Type 2 diabetes is treated with a combination of lifestyle changes and medications tailored to blood sugar levels, overall health, and personal preferences. Treatment often starts with non‑drug approaches and adds medicines as needed, with insulin therapy considered for some individuals over time. Key components of treatment
- Lifestyle changes
- Healthy eating: focus on balanced meals, portion control, fiber-rich foods, and limiting added sugars and refined carbs.
- Physical activity: at least 150 minutes of moderate exercise per week, plus resistance training a couple of days per week.
- Weight management: even modest weight loss (5–10% of body weight) can improve blood sugar control and health risks.
- Smoking cessation and limiting alcohol as appropriate.
- Blood sugar–lowering medications
- Metformin is commonly the first-line oral medication.
- Additional oral agents can include DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists, sulfonylureas, or TZDs, chosen based on effect on blood sugar, weight, cardiovascular and kidney health, and side effects.
- In some people, insulin therapy becomes necessary, either alone or in combination with other diabetes medicines.
- The goal is to achieve and maintain blood sugar in a target range set by your healthcare provider, while reducing risk of complications.
- Weight management options
- Structured programs, medications for weight loss in certain cases, or weight‑loss surgery may be considered for eligible individuals, particularly when BMI is elevated.
- Monitoring and support
- Regular monitoring of blood glucose, kidney function, blood pressure, cholesterol, and eye health.
- Education and psychological support to help with long‑term adherence and mental well-being.
When to expect changes
- Some people can manage with lifestyle changes alone for a period, and in rare cases, diabetes can go into remission with significant weight loss.
- If blood sugar remains above target despite lifestyle changes, medications are typically added or adjusted.
- If complications or other health conditions arise, treatment plans may shift to prioritize cardiovascular or renal protection.
Common questions
- Do you need medication right away? Many people start with lifestyle changes plus metformin if blood sugar remains above target after a trial of lifestyle modification; others may require earlier pharmacotherapy depending on blood sugar levels, age, and comorbidities.
- Is insulin always required? Not for everyone. Some people manage with oral medications and lifestyle changes for years; others may require insulin if other treatments no longer control blood sugar.
If you’d like, share your current blood sugar ranges, A1C level, weight, any other health conditions, and any medications you’re already taking. A more personalized overview of which treatment options are commonly considered for someone like you can be provided.
