Materiały źródłowe

• #1 Diabetes: What It Is, Causes, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/7104-diabetes

  Diabetes is a common condition that affects people of all ages. A combination of treatment strategies can help you manage the condition to live a healthy life and prevent complications. […] Most forms of diabetes are chronic (lifelong), and all forms are manageable with medications and/or lifestyle changes. […] Diabetes is a complex condition, so its management involves several strategies. In addition, diabetes affects everyone differently, so management plans are highly individualized. […] The four main aspects of managing diabetes include: Blood sugar monitoring, Oral diabetes medications, Insulin, Diet, Exercise. […] People with Type 1 diabetes need to inject synthetic insulin to live and manage diabetes. Some people with Type 2 diabetes also require insulin. […] Meal planning and choosing a healthy diet for you are key aspects of diabetes management, as food greatly impacts blood sugar.

• #1 Diabetes – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451

  The best current treatment for type one diabetes is an automated insulin delivery system. This system includes a continuous glucose monitor, insulin pump, and a computer algorithm that continually adjusts insulin responding to the continuous glucose monitoring signal. […] Current guidelines recommend use of a continuous glucose monitor. The percentage of time that is spent daily with glucose between 70 and 180 milligram per deciliter is the main measurement of appropriate treatment. This percentage should be 70% or higher daily. […] In certain people with type one diabetes transplantation can be undertaken. This could be pancreas transplantation or transplantation of insulin making cells called islet. […] The treatment being tested is medication that suppresses the immune system. […] Treatment for type 1 diabetes involves insulin injections or the use of an insulin pump, frequent blood sugar checks, and carbohydrate counting. For some people with type 1 diabetes, pancreas transplant or islet cell transplant may be an option.

• #1 Type 1 Diabetes Mellitus Treatment & Management: Approach Considerations, Self-Monitoring of Glucose Levels, Continuous Glucose Monitoring

  https://emedicine.medscape.com/article/117739-treatment

  Use of CGMs may help to prevent significant glucose variability in patients receiving either multiple daily injection therapy or continuous insulin infusion therapy. […] The goal of treatment in type 1 DM is to provide insulin in as physiologic a manner as possible. Insulin replacement is accomplished by giving a basal insulin and a preprandial (premeal) insulin. […] The initial daily insulin dose is calculated on the basis of the patients weight. […] Multiple subcutaneous insulin injections are administered to control hyperglycemia after meals and to maintain normal plasma glucose levels throughout the day. […] Hypoglycemia may result from a change in insulin dose, a small or missed meal, or strenuous exercise. […] Management of hyperglycemia involves a plan for lowering and monitoring the patients glucose levels.

• #1 Medications for Diabetes Mellitus Treatment – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/medications-for-diabetes-mellitus-treatment

  Insulin is typically administered as either multiple daily subcutaneous injections administered by the patient, with 2 preparations of insulin used depending on the anticipated glycemic control needs or an insulin pump that delivers a rapid- or short-acting insulin and administers a basal rate of insulin and additional boluses with meals or for correcting a high blood glucose level. […] Insulin pumps can eliminate the need for multiple daily injections, provide maximal flexibility in the timing of meals, and substantially reduce variability in glucose levels. […] Teplizumab, an anti-CD3 monoclonal antibody, is a disease-modifying medication for type 1 diabetes. It delays clinical type 1 diabetes in at-risk individuals. […] Pharmacologic measures to prevent or treat complications of diabetes mellitus are critical, including angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), aspirin, and statins.

