These medications are useful for people whose blood sugar is not controlled on the highest dose of one or two oral medicines. They may be especially helpful for overweight people who are gaining weight or struggling to lose weight on other diabetes medicines.

Liraglutide, dulaglutide, or semaglutide injections are recommended for people who have, or are at high risk for, cardiovascular disease, as they have been shown to have cardiovascular benefits in these groups.

GLP-1 receptor agonists do not usually cause low blood sugar when used without other medications that cause low blood sugar. They promote loss of appetite and a sense of feeling full after eating a smaller amount of food, which helps with weight loss, but can also cause bothersome side effects, including nausea, vomiting, and diarrhea.

Gastrointestinal side effects usually improve with time. Pancreatitis inflammation of the pancreas has been reported rarely in people taking GLP-1 receptor agonists, but it is not known if the medications caused the pancreatitis. They have also been associated with gall bladder disease.

You should stop taking these medications if you develop severe abdominal pain. Exenatide and lixisenatide should not be used in people with abnormal kidney function, and liraglutide and dulaglutide should be used with caution in this situation.

These drugs are generally expensive. Meglitinides — Meglitinides include repaglinide brand name: Prandin and nateglinide brand name: Starlix. They work to lower blood sugar levels, similar to the sulfonylureas, but they act more quickly than sulfonylureas and should be taken right before a meal; they might also be recommended in people who are allergic to sulfonylureas.

They are taken in pill form. Meglitinides are not generally used as a first-line treatment, because they are more expensive than sulfonylureas. Repaglinide can be used in patients with kidney failure.

Thiazolidinediones — This class of medicines includes pioglitazone brand name: Actos and rosiglitazone brand name: Avandia , which work to lower blood sugar levels by increasing the body's sensitivity to insulin. They are taken in pill form and usually in combination with other medicines such as metformin, a sulfonylurea, or insulin.

The risk of heart failure is small but serious. An early sign of heart failure is swelling of the feet and ankles. People who take thiazolidinediones should monitor for swelling.

Alpha-glucosidase inhibitors — These medicines, which include acarbose brand name: Precose and miglitol brand name: Glyset , work by interfering with the absorption of carbohydrates in the intestine. This helps to lower blood sugar levels but not as well as metformin or the sulfonylureas. They can be combined with other medicines if the first medicine does not lower blood sugar levels enough.

The main side effects of alpha-glucosidase inhibitors are gas flatulence , diarrhea, and abdominal pain; starting with a low dose may minimize these side effects.

The medicine is usually taken three times per day with the first bite of each meal. Insulin — In the past, insulin treatment was reserved for patients with type 2 diabetes whose blood sugar was not controlled with oral medicines and lifestyle changes ie, diet and exercise.

However, there is increasing evidence that insulin treatment at earlier stages may improve overall diabetes management over time. Side effects include low blood sugar, if you take more insulin than your body needs, and weight gain. Adjusting the dose of insulin to the body's needs can minimize the risk of these side effects.

It may be necessary to readjust your dose frequently. In some situations, insulin injections shots can be used as a first-line treatment for type 2 diabetes.

In other cases, insulin can be added to or substituted for oral medicines. If you take insulin, you will need to get comfortable giving yourself the injections or have a family member or housemate learn how to do it for you.

More detailed information about insulin treatment is available separately. Living with type 2 diabetes can be stressful. It is a lot of responsibility to have to monitor your blood sugar if you need to do this , watch your diet, exercise regularly, keep all your appointments, and take your medications every day.

It can also be scary to think about the potential complications of diabetes. It can help to involve your family and friends and make sure you have a solid support system in place to provide encouragement, reminders, and help as you need it.

It is not uncommon for stress to lead to burnout or even depression, and this can make taking care of yourself more difficult. Having an open and honest discussion with your doctor, nurse, or other health care provider can help you to understand your diagnosis, treatment plan, and what to do if you are overwhelmed.

Some people also benefit from talking with a counselor or social worker to help them cope with their responsibilities and worries. Your health care provider is the best source of information for questions and concerns related to your medical problem.

This article will be updated as needed on our website www. Related topics for patients, as well as selected articles written for health care professionals, are also available. Some of the most relevant are listed below. Patient level information — UpToDate offers two types of patient education materials.

The Basics — The Basics patient education pieces answer the four or five key questions a patient might have about a given condition.

These articles are best for patients who want a general overview and who prefer short, easy-to-read materials. Patient education: Treatment for type 2 diabetes The Basics Patient education: Type 2 diabetes The Basics Patient education: Using insulin The Basics Patient education: Low blood sugar in people with diabetes The Basics Patient education: Nonalcoholic fatty liver disease The Basics Patient education: Exercise and movement The Basics Patient education: Carb counting for adults with diabetes The Basics Patient education: Lowering your risk of prediabetes and type 2 diabetes The Basics Patient education: Diabetic ketoacidosis The Basics Patient education: Hyperosmolar hyperglycemic state The Basics.

