Treatment

Treatment

The major treatment goals for people with type 2 diabetes are:

• Treat all conditions that place the patients at risk for heart disease and stroke, which are the major killers of people with type 2 diabetes.
• Control blood glucose levels. The goal is to achieve fasting blood glucose levels of less than 110 mg/dL and glycolated hemoglobin (HbA1c) levels of less than 7%. The objective is to reduce complications in small blood vessels and the nerve damage associated with diabetes.

An intensive multi-pronged approach is critical for reducing complications and improving survival rates in patients with diabetes. Intensive therapy includes:

• Healthy lifestyle changes: Regular exercise; heart-healthy diet; quitting smoking.
• Controlling blood sugar levels. Monitor blood sugar and hemoglobin A1C levels. Oral anti-hyperglycemic drugs such as metformin are first-line drug treatments. Insulin may eventually be needed.
• Heart-protective drugs. These medications include various drugs to control high blood pressure (ACE inhibitors, diuretics, others) and cholesterol (statins, fibrates). Controlling high blood pressure is a proven factor in reducing mortality rates. Aspirin may help prevent blood clots and heart attack.

Treating Special Populations

Different goals may be required for specific individuals, including pregnant women, very old and very young people, and those with accompanying serious medical conditions. Treating children with type 2 diabetes depends on the severity of the condition at diagnosis. Metformin is now approved for children. Until recently, only insulin was approved for treating children with diabetes.