• #1 Type 1 Diabetes Treatment and Therapy – Breakthrough T1D

  https://www.breakthrought1d.org/t1d-basics/treatments/

  Treatment for type 1 diabetes […] Therapies for treating type 1 diabetes […] Insulin is the primary type 1 diabetes treatment. People with type 1 diabetes (T1D) must take insulin to survive because their body does not make enough of it. Insulin is administered by injection, inhalation, or insulin pump. […] There are several different types of insulin used today, with most individuals with T1D using basal (long-acting) and bolus (short-acting) insulins. […] Managing type 1 diabetes involves three main steps: checking blood sugar, administering insulin, and counting carbohydrates. […] There are four primary methods for administering insulin: injections with syringe or pen, inhaler, insulin pump, or artificial pancreas system/automated insulin delivery system. […] People with T1D must balance the amount of carbs they consume with the right dose of insulin. […] Adjunctive therapies complement insulin to achieve better glucose control. […] Pramlintide is a synthetic amylin analog administered via syringe. It is approved for people with T1D who use mealtime insulin and do not achieve their glycemic targets despite optimal insulin therapy. Pramlintide limits glucose fluctuations after meals. Pramlintide therapy can also lead to weight loss and improvements in risk factors for cardiovascular disease. […] Therapies such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), statins, and other lipid-lowering drugs may be prescribed to manage cardiovascular disease and reduce the risk of cardiovascular complications. […] The U.S. Food and Drug Administration (FDA) approved Tzield™ (teplizumab-mzwv) in November 2022, making it the first approved disease-modifying therapy for delaying T1D onset in people at risk of developing the disease. Studies have shown Tzield can delay the onset of T1D for approximately 2 years. […] Though not approved for T1D, these drugs have tremendous promise as a type 1 diabetes treatment in terms of glucose and metabolic control, weight loss, and more. […] For a treatment, drug, or device to make it into the hands of people with type 1 diabetes, it must first complete a vital step—a clinical trial.

• #1 Diabetes – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451

  Many types of insulin are available, including short-acting (regular insulin), rapid-acting insulin, long-acting insulin and intermediate options. Depending on your needs, your provider may prescribe a mixture of insulin types to use during the day and night. […] Sometimes your provider may prescribe other oral or injected drugs as well. Some diabetes drugs help your pancreas to release more insulin. Others prevent the production and release of glucose from your liver, which means you need less insulin to move sugar into your cells. […] If you decide to try any type of alternative therapy, don’t stop taking the drugs that your provider has prescribed. Be sure to discuss the use of any of these therapies with your provider.

• #1 Medication Treatment of Diabetes Mellitus – Hormonal and Metabolic Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/hormonal-and-metabolic-disorders/diabetes-mellitus-dm-and-disorders-of-blood-sugar-metabolism/medication-treatment-of-diabetes-mellitus

  People with type 1 diabetes almost always require insulin therapy and will become very sick without it. Many people with type 2 diabetes require insulin as well. […] Insulin is injected under the skin into the fat layer, usually in the arm, thigh, or abdomen. […] Insulin preparations are stable at room temperature for up to 1 month, allowing them to be carried, brought to work, or taken on a trip. […] The choice of insulin is complex. Doctors consider the following factors when deciding which insulin is best and how much insulin to use: How well the body responds to the insulin it makes, how much the blood glucose level rises after meals, whether other antihyperglycemic medications can be used instead of insulin, how willing and able people are to monitor their blood glucose levels and adjust their insulin dosage, how often people are willing to inject insulin, how varied daily activity is, how likely a person is to have symptoms of hypoglycemia (low blood glucose levels).

• #1 FDA Approves First Cellular Therapy to Treat Patients with Type 1 Diabetes | FDA

  https://www.fda.gov/news-events/press-announcements/fda-approves-first-cellular-therapy-treat-patients-type-1-diabetes

  Today, the U.S. Food and Drug Administration approved Lantidra, the first allogeneic (donor) pancreatic islet cellular therapy made from deceased donor pancreatic cells for the treatment of type 1 diabetes. Lantidra is approved for the treatment of adults with type 1 diabetes who are unable to approach target glycated hemoglobin (average blood glucose levels) because of current repeated episodes of severe hypoglycemia (low blood sugar) despite intensive diabetes management and education. […] Todays approval, the first-ever cell therapy to treat patients with type 1 diabetes, provides individuals living with type 1 diabetes and recurrent severe hypoglycemia an additional treatment option to help achieve target blood glucose levels. […] Lantidra provides a potential treatment option for these patients.

