Diabetes Treatments: 

  

There is no cure for diabetes, but it usually can be treated and managed effectively. In
fact, some people with mild type 2 diabetes can manage their condition with just diet
and exercise and can avoid even having to take medication. Your healthcare provider
will consider a comprehensive list of factors—your age; overall health; medical history;
type of diabetes; extent of the disease; tolerance for specific medications, procedures,
or therapies; expectations for the course of the disease; and your opinion or
preferences—when assessing your treatment options. Treatments primarily involve
diabetes medication, insulin therapy, and/or a diet and exercise plan.

Diabetes Drugs
Several different classes of oral medications are available to treat type 2 diabetes, and
they are effective because these patients still have some ability to produce insulin in the
pancreas. There are many types of diabetes pills, each with a specific purpose, and
most patients take several different medications. There are no similar medications to
treat people with type 1 diabetes. However, these medications may be used in
combination with an insulin regime to manage blood glucose levels in type 1 diabetics.
Learn more about drugs that lower blood sugar levels.

Insulin Therapy
Insulin therapy is needed for people with type 1 diabetes because their pancreases no
longer produce it naturally. In type 2 diabetics, the pancreas produces low levels of
insulin and may need lower levels of insulin therapy if other types of treatment do not
adequately maintain healthy glucose levels.

Because stomach enzymes interfere with insulin, ingesting insulin orally isn’t effective in
lowering blood sugar in diabetics. Insulin must be directly introduced into the
bloodstream via injection. Common forms of delivery include a needle and syringe, an
insulin pen that contains an insulin cartridge, or an insulin pump that continuously
administers proper doses.
 Not all insulin is the same. They differentiate from each other by several factors: when
the isulin begins working after injection, when it works the hardest, and how long it
lingers in the body. For these reasons, your doctor may prescribe different types of
insulin to use at different times of the day. These include:

 rapid-acting insulin
 short-acting insulin
 long-acting insulin
 intermediate options
Learn more about insulin therapy.

Glucose Monitoring
Regularly checking your blood sugar level is the only way to know if your blood sugar
levels remain within your target range. Food, exercise, medications, illnesses, alcohol,
time of day, and stress can all affect your glucose levels, causing many unwanted
fluctuations.

The more you test your blood sugar and know how your body responds to those factors,
the safer you will be. Also, paying attention to any signs of hypoglycemia (low blood
sugar) or hyperglycemia (high blood sugar) can help manage your diabetes. Should you
experience symptoms of either, immediately check your glucose level.

You doctor also may recommend regular testing, beyond your regular blood-sugar
monitoring, of how effective your diabetes treatment plan is. A common way to do this
through called A1C testing. It is not only the international standard for a diabetes
diagnosis, but it measures your average blood sugar level over a period of two to three
months. The test determines if changes need to be made to diet, insulin regimen, or
other factors. While a patient’s target A1C goal varies depending on age and other
factors, the American Diabetes Association recommends an A1C reading of below
seven percent for most people.

Diet
Diet plays a crucial part in managing diabetes. However, no single diet is perfect for
everyone. Diabetics, possibly in conjunction with advice from a dietician, should stick to
highly nutritious foods that are low in fat and calories, such as fruits, vegetables, and
whole grains. Limiting animal products and sugars also helps in maintaining healthy
blood sugar levels. Balancing proportionate amounts of carbohydrates, proteins, sugars,
and fats are key to managing diabetes. Regular blood sugar monitoring after meals can
help you and your doctor or dietician discover the foods are best for you and those you
should avoid.

Exercise
Exercise helps diabetics by lowering their blood sugar. Physical activity not only helps
maintain a healthy weight, but it also transports sugar to cells where it is turned into
energy. Along with this, aerobic exercise increases a person’s sensitivity to insulin. With
exercise, a person’s body needs less insulin to transport sugar. While every person’s
diabetes treatment varies, getting about 30 minutes of aerobic exercise each day can
help manage your diabetes. As with any part of your diabetes treatment, work with your
doctor on an exercise program that fits your age and fitness level.

Pancreas Transplant
Pancreas transplants are usually reserved for people whose diabetes has become so
severe that it is unmanageable through traditional treatments. As with any organ
transplants, pancreas transplants require immune system-suppressing drugs to prevent
the body from rejecting the new organ. Those drugs increase the likelihood of serious
side effects, including infection, organ injury, and even cancer. However, if a pancreas
transplant is successful, the patient no longer will need insulin treatment because the
new pancreas will naturally produce insulin and regulate glucose.

