Woman with a diabetes monitor making a salad

Blog - Diabetes Treatment

What are the Diabetes Treatment Options?

Often described as an ‘invisible condition’, diabetes is largely managed through consistent daily activities, such as regular exercise, a balanced diet and general wellbeing. Medications may play a role in this for people with type 2 diabetes, while insulin delivery therapy is crucial for people living with type 1 diabetes. Either way, it’s important to monitor your blood sugar levels to inform your diabetes treatment decisions.

The difference between type 1 and type 2 diabetes

Caused by a number of factors, type 1 diabetes (T1D) is an autoimmune condition in which your body stops making insulin to regulate blood glucose, sometimes called blood sugar, levels.

Type 2 diabetes (T2D) is more closely tied to lifestyle factors and reduces the pancreas’ ability to produce insulin.¹ If you have T1D, you’ll need to use insulin, while T2D is primarily treated with other medications (such as Metformin), as well as eating well and moving more. However, some people living with T2D may need to take insulin.²

Type 2 diabetes treatments

See how T2D can be actively managed with the treatments listed below:

1. Diet and exercise

While there’s no such thing as a ‘diabetes diet’, you can actively manage your condition by making healthier food choices. This generally involves eating more high-fibre foods, such as fruit, low starch vegetables and whole grains. It may also be beneficial to eat smaller portions and stick to a consistent schedule for meals and snacking.^3,4

Regular exercise is also important for losing or maintaining a healthy weight. Limit physical inactivity by increasing movement throughout the day. Diabetes UK recommends a minimum of 150 minutes of moderate exercise per week - 30 minutes of aerobic exercise most days, as well as 2-3 sessions of resistance training a week.^3,5 Be sure to speak to your healthcare professional (HCP) before making any lifestyle-related changes.

2. Weight management

It is estimated that around 85% of people with T2D are carrying extra weight.⁶ It is typically gained most noticeably around the waist, which means that fat can build up around your organs, including your pancreas. This can potentially cause insulin resistance. Weight loss not only results in better control of blood glucose levels, but also improves cholesterol and blood pressure (among other benefits). By losing as little as 5% of your BMI, you may see improvements in these factors.³

3. Non-insulin medication

If you can’t maintain your target blood sugar level with lifestyle changes, your HCP may prescribe you oral diabetes medications. One of the most common is Metformin which lowers glucose production in the liver and allows your body to use insulin more efficiently. Other examples are Sulfonylureas, which help the body produce more insulin, and SGLT2 Inhibitors which help to excrete glucose from the body. Your HCP may also prescribe blood pressure and cholesterol-lowering medicines, as well as low-dose aspirin to help prevent heart disease.³

According to the National Library of Medicine, medicines (like Metformin) are not formally recommended to treat T1D.⁷ While recent research indicates that they may have some minor benefits, people with T1D are effectively treated with insulin therapy.⁸

Insulin for type 2 diabetes

People with T2D ordinarily need to monitor their blood glucose levels throughout the day and treat their symptoms. In some cases, people with T2D may use insulin, usually administered with multiple daily injections. However, as the condition can generally be managed with the treatments listed above, this is less common.^2,9

Type 1 diabetes treatments

See how T1D can be actively managed with the treatments listed below:

1. Meal planning and carb counting

As with T2D, there is no such things as a ‘type 1 diabetes diet’. However, the American Diabetes Association offers a simple method for meal planning. It involves filling half your plate with non-starchy vegetables, a quarter with lean protein and the last quarter with whole grains, such as brown rice or a starchy vegetable.^4,10

Refined carbohydrates in particular need to be carefully considered. This is because they’re composed of sugars with simple chemical structures, often leading to a quick and rapid rise of blood sugar levels.¹¹

So, people with T1D need to calculate the amount of carbohydrates they’re consuming so that they can adjust their insulin dose accordingly.¹⁰ Carb counting is an effective way to manage your diabetes but can be tricky at first.¹² You can create a plan with your registered dietician and use apps such as Glooko and Sugarmate to assist you. Remember to speak to your HCP before making any dietary changes.

2. Insulin therapy

Anyone who has T1D will need insulin therapy throughout their life. They’re many types of insulin, including ultra-short-acting, short-acting, rapid-acting, intermediate-acting, and long- and ultra-long-acting insulin. You’ll probably need several daily injections that include a combination of long- and rapid-acting insulin. These behave more like the body’s normal use of insulin, rather than older methods that require fewer shots of the longer-acting insulin types.⁹

You’ll need to be especially vigilant and possibly adjust your dose before, after or during exercise and depending on what you eat.^10,13 Insulin can be delivered manually with injections and pens, as well as with pumps or a hybrid closed-loop system. To learn more about which pumps and pens connect with Dexcom Continuous Glucose Monitoring (CGM) Systems, please visit our integrations and connectivity page. However, you may still need to inject from time to time. Talk to your HCP for an insulin regime that fits your specific requirements.

3. Exercise and wellbeing

T1D can be better managed with regular movement and stress management. Regardless of what diabetes you have, exercise is important for your overall health and wellbeing.⁹ However, certain activity can cause your blood sugar levels to rise (hyperglycaemia) or drop (hypoglycaemia). You can avoid hypos by regularly checking your glucose levels, adjusting your insulin and eating the right amount of carbs before, during and after exercise.¹³ For more information, see our guide on how to manage blood sugar levels during exercise.

According to Diabetes UK, stress can also have an impact on diabetes management. The hormones responsible for the ‘fight or flight’ response may cause a spike in blood sugar, potentially leading to hypers.¹⁴ Stress can be managed by getting regular exercise, adequate sleep and ample time for relaxation. Activities, such as yoga, mindfulness and meditation have also been shown to reduce stress and lower blood sugar levels.¹⁵

How to inform treatment decisions

While most of the diabetes treatment options should be part of your daily life, you can use several tools to help you monitor your glucose levels to make informed decisions.

1. Education (and noticing the symptoms)

It’s important to consult your HCP as the first ‘port of call’ for diabetes education and treatment plans. However, self-education – whether formal or informal – is also crucial in managing your condition.¹⁶ Soon you should be able to notice the symptoms and potential onset of hypers and hypos with the knowledge of how to treat them.

2. Blood glucose meter

Blood glucose meters require finger pricks and offer a snapshot of your blood sugar level at that exact moment in time.¹⁷ If you have T1D, your HCP may recommend that you test 4 to 10 times a day, as well as before meals, before and after exercise and before you go to bed.¹⁸ Up until relatively recently, this was the only way to check your blood sugar levels to make treatment decisions.

3. Flash glucose monitoring

Flash glucose monitoring measures your glucose levels with a sensor that is inserted beneath the skin. When the receiver device is swiped close to the sensor, it transmits your glucose data.¹⁷ While it continuously displays glucose trends to make informed decisions, the need to periodically scan makes it less seamless than real-time continuous glucose monitoring (rtCGM) systems.

4. Real-time CGM systems

Like Flash glucose monitoring, rtCGM systems allow you to view your glucose trends over time with the use of a sensor and receiver device. The Dexcom CGM Systems require zero finger pricks* or scanning, and accurately predict where your glucose levels are heading and how quickly. With this knowledge, you can make timely and informed diabetes treatment decisions.

See how you can use real-time CGM for T1D or T2D

References

* If your glucose alerts and readings from the Dexcom system do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions.
1 Diabetes UK. Differences between type 1 and type 2 diabetes. Accessed 20 March 2023. Diabetes.org.uk.
2 Diabetes UK. Diabetes treatments. Accessed 20 March 2023. Diabetes.org.uk.
3 Mayo Clinic. Type 2 diabetes. Accessed 20 March 2023. Mayoclinic.org.
4 Centers for Disease Control and Prevention. Diabetes Meal Planning. Accessed 20 March 2023. Cdc.gov.
5 Diabetes UK. Sports nutrition and type 2 diabetes. Accessed 20 March 2023. Diabetes.org.uk.
6 Diabetes UK. Weight loss and diabetes. Accessed 20 March 2023. Diabetes.org.uk.
7 National Library of Medicine. The effects of metformin in type 1 diabetes mellitus. Accessed 20 March 2023. Ncbi.nlm.nih.gov.
8 JDRF. Type 1 Diabetes Treatments. Accessed 20 March 2023. Jdrf.org.
9 Mayo Clinic. Type 1 diabetes. Accessed 20 March 2023. Mayoclinic.org.
10 Mayo Clinic. Diabetes diet: Create your healthy-eating plan. Accessed 20 March 2023. Mayoclinic.org.
11 Harvard School of Public Health. Carbohydrates and Blood Sugar. Accessed 20 March 2023. Hsph.harvard.edu.
12 Diabetes UK. Learn about carb counting. Accessed 20 March 2023. Diabetes.org.uk.
13 NHS. Exercise and sport. Accessed 20 March 2023. Nhs.uk.
14 Diabetes UK. Stress and diabetes. Accessed 20 March 2023. Diabetes.org.uk.
15 National Library of Medicine. Effect of 6 Months of Meditation on Blood Sugar, Glycosylated Hemoglobin, and Insulin Levels in Patients of Coronary Artery Disease. Accessed 20 March 2023. Ncbi.nlm.nih.gov.
16 Centers for Disease Control and Prevention. Diabetes Education Linked to Better Diabetes Self-Care. Accessed 20 March 2023. Cdc.gov.17 Diabetes UK. Checking your blood sugar levels. Accessed 20 March 2023. Diabetes.org.uk.
18 Mayo Clinic. Blood sugar testing: Why, when and how. Accessed 20 March 2023. Mayoclinic.org.