• #1 Type 1 Diabetes Mellitus Treatment & Management: Approach Considerations, Self-Monitoring of Glucose Levels, Continuous Glucose Monitoring

  https://emedicine.medscape.com/article/117739-treatment

  Pancreatic transplantation for patients with type 1 DM is a possibility in some referral centers. It is performed most commonly with simultaneous kidney transplantation for end-stage renal disease (ESRD). […] Allogeneic pancreatic islet cellular therapy produced from deceased donor pancreatic cells received FDA approval in June 2023. The first treatment of its kind, donislecel (Lantidra), is indicated for adults with type 1 diabetes who, owing to current, repeated episodes of severe hypoglycemia, have been unable to approach the target HbA1c, even with intensive diabetes management and education. […] The care of patients with type 1 diabetes mellitus is summarized below. […] The association between chronic hyperglycemia and increased risk of microvascular complications in patients with type 1 DM was demonstrated in the Diabetes Control and Complications Trial (DCCT).

• #1 Diabetes – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451

  Treatment of type 2 diabetes mostly involves lifestyle changes, monitoring of your blood sugar, along with oral diabetes drugs, insulin or both. […] Insulin can’t be taken orally to lower blood sugar because stomach enzymes interfere with insulin’s action. Insulin is often injected using a fine needle and syringe or an insulin pen a device that looks like a large ink pen. […] In some people who have type 1 diabetes, a pancreas transplant may be an option. Islet transplants are being studied as well. With a successful pancreas transplant, you would no longer need insulin therapy. […] Treatment for prediabetes usually involves healthy lifestyle choices. These habits can help bring your blood sugar level back to normal. Or it could keep it from rising toward the levels seen in type 2 diabetes.

• #1 Diabetes: What It Is, Causes, Symptoms, Treatment & Types

  https://my.clevelandclinic.org/health/diseases/7104-diabetes

  Regular exercise is an important part of management for all people with diabetes. […] You cant prevent autoimmune and genetic forms of diabetes. But there are some steps you can take to lower your risk for developing prediabetes, Type 2 diabetes and gestational diabetes. […] The prognosis (outlook) for diabetes varies greatly depending on several factors, including: The type of diabetes, How well you manage the condition over time and your access to diabetes care, Your age at diagnosis/how long you’ve had diabetes, If you have other health conditions, If you develop diabetes complications. […] However, it’s important to know that you can live a healthy life with diabetes. The following are key to a better prognosis: Lifestyle changes, Regular exercise, Dietary changes, Regular blood sugar monitoring.

• #1 Initial management of hyperglycemia in adults with type 2 diabetes mellitus – UpToDate

  https://www.uptodate.com/contents/initial-management-of-hyperglycemia-in-adults-with-type-2-diabetes-mellitus

  For patients with overweight, obesity, or a metabolically adverse pattern of adipose tissue distribution, body weight management should be considered as a therapeutic target in addition to glycemia. […] Glycemic management—Target glycated hemoglobin (A1C) levels in patients with type 2 diabetes should be tailored to the individual, balancing the anticipated reduction in microvascular complications over time with the immediate risks of hypoglycemia and other adverse effects of therapy. […] A reasonable goal of therapy is an A1C value of ≤7 percent (53.0 mmol/mol) for most patients. […] Improved glycemic management lowers the risk of microvascular complications in patients with type 2 diabetes. […] Cardiovascular risk factor management—In addition to glycemic management, vigorous cardiac risk reduction (smoking cessation; blood pressure control; reduction in serum lipids with a statin; diet, exercise, and weight loss or maintenance; and aspirin for those with established atherosclerotic cardiovascular disease [ASCVD] or after shared decision-making) should be a top priority for all patients with type 2 diabetes.

