Diabetes

Care & Treatment

Happily, you can take steps to treat and manage diabetes and prevent its complications after diagnosis. Glycemic control (control of blood sugar) is important in preventing or delaying problems from diabetes. A small weight loss of 10 to 15 pounds can bring a big improvement in your blood glucose level. Exercise is also helpful for losing weight and controlling your blood glucose.  Even small increases in physical activity can help. If diet and exercise alone don’t control your type 2 diabetes, your healthcare provider will prescribe a medication to help lower your blood sugar. 

Non-insulin Medications

If you have prescriptions from more than one healthcare provider, it’s best to get them filled at one pharmacy. That way, the pharmacist can look out for potential medication interactions. Be certain that each healthcare provider you see knows about the other medications you’re taking.

Many medications are available to treat diabetes. Most of them are oral medications (pills), but some are shots. Each medication has advantages and possible side effects. Depending on the medication, side effects may include upset stomach, liver damage, heart failure, or other problems.

Your healthcare provider will talk with you and your family or other caregivers about which medication is right for you. Your pharmacist is also a good source of information about any medications you are taking.

Insulin

If diet, exercise, and non-insulin medications don’t control your blood glucose level, your healthcare professional may suggest insulin treatment. Insulin may also be the first choice of treatment if your blood glucose levels are very high.

Caution: With most medications used to treat diabetes, there is a risk of lowering your blood sugar level too much (this is called hypoglycemia). This is a serious concern for frail older adults, who may not experience early warning symptoms of low blood sugar.

Monitoring your Glucose Levels

Once you’ve been diagnosed with diabetes, your healthcare provider will teach you or your caregivers how to use a blood glucose meter, or glucometer. This simple device lets you check your blood glucose level. However, if you are taking non-insulin medications for diabetes, you may not need to monitor your blood glucose often. Your healthcare provider can conduct the A1c test every three to six months to monitor your diabetes control.

If you take insulin, your healthcare provider may ask you to check your blood glucose once or more a day, to help adjust your insulin levels. Your healthcare provider may also recommend making a note of your readings and bringing the records with you to your appointments.

There are now continuous glucose monitoring (CGM) devices.  A sticker-like patch is worn on the skin and a small monitor is placed against it to obtain the glucose reading.  These devices are very helpful for those on multiple injections of insulin daily or have a lot of variation in glucose readings.  CGM requires some technical skill to access glucose readings and may not be affordable depending on insurance coverage.

Hemoglobin A1c Level

Everyone with diabetes needs to work with their healthcare provider to decide what level of A1C will be best for their long-term health no matter what one’s age or general health is. Treatment and management will depend on how long you have had diabetes, what other conditions you have and your life expectancy. You should talk to your healthcare professional about what target is right for you. 

Don’t get discouraged if you have difficulty reaching your target A1c level—the benefits of improving glycemic control from “poor” to “fair” far outweigh the benefits of improving control from “fair” to “ideal”.

 

Last Updated July 2020