Diabetes Alternative Treatments    

Some people find using alternative treatments in conjunction with their traditional
treatments helpful in managing their diabetes. As is the case with many alternative
treatments for any disease or condition, opinions are often mixed as to the efficacy of
some treatment methods, and research is often minimal in comparison to traditional
medicine treatments.
However, many people have had success in using alternative treatments in the
management of many diseases and conditions, including diabetes. Before trying any
alternative treatments, you should always check with your doctor to be sure that the
methods are safe and right for you.

Herbs and Supplements

Some over-the-counter dietary supplements and herbs are believed by some to help
control the symptoms of diabetes. However, there is no definitive clinical evidence to
suggest that herbs and nutritional supplements are effective in managing diabetes.

Alpha-lipoic Acid
Alpha-lopic acid is an antioxidant found in liver, spinach, broccoli, potatoes and other
foods. It is believed to lower blood glucose levels by improving the body’s ability to use
insulin and possibly help against diabetic neuropathy (a nerve disorder). While some
studies have found benefits, more research is needed into those claims. Diabetics
should monitor their blood sugar closely with alpha-lipoic acid because it could lower
blood sugar too far.

Chromium
Chromium is an essential trace mineral that may help control blood glucose levels. It
occurs naturally in broccoli, grape juice, potatoes, garlic, and other fruits and
vegetables. Research has been mixed with regard to chromium’s effect on glucose
control in diabetics. Short-term, low-dose use of chromium appears to be safe for most
adults. However, diabetics could see blood sugar levels drop too far. High doses can
cause kidney problems and other serious side effects.

Omega-3 Fatty Acids

 These good fats—found naturally in walnuts, salmon, soybeans, and other foods—have
been proven effective for lowering triglycerides and reducing heart disease risk in
people with type 2 diabetes without affecting blood glucose control. In some studies,
omega-3 fatty acids also raised LDL or “bad” cholesterol.

Polyphenols
Polyphenols are antioxidants found in tea, dark chocolate, and other foods. They are
being studied for potential benefits on the body’s ability to use insulin and protect blood
vessels. Some studies suggest that polyphenols found in green tea may protect against
cardiovascular disease and have a beneficial effect on insulin activity and glucose
control. However, many sources of polyphenols also contain caffeine, which in some
people can cause insomnia, anxiety, irritability, and other adverse effects.

Other Supplements
For controlling blood glucose levels, other herbs and supplements have been tested
with some success. However, much of the research is limited or has turned out mixed
results.

 Garlic – Results are inconsistent.

 Magnesium – Studies are inconsistent in confirming supplements are effective
for treating diabetes, but a diet high in magnesium can help lower the risk of diabetes
 Ginseng – A small University of Toronto study found ginseng helpful in blood-
sugar response following a meal in type 2 diabetics.
 Gurmar (Gymnema sylvestre) – One study in India found gurmar leaf powder to
have “positive and encouraging effects” on blood sugar levels in diabetics, but more
studies are needed.
 Vanadium – A few studies show vanadium’s ability to increase a person’s
sensitivity to insulin; however not enough evidence exists to recommend the treatment
to diabetics.
 Prickly pear cactus (Oputina) – While definitive conclusions cannot be made
regarding the effectiveness of the herbal remedy, one study’s findings suggest benefits
regarding control of diabetes.
 Coccinia indica – This Bengal herb was tested in limited amounts but showed
promising results in glucose tolerance in adult-onset diabetes.
 Aloe vera – Study results are mixed on aloe vera’s effectiveness with type 2
diabetics and more research is needed.

Mind/Body Approaches
Having a chronic, lifelong condition like diabetes is more than a physical challenge; it
can be mentally stressful as well. Because an increased production of stress hormones
reduces insulin action, feelings of stress can raise blood glucose levels in people with
diabetes. Also, patients under perceived stress may find that caring for their diabetes is
less of a priority, leading to poor glycemic control.

Decreasing stress reactions by meditation, deep breathing exercises, or other

relaxation techniques may lead to better glucose control and improvement in immune
system function.

Relaxation Therapy

Relaxation techniques such as meditation and deep breathing exercises can reduce
stress; alter hormone levels; enhance mood; and reduce blood pressure, heart rate, and
adrenaline levels. Studies have been done to show that various relaxation techniques
ranging from yoga practice to biofeedback therapy can help keep excess stress
hormones in check, thereby stabilizing stabilize glucose levels and protecting the heart.
Both are very important issues for people with diabetes.

Acupuncture

This technique, used in traditional Chinese medicine, involves placing very thin needles
in strategic points on the body. Acupuncture may help alleviate diabetes symptoms.
Acupressure, based on the same schema as acupuncture but with pressure instead of
needles, can be used to similar effect. 
 Diabetes Drugs

In type 1 diabetes, the pancreas produces too little or no insulin at all. Therefore, type 1
diabetics will always need to take insulin to manage their condition. Type 2 diabetics
may or may not need to undergo insulin therapy; for some people with type 2 diabetes,
healthy lifestyle choices like increased exercise and a healthier diet are enough to
control their condition. However, some people with type 2 diabetes may be prescribed
an oral medication to control their blood sugar. Oral medications are used for mild cases
of diabetes, and insulin is used for more severe, or poorly controlled, type 2 diabetes.

Insulin
If your body no longer makes enough insulin, you will need to get it from an outside
source. The primary means of insulin administration is injection, using a needle and
syringe or an insulin pen. Another option is to use an insulin pump, which is a small
machine that can be worn on a belt or in a pocket that connects to a small plastic tube
and a small needle. The pump delivers insulin in small amounts regularly via the needle,
which is inserted under the skin and stays there for a few days at a time. A third option
(though uncommon) is an insulin jet injector, which looks like a large pen and uses
high-pressure air to release a fine spray of insulin into the skin. There are also currently
a number of companies developing oral insulin in the form of a pill, but none have
been approved for use.

Insulin used to treat diabetes can generally be broken down into four groups,
categorized by how long they take to begin working after administration, when they
peak in effectiveness, and how long they last.

Onset Peak time Duration

Insulin type (and examples)
(approx.) (approx.) (approx.)

Rapid acting 5 to 15 45 to 90 3 to 4 hours

minutes minutes
 Insulin aspart (NovoLog)
 Insulin glulisine (Apidra)
 Insulin lispro (Humalog)

Short acting 30 minutes 2 to 5 hours 5 to 8 hours

 Insulin regular (Humulin

 R, Novolin R)

Intermediate acting 1 to 3 hours 6 to 12 hours 16 to 24 hours

 Insulin NPH (Humulin N,

Novolin N)

Long acting 1 to 4 hours none 20 to 24 hours

 Insulin glargine (Lantus)

 Insulin detemir (Levemir)
 

Many diabetes patients are prescribed a mixture of insulin. Common mixtures include:

Onset Peak time Duration

Mixture type (and brand name)
(approx.) (approx.) (approx.)

70% NPH/30% regular (Humulin

30 minutes 2 to 4 hours 12 to 24 hours
70/30)

70% NPH/30% regular (Novolin

30 minutes 2 to 12 hours 20 to 24 hours
70/30)

50% lispro protamine/50%

insulin lispro (Humalog Mix 30 minutes 2 to 12 hours 20 to 24 hours
50/50)

75% lispro protamine

30 minutes to
(NPL)/25% lispro (Humalog Mix 15 minutes 16 to 22 hours
3 hours
75/25)

70% aspart protamine/30% 10 to 20 1 to 4 hours 20 to 24 hours

 aspart
minutes
(NovoLog Mix 70/30)

Type 2 Medications

Each type of medication for type 2 diabetes will help lower blood sugar levels in a
different way. Your physician will prescribe the treatment plan that will work best for you
and will give you directions as to the times, dosage, and frequency of each type of
medication. Diabetes drugs are categorized by the action they produce:

Medications that Increase Insulin Production

 DPP-IV inhibitors
 Saxagliptin (Onglyza)
 Sitagliptin (Januiva)
 Meglitinides
 Repaglinide (Prandin)
 Nateglinide (Starlix)
 Sulfonylureas
 Glipizide (Glucotrol)
 Glimepiride (Amaryl)
 Glyburide (DiaBeta, Glynase)

Medications that Alter Insulin Action

 These drugs act primarily by decreasing the amount of glucose produced by the liver.
They also help lower blood glucose levels by making muscle tissue more sensitive to
insulin, so that glucose is better absorbed. 

 Metformin (Glucophage, Glucophage XR, Riomet)

 Thiazolidinediones
 Rosiglitazone (Avandia)
 Pioglitazone (Actos)