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Your Health Blog

    Type II Diabetes: Managing Your Options

    Mark Graves, MD Internal Medicine, Deaconess Clinic  10/12/2016

    According to the Centers for Disease Control, over 29 million Americans have diabetes and of those 29 million, one in four people do not know they have diabetes.  Another alarming statistic is that currently, one in three people will develop Type II diabetes during their lifetime. 

    Risk factors include ethnicity, age, gestational diabetes during pregnancy, a history of inactivity, fat distribution and weight.  Managing Type II diabetes requires patient vigilance as well as a commitment to a treatment program.
     
    Currently, management and treatment options for Type II diabetes patients include:

    • Lifestyle Choices - These may include reducing stress, participating in an exercise program and changing eating habits to reduce fat and sugar intake.  While lifestyle choices are an essential management tool, overhauling diet and activity level is challenging for most patients and adherence is varied. 
    • Traditional Prescription Options - These include Metformin, Sulfonylureas, Meglitinides, Thiazolidinediones and DPP-4 Inhibitors.  All of these medications serve to regulate the delicate balance of insulin and/or glucose within the body.  Patient compliance is easy but all of the options have side effects including but not limited to nausea, weight gain, joint pain, urinary tract infections and upper respiratory infections. 
    • Bariatric Surgery - For individuals with a high body mass index, bariatric surgery is sometimes recommended.  Weight loss aids in stabilizing blood sugar levels and for some patients, medication is no longer needed.  However, there is a substantial downside as it’s an invasive procedure with a significant recovery time.
    • Insulin therapy - Insulin therapy aims to replace what the body isn’t producing.  As it cannot be taken orally, patients must learn to administer self-injections and the hesitancy to do so affects compliance.  This therapy promotes weight gain.
    • Semaglutide - A GLP-1 agonist, Semaglutide is currently in clinical trials as a promising new option for Type II diabetes patients.  GLP-1 agonists lower blood sugar and early evidence is showing weight reduction as well.  Semaglutide is taken orally thus increasing the chances of patient compliance 
       
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