Treatment of type 2 diabetes

Type 2 diabetes

In type 2 diabetes, the body has difficulty keeping blood sugar low enough. Physical activity and good food can help lower blood sugar levels, but you may also need medication.

The blood sugar value is the measure that indicates how much sugar is in the blood.

What is Type 2 Diabetes?

The cells in the body need insulin to absorb blood sugar. In type 2 diabetes, insulin in the body is not enough. The cells are also less sensitive to the insulin that is present. This makes it more difficult for the cells to absorb the sugar contained in the blood and the blood sugar value is increased.

Read more about type 2 diabetes and what it is due to here.

Regular contact with health care personnel

It is good to have regular contact with healthcare professionals who have specialized knowledge in diabetes. They can give you advice and support when needed. They can also tell you more about type 2 diabetes, such as what you can do yourself to affect blood sugar levels.

You will also see your doctor regularly to see how the treatment is going.

You can affect your blood sugar value yourself

The blood sugar value is influenced by what you do and what you eat. Physical activity, good eating habits and not smoking can prevent type 2 diabetes and to some extent lower blood sugar levels.

Physical activity and changing eating habits can also cause you to lose weight if you are overweight. Losing weight is good for blood sugar levels.

Be physically active

Physical activity is a very effective way to increase the cells’ sensitivity to insulin.

It is good if you are able to be physically active three times a week, but the more often you are physically active the better. Feel free to activate more muscle groups at the same time, for example, Nordic walking has the effect of walking without rods.

Read more about training and how to get started in the text Advice on training.

Read more about how physical activity can affect your health here.

Eat good food

Good eating habits can largely affect type 2 diabetes. With good food and eating habits you can get better blood sugar value, lower blood fat levels, reduce weight and reduce the risk of other diseases. You can also reduce the need for medicines that lower blood sugar levels.

Do not smoke

You should not smoke at all if you have diabetes. Smoking increases the risk of most complications that can occur in diabetes, including on the small blood vessels in the kidneys, in the feet and in the retina of the eyes. The risk of having a heart attack or stroke also doubles.

An infected wound that is not taken care of can lead to a fire, although it is rare.

There is help to get if you smoke and want to quit.

Treatment with drugs may be needed

You will probably need to be treated with medicines to lower your blood sugar when you are diagnosed with type 2 diabetes. It is also important to prevent and treat high blood pressure and high levels of blood fats.

The goal of the treatment is to avoid the complications that can occur due to elevated blood sugar value, such as damage to the body’s large and small blood vessels. Read more about complications in the text Diabetes type 2.

Medicines at high blood sugar value

There are several different drug groups that work in different ways. Which drug you may start with depends, among other things, on whether you have any other illness. Sometimes insulin is also needed.

Metformin

Metformin increases the cells’ sensitivity to insulin. Then the cells can absorb sugar from the blood and the blood sugar value drops. Metformin also reduces the liver’s own production of sugar.

Most often, drug therapy begins with metformin. It is the drug most commonly used in type 2 diabetes.

Incretins

There are two different types of drugs included in the group of incretins, GLP-1 analogs and DPP4 inhibitors. Both affect the body’s own hormone GLP-1, but in different ways.

The hormone GLP-1 increases, among other things, the production of insulin by the pancreas. The hormone also makes you feel measured faster.

GLP-1 analogs are copies of the hormone GLP-1 and have similar effect. You can be treated with GLP-1 analogues if you have cardiovascular disease.

DPP4 inhibitors slow down the hormone GLP-1 in the body. Thus, the effect of GLP-1 is prolonged.

Inhibitors of SGLT2

Inhibitors of SGLT2 are a new group of diabetes drugs. The drug causes the kidneys to secrete a greater amount of sugar in the urine. This way the blood sugar value is lowered. You can be treated with these if you have cardiovascular disease.

Sulphonylureas

Sulphonylureas cause the pancreas to produce more insulin. Sulfonide rides work best in the first few years after being diagnosed. Then the pancreas often has a relatively good own production of insulin. The effect of sulphonylureas decreases as the production of insulin by the pancreas decreases.

Glitinider

Glitinides make the pancreas produce more insulin. They are similar to sulfoneurides, but have a faster and shorter duration of effect. Glitinides also work best in the first years after being diagnosed, when the pancreas still has its own insulin production.

Glitinides are sometimes called glinids.

Glitazones

Glitazones help the body to make better use of its own insulin. Glitazones improve the sensitivity of the fat cells to insulin. Glitazones also affect the sugar metabolism in the liver and muscles so that blood sugar levels can be lowered more easily.

Alpha-glucosidase

Alpha-glucosidase inhibitors cause the sugar you eat to break down more slowly in the gut. When the digestion takes longer, it also takes time before the sugar from the intestine is taken up by the blood. The drugs lower blood sugar levels, but not as much as the other drugs.

Insulin

To get a good blood sugar value, most people with type 2 diabetes eventually need to supplement treatment with insulin. You may also need insulin when you are diagnosed, but it usually takes several years.

Read more about insulin in the chapter Insulin, in the text Treatment of type 1 diabetes.

Side effects of drugs used at high blood sugar levels

Ask your doctor or pharmacist at the pharmacy what side effects you may get from your drug. They can also tell you if there is anything special you should pay attention to when using the drug.

You may not experience side effects from your medication. But talk to your doctor if you get any side effects that bother you and ask if you can do anything to reduce them. Otherwise, you may want to try replacing the medicine if your doctor thinks it is going well.

Metformin and lactate acidosis

It is unusual, but metformin can cause lactic acid poisoning, called lactic acidosis. It is a serious condition that needs to be treated in hospitals. Ask your doctor what symptoms you should pay attention to.

The risk of lactic acidosis increases if you get a fluid deficiency. Therefore, do not take metformin if you are vomiting, have diarrhea or have difficulty getting fluid in you. Talk to your doctor or diabetes nurse about the risk of fluid deficiency going on for several days and you are unsure if you can take metformin.

In X-ray examinations with contrast agents, you may have to refrain from taking metformin for a few days. You get information about it in the notice.

Too low blood sugar value – insulin sensation

Some medicines may cause you to have very low blood sugar levels, especially sulfonylureas and insulin. Getting very low blood sugar is called insulin sensitivity or hypoglycemia.

With an insulin sensation, you may feel hungry, dull, and anxious. You can also start sweating or trembling. Symptoms usually disappear quite quickly when you eat something sweet, such as grape sugar. Even a glass of milk can help.

Common to gain weight

Many blood sugar lowering drugs can cause you to gain weight. Therefore, it may be good to get a drug that does not increase the weight further, if you have weight problems. Consult your doctor.

Drugs at high blood pressure

Blood pressure should be below 140/85 mmHg. It may be sufficient to eat less salt, be physically active and lose weight if you have only slightly elevated blood pressure. Otherwise, you may need drug medication to lower blood pressure.

Medicines for high blood fats

In type 2 diabetes, it is common to have too high levels of harmful blood fats. The composition of the blood fats is improved by, among other things, good eating habits, physical activity and if the blood sugar value is improved. If that is not enough, you may need medication to lower blood fat.

You may need medication if you have multiple conditions or habits that increase the risk of cardiovascular disease, even if you have fairly low levels of blood fat. Examples of such conditions and habits are high blood pressure and smoking.

It is especially important that you be treated with medicines to lower blood fat if you have had a heart attack or stroke. The treatment reduces the risk of a new heart attack or stroke.

Obesity Surgery

Obesity surgery can be a treatment method if you have type 2 diabetes and obesity with a BMI value above 40. BMI is a measure of the relationship between length and weight. Read more about how you assess your weight here.

Obesity surgery can also be a treatment if you have a BMI value over 35 and have difficulty lowering blood sugar value, blood pressure or blood fat content despite drugs and changing lifestyle habits.

Obesity surgery is also called obesity surgery.

Pregnancy

Ideally, do not use any type of blood sugar lowering tablets if you are pregnant and have type 2 diabetes. You may be treated with metformin.

Insulin is the only option if metformin is not considered appropriate and if you cannot keep your blood sugar level at a good level with appropriate eating habits and regular exercise. Discuss with your doctor if you have type 2 diabetes and are or are planning to become pregnant.

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