • repaglinide and metformin (PrandiMet)
  • rosiglitazone and glimepiride (Avandaryl)
  • rosiglitazone and metformin (Avandamet)
  • saxagliptin and metformin (Kombiglyze XR)
  • sitagliptin and metformin (Janumet and Janumet XR)

Diet and lifestyle

Not only medication as I said, achieving a required blood glucose level in diabetic patients requires diet selection and lifestyle modification.

Recommended foods for diabetic patients

Make your calories count with these nutritious foods. Choose healthy carbohydrates, fiber-rich foods, fish and “good” fats.

Healthy carbohydrates

During digestion, sugars (simple carbohydrates) and starches (complex carbohydrates) break down into blood glucose. Focus on healthy carbohydrates, such as:

  • Fruits
  • Vegetables
  • Whole grains
  • Legumes, such as beans and peas
  • Low-fat dairy products, such as milk and cheese

Avoid less healthy carbohydrates, such as foods or drinks with added fats, sugars and sodium.

Fiber-rich foods

Dietary fiber includes all parts of plant foods that your body can’t digest or absorb. Fiber moderates how your body digests and helps control blood sugar levels. Foods high in fiber include:

  • Vegetables
  • Fruits
  • Nuts
  • Legumes, such as beans and peas
  • Whole grains

Heart-healthy fish

Eat heart-healthy fish at least twice a week. Fish such as salmon, mackerel, tuna and sardines are rich in omega-3 fatty acids, which may prevent heart disease.Treatment of type 2 diabetes mellitus

Avoid fried fish and fish with high levels of mercury, such as king mackerel.

‘Good’ fats

Foods containing monounsaturated and polyunsaturated fats can help lower your cholesterol levels. These include:

  • Avocados
  • Nuts
  • Canola, olive and peanut oils

But don’t overdo it, as all fats are high in calories.

Foods to avoid

Diabetes increases your risk of heart disease and stroke by accelerating the development of clogged and hardened arteries. Foods containing the following can work against your goal of a heart-healthy diet.

  • Saturated fats. Avoid high-fat dairy products and animal proteins such as butter, beef, hot dogs, sausage and bacon. Also limit coconut and palm kernel oils.
  • Trans fats. Avoid trans fats found in processed snacks, baked goods, shortening and stick margarines.
  • Cholesterol. Cholesterol sources include high-fat dairy products and high-fat animal proteins, egg yolks, liver, and other organ meats. Aim for no more than 200 milligrams (mg) of cholesterol a day.
  • Sodium. Aim for less than 2,300 mg of sodium a day. Your doctor may suggest you aim for even less if you have high blood pressure.

Excercises

  • At least two and a half hours of moderate to vigorous intensity physical activity per week (i.e., brisk walking, water aerobics, swimming, or jogging).
  • Two to three sessions of resistance exercise per week. Resistance exercise is physical activity that strengthens muscle strength, such as lifting five-pound weights or doing pushups.
  • No more than two days in a row without physical activity.
  • Breaking up sitting time every 30 minutes during the day.
  • Incorporate flexibility exercises, like stretching or yoga into your weekly routine.

Managing complications of DMT2d

Diabetes increases your risk for many serious health problems. The good news? With the correct treatment and recommended lifestyle changes, many people with diabetes are able to prevent or delay the onset of complications.

  • Hypoglycemia

Not common in type 2 DM but it occurs. Patient experience low blood sugar after taking anti diabetic drugs. If patient starts feeling week and dizzy it maybe hypoglycemia and taking a light meal or a drink the symptoms go away.

In case of severe hypoglycemia dextrose is given IV.

  • Skin Complications

Stay alert for symptoms of skin infections and other skin disorders common in people with diabetes.

  • Eye Complications

Keep your risk of glaucoma, cataracts and other eye problems low with regular checkups.

  • Neuropathy

Nerve damage from diabetes is called diabetic neuropathy (new-ROP-uh-thee). About half of all people with diabetes have some form of nerve damage.

Explore: Complications

  • Foot Complications

Learn about neuropathy (which can cause numbness in the feet) as well as other complications.

  • DKA (Ketoacidosis) & Ketones

Know the warning signs of DKA and check urine for ketones, especially when you’re sick.

  • Kidney Disease (Nephropathy)

Keep your diabetes and blood pressure under control to lower the chance of getting kidney disease.

  • High Blood Pressure

High blood pressure—also called hypertension—raises your risk for heart attack, stroke, eye problems, and kidney disease.

  • Stroke

Maintain target levels for blood glucose, blood pressure, and cholesterol to reduce your risk of stroke.

  • Gastroparesis

Get treatment to help you manage gastroparesis, so that you can be as healthy and comfortable as possible.

See also difference between type 1 and type 2 diabetes mellitus

Dmitri

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