• #1 Treatments for Diabetes (Nonpharmacologic) – Endocrinology Advisor

  https://www.endocrinologyadvisor.com/ddi/treatments-for-diabetes-nonpharmacologic/

  Smoking or exposure to secondhand smoke puts individuals with diabetes at greater risk of microvascular complications, cardiovascular disease, poor glycemic control, and premature death. […] Nonpharmacologic treatments for diabetes improve overall health and reduce complications associated with diabetes.

• #1 Patient education: Type 2 diabetes: Treatment (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/type-2-diabetes-treatment-beyond-the-basics/print

  Patient education: Type 2 diabetes: Treatment (Beyond the Basics) […] People with type 2 diabetes require regular monitoring and ongoing treatment to maintain blood sugar levels at goal. Treatment includes lifestyle changes (including dietary changes and exercise to promote weight loss), self-care measures, and often medications, which can minimize the risk of diabetes-related and cardiovascular (heart-related) complications. […] The main goals of treatment in type 2 diabetes are to keep your blood sugar levels within your goal range and treat other medical conditions that go along with diabetes (like high blood pressure and high cholesterol); it is also very important to stop smoking if you smoke. These measures will reduce your risk of complications. […] Blood sugar management — It is important to keep your blood sugar levels at goal. This can help prevent long-term complications that can result from poorly managed blood sugar (including problems affecting the eyes, kidneys, nervous system, and cardiovascular system).

• #1 Patient education: Type 2 diabetes: Treatment (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/type-2-diabetes-treatment-beyond-the-basics/print

  A number of medications are available to treat type 2 diabetes. […] Metformin — Most people who are newly diagnosed with type 2 diabetes will immediately begin a medicine called metformin. Metformin improves your body’s response to insulin and, as a result, lowers blood sugar levels. […] Your doctor or nurse might recommend a second medication in addition to metformin. This may happen within the first two to three months if your blood sugar and A1C levels are still higher than your goal; otherwise, many people need to add a second glucose-lowering medication later (after several years of having diabetes). […] Insulin — In the past, insulin treatment was reserved for patients with type 2 diabetes whose blood sugar was not adequately managed with oral medicines and lifestyle changes (ie, diet and exercise). However, increasing evidence suggests that insulin treatment at earlier stages may improve overall diabetes management over time. […] More detailed information about insulin treatment is available separately.

• #1 Initial management of hyperglycemia in adults with type 2 diabetes mellitus – UpToDate

  https://www.uptodate.com/contents/initial-management-of-hyperglycemia-in-adults-with-type-2-diabetes-mellitus

  Pharmacologic therapy should be initiated along with consultation for lifestyle modification focusing on dietary and other lifestyle contributors to hyperglycemia. […] For most patients presenting with A1C at or above target level (ie, >7.5 to 8 percent), pharmacologic therapy should be initiated at the time of type 2 diabetes diagnosis (with lifestyle modification). […] In the absence of specific contraindications, we suggest metformin as initial therapy for patients with newly diagnosed type 2 diabetes who are asymptomatic. […] Metformin is the preferred initial therapy because of glycemic efficacy, promotion of modest weight loss, very low incidence of hypoglycemia, general tolerability, and very low cost. […] For patients who have gastrointestinal intolerance of metformin, slower titration, ensuring that the patient is taking the medication with food, or switching to an extended-release formulation may improve tolerability.

• #1 Diabetes Treatments | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/diabetes-treatments

  Insulin helps you manage your blood glucose levels by „unlocking” cells so that they can access your blood glucose for the energy they need. […] Over time, many people need additional help in controlling blood glucose levels. This is when doctors typically prescribe insulin. […] The type of insulin you take is based on three factors: how long it takes to start working (onset), when it is at its strongest action (peak), and how long it lasts (duration). […] People with type 2 diabetes usually need treatment with oral medicines for several or even many years but may eventually need insulin to maintain glucose control. […] Metformin is a medication commonly used as the first medication for people with diabetes. […] DPP-4 inhibitor medicines (generic names: sitagliptin saxagliptin, and linagliptin) are a type of incretin-based medicine for type 2 diabetes.

