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TYPE 2 DIABETES TREATMENT

Diagnosis

Glycated hemoglobin test

The blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you’ll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered pre-diabetes, which indicates a high risk of developing diabetes. Normal levels are below 5.7 percent. If the A1C test isn’t available, or if you have certain conditions such as if you’re conceiving or have an uncommon form of hemoglobin known as a hemoglobin variant that can make the A1C test inaccurate, your physician may use the following tests to diagnose diabetes

Random blood sugar test

A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter. Regardless of when you last ate, a random blood sugar level of 200 mg/dL or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst. Fasting blood sugar test. A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL is normal. A fasting blood sugar level from 100 to 125 mg/dL is considered prediabetes. If it’s 126 mg/dL or higher on two separate tests, you have diabetes.

Oral glucose tolerance test. For this test, you fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours. A blood sugar level less than 140 mg/dL is normal. A reading between 140 and 199 mg/dL indicates prediabetes. A reading of 200 mg/dL or higher after two hours may indicate diabetes. The American Diabetes Association recommends routine screening for type 2 diabetes beginning at age 45, especially if you’re overweight.

If the results are normal, repeat the test every three years. If the results are borderline, ask your physician when to come back for another test. Screening is also recommended for people who are under 45 and overweight if there are other heart disease or diabetes risk factors present, such as a sedentary lifestyle, a family history of type 2 diabetes, a personal history of gestational diabetes or blood pressure above 140 or 90 millimeters of mercury. If you’re diagnosed with diabetes, the physician may do other tests to distinguish between type 1 and type 2 diabetes since the two conditions often require different treatments.

After the diagnosis

A1C levels need to be checked between two and four times a year. Your target A1C goal may vary depending on your age and other factors. However, for most people, the American Diabetes Association recommends an A1C level below 7 percent. Ask your physician what your A1C target is. Compared with repeated daily blood sugar tests, the A1C test is a better indicator of how well your diabetes treatment plan is working. An elevated A1C level may signal the need for a change in your treatments, meal plan or activity level. In addition to the A1C test, your physician will take blood and urine samples periodically to check your cholesterol levels, thyroid function, liver function and kidney function. The physician will also assess your blood pressure. Regular eye and foot exams also are important.

Treatment

Management of type 2 diabetes includes:

– Healthy eating

– Regular exercise

– Possibly, diabetes treatment or insulin therapy

– Blood sugar monitoring

These steps will help keep your blood sugar level closer to normal, which can delay or prevent complications.

Healthy eating

Contrary to popular perception, there’s no specific diabetes diet. However, it’s important to center your diet on these high-fiber, low-fat foods – 1. Fruits 2. Vegetables 3. Whole grains. You’ll also need to eat fewer animal products, refined carbohydrates and sweets. Low glycemic index foods also may be helpful. The glycemic index is a measure of how quickly a food causes a rise in your blood sugar. Foods with a high glycemic index raise your blood sugar quickly. Low glycemic index foods may help you achieve a more stable blood sugar.

Foods with a low glycemic index typically are foods that are higher in fiber. A registered dietitian can help you put together a meal plan that fits your health goals, food preferences and lifestyle. He or she can also teach you how to monitor your carbohydrate intake and let you know about how many carbohydrates you need to eat with your meals and snacks to keep your blood sugar levels more stable.

Physical activity

Everyone needs regular aerobic exercise, and people who have type 2 diabetes are no exception. Get your physician’s OK before you start an exercise program. Then choose activities you enjoy, such as walking, swimming and biking. What’s most important is making physical activity part of your daily routine. Aim for at least 30 minutes of aerobic exercise five days of the week. Stretching and strength training exercises are important, too. If you haven’t been active for a while, start slowly and build up gradually.

A combination of exercises aerobic exercises, such as walking or dancing on most days, combined with resistance training, such as weightlifting or yoga twice a week often helps control blood sugar more effectively than either type of exercise alone. Remember that physical activity lowers blood sugar. Check your blood sugar level before any activity. You might need to eat a snack before exercising to help prevent low blood sugar if you take diabetes treatments that lower your blood sugar.

Monitoring your blood sugar

Depending on your treatment plan, you may need to check and record your blood sugar level every now and then or, if you’re on insulin, multiple times a day. Ask your physician how often he or she wants you to check your blood sugar. Careful monitoring is the only way to make sure that your blood sugar level remains within your target range.

Sometimes, blood sugar levels can be unpredictable. With help from your diabetes treatment team, you’ll learn how your blood sugar level changes in response to food, exercise, liquor , illness and treatment.

Bariatric operation

If you have type 2 diabetes and your body mass index is greater than 35, you may be a candidate for weight-loss operation. Blood sugar levels return to normal in 55 to 95 percent of people with diabetes, depending on the procedure performed. Operation that bypass a portion of the small intestine have more of an effect on blood sugar levels than do other weight-loss operations. Drawbacks to the operation include its high cost, and there are risks involved, including a risk of death. Additionally, drastic lifestyle changes are required and long-term complications may include nutritional deficiencies and osteoporosis.