Beyond the Basics — Beyond the Basics patient education pieces are longer, more sophisticated, and more detailed. These articles are best for patients who want in-depth information and are comfortable with some medical jargon.

Patient education: Type 2 diabetes: Overview Beyond the Basics Patient education: Type 2 diabetes: Insulin treatment Beyond the Basics Patient education: Type 2 diabetes and diet Beyond the Basics Patient education: Glucose monitoring in diabetes Beyond the Basics Patient education: Hypoglycemia low blood glucose in people with diabetes Beyond the Basics Patient education: Exercise and medical care for people with type 2 diabetes Beyond the Basics Patient education: Preventing complications from diabetes Beyond the Basics.

Professional level information — Professional level articles are designed to keep doctors and other health professionals up-to-date on the latest medical findings. These articles are thorough, long, and complex, and they contain multiple references to the research on which they are based.

Professional level articles are best for people who are comfortable with a lot of medical terminology and who want to read the same materials their doctors are reading. Alpha-glucosidase inhibitors for treatment of diabetes mellitus Measurements of chronic glycemia in diabetes mellitus Glycemic control and vascular complications in type 2 diabetes mellitus Insulin therapy in type 2 diabetes mellitus Management of persistent hyperglycemia in type 2 diabetes mellitus Metformin in the treatment of adults with type 2 diabetes mellitus Overview of general medical care in nonpregnant adults with diabetes mellitus Sodium-glucose cotransporter 2 inhibitors for the treatment of hyperglycemia in type 2 diabetes mellitus Sulfonylureas and meglitinides in the treatment of type 2 diabetes mellitus Thiazolidinediones in the treatment of type 2 diabetes mellitus.

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View Topic Loading Font Size Small Normal Large. Patient education: Type 2 diabetes: Treatment Beyond the Basics. Formulary drug information for this topic. No drug references linked in this topic. Find in topic Formulary Print Share. Official reprint from UpToDate ® www. com © UpToDate, Inc.

Remember these tips for eating on the go:. Check out our Top 10 Tips for making healthy choices without breaking the bank. Our online collection of tasty, diabetes-friendly recipes can satisfy your cravings, whether sweet, savory or somewhere in between.

And your risk continues to decrease as you lose even more weight. For good health, healthy adults need at least minutes per week of moderate-intensity aerobic physical activity or 75 minutes per week of vigorous-intensity aerobic activity, or an equivalent combination of both.

For example, you can meet the recommendation by walking briskly 30 minutes twice during the week and then jogging 20 minutes on two other days. Moderate-intensity aerobic activity is generally equivalent to a brisk walk that raises your heart rate.

Work with your health care team to customize a plan for you to get moving and get resources about getting active from the American Heart Association. Cigarette smoking is the leading avoidable cause of death in the United States.

It's also the most important modifiable cause of premature death. If you have diabetes, smoking is even worse because you're:.

Learn how to deal with urges and get resources to kick the habit. We can't get rid of stress, but we can deal with it in a healthy way. Find out more about stress management.

Learn how to find a support system. Download: 7 Tips to Care for Your Heart PDF. Written by American Heart Association editorial staff and reviewed by science and medicine advisors.

See our editorial policies and staff. About Diabetes. Diabetes Complications and Risks. Diabetes Risk Factors. Symptoms, Diagnosis and Monitoring of Diabetes. Preventing and Treating Diabetes. Diabetes Tools and Resources.

Get monthly science-based diabetes and heart-healthy tips in your inbox. Know Diabetes by Heart raises awareness that living with Type 2 diabetes increases risk for heart disease and stroke — and that people should talk with their doctor at their next appointment about ways to reduce risk.

Home Health Topics Diabetes Preventing and Treating Diabetes Living Healthy with Diabetes. Type 2 diabetes is a major cause of vision loss and blindness, kidney failure requiring dialysis, heart attacks, strokes, amputations, infections, and even early death.

And one in four people who have full-blown diabetes don't know they have it. Research suggests that a healthy lifestyle can prevent diabetes from occurring in the first place — and even reverse its progress.

The Diabetes Prevention Program DPP , a large, long-term study, asked the question: we know an unhealthy diet and lifestyle can cause type 2 diabetes, but can adopting a healthy diet and lifestyle prevent it?

This answer is yes: the vast majority of prediabetes and type 2 diabetes can be prevented through diet and lifestyle changes, and this has been proven by 20 years of medical research.