• #1 Drug Therapies for Diabetes – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38138975/

  The treatment of type 2 diabetes (T2D) necessitates a multifaceted approach that combines behavioral and pharmacological interventions to mitigate complications and sustain a high quality of life. […] Treatment encompasses the management of glucose levels, weight, cardiovascular risk factors, comorbidities, and associated complications through medication and lifestyle adjustments. […] Metformin, a standard in diabetes management, continues to serve as the primary, first-line oral treatment across all age groups due to its efficacy, versatility in combination therapy, and cost-effectiveness. […] Glucagon-like peptide-1 receptor agonists (GLP-1 RA) offer notable benefits for HbA1c and weight reduction, with significant cardiovascular benefits. […] Sodium-glucose cotransporter inhibitors (SGLT-2i) lower glucose levels independently of insulin while conferring notable benefits for cardiovascular, renal, and heart-failure outcomes.

• #1 What Are My Options for Type 2 Diabetes Medications? | ADA

  https://diabetes.org/health-wellness/medication/oral-other-injectable-diabetes-medications

  There are different types, or classes, of medications that work in different ways to lower blood glucose levels. Some options are taken by mouth and others are injected. […] Metformin lowers blood glucose levels primarily by decreasing the amount of glucose produced by the liver. […] DPP-4 inhibitors help improve A1C (a measure of average blood glucose levels over two to three months) without causing hypoglycemia (low blood glucose). […] Use of GLP-1 and dual GLP-1/GIP receptor agonists is another strategy to help use these hormones to improve blood glucose management in people with type 2 diabetes. […] SGLT2 inhibitors are also known to help improve outcomes in people with heart disease, kidney disease, and heart failure. […] Sulfonylureas have been in use since the 1950s and they stimulate beta cells in the pancreas to release more insulin.

• #1 Diabetes Treatments | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/diabetes-treatments

  GLP-1 receptor agonist medicines, also called incretin mimetics, are a type of incretin-based medicine for type 2 diabetes. […] Sodium-Glucose cotransporter-2 inhibitors is a class of diabetes medications that comes as a pill. […] Insulin secretagogues are one type of medicine for type 2 diabetes. […] TZDs help keep your blood glucose levels on target by decreasing insulin resistance and making body tissues more sensitive to insulin’s effects.

• #1 Type 2 diabetes – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/drc-20351199

  Living with type 2 diabetes involves learning about the condition and lifestyle changes. Diabetes education is an important part of managing the condition. Management includes: […] Diabetes medicine or insulin therapy if needed. […] If you can’t stay at your target blood sugar level with diet and exercise, your healthcare team may prescribe diabetes medicines that help lower glucose levels. Or you may start insulin therapy. Medicines for type 2 diabetes include the following. […] Metformin (Fortamet, Glumetza, others) is most often the first medicine prescribed for type 2 diabetes. It works mainly in two ways. It lowers the amount of glucose the liver makes. And it helps the body use insulin better. […] Some people who have type 2 diabetes need insulin therapy. In the past, people tried insulin therapy only after other treatments had failed. But today, it may be prescribed sooner if lifestyle changes and other medicines don’t manage blood sugar levels.

• #1 Diabetes Treatment Updates

  https://www.uspharmacist.com/article/diabetes-treatment-updates-

  Pharmacologic approaches that provide adequate efficacy to achieve and maintain treatment goals should be considered, such as metformin or other agents, including combination therapy. […] Metformin should be continued upon initiating insulin therapy (unless contraindicated or not tolerated) for ongoing glycemic and metabolic benefits. […] The early introduction of insulin should be considered if there is evidence of ongoing catabolism (weight loss), if symptoms of hyperglycemia are present, or when A1C levels (10% [86 mmol/mol]) or blood glucose levels (300 mg/dL [16.7 mmol/L]) are very high. […] Among individuals with T2DM who have established atherosclerotic cardiovascular disease or indicators of high cardiovascular risk, established kidney disease, or heart failure, a sodium-glucose cotransporter-2 inhibitor and/or glucagon-like peptide 1 receptor agonist with demonstrated cardiovascular disease benefit is recommended as part of the glucose-lowering regimen and comprehensive cardiovascular risk reduction, independent of A1C and in consideration of person-specific factors.

• #1 Drug Therapies for Diabetes – PubMed

  https://pubmed.ncbi.nlm.nih.gov/38138975/

  Combined therapies emphasizing early and sustained glycemic control are promising options for diabetes management. […] As insulin therapy remains pivotal, metformin and non-insulin agents such as GLP-1 RA and SGLT-2i offer compelling options. […] Notably, exciting novel treatments like the dual GLP-1/ glucose-dependent insulinotropic polypeptide (GIP) agonist show promise for substantially reducing glycated hemoglobin and body weight. […] This comprehensive review highlights the evolving landscape of pharmacotherapy in diabetes, the drugs currently available for treating diabetes, their effectiveness and efficacy, the impact on target organs, and side effects. […] This work also provides insights that can support the customization of treatment strategies.

• #1 Type 2 diabetes – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/type-2-diabetes/diagnosis-treatment/drc-20351199

  Weight-loss surgery may be a choice for adults living with type 2 diabetes who have a body mass index (BMI) of 35 or higher. […] People who have type 2 diabetes often need to change their treatment plan during pregnancy and follow a diet that controls carbohydrates. Many people need insulin therapy during pregnancy. […] Talk with your healthcare team before using a dietary supplement or natural treatment. Don’t use alternative medicines in place of your prescribed diabetes medicines.

• #1 Type 2 Diabetes Mellitus Treatment & Management: Approach Considerations, Pharmacologic Therapy, Management of Glycemia

  https://emedicine.medscape.com/article/117853-treatment

  In morbidly obese patients, bariatric surgery has been shown to improve diabetes control and, in some situations, normalize glucose tolerance. […] According to guidelines released in 2016 by the 2nd Diabetes Surgery Summit (DSS-II), an international consensus conference, bariatric surgery should be considered even for type 2 diabetes patients with mild, class 1 obesity (BMI 30.0-34.9 kg/m2) if their hyperglycemia is inadequately controlled with optimal treatment.

• #1 Surgery for Diabetes – American Society for Metabolic and Bariatric Surgery

  https://asmbs.org/patients/surgery-for-diabetes/

  Obesity and type 2 diabetes (adult-onset diabetes) are closely related conditions, both linked to problems with the body’s metabolism. The same changes that lead to weight loss after surgery can also lead to the remission of type 2 diabetes. Most importantly, patients with this disease should know that the body’s ability to use sugar in a healthy way can be regained with surgery. […] Diabetes surgery is the most effective treatment for type 2 diabetes and may result in remission (being able to stop taking all medications) or improvement in nearly all cases. […] For patients with type 2 diabetes and even milder degrees of obesity, bariatric surgery should be recommended. It is the single most effective way to resolve the condition and stop the need for medication. […] If you are living with diabetes, you should know that one of the most important discoveries in the management of diabetes is that surgery can help control or improve type 2 diabetes in the large majority of patients.

• #1 Surgery for Diabetes – American Society for Metabolic and Bariatric Surgery

  https://asmbs.org/patients/surgery-for-diabetes/

  Nearly all individuals who have surgery to treat diabetes (also called metabolic/bariatric surgery) show improvement in their diabetes, sometimes as quickly as a few days after surgery. […] Overall, 78 percent of patients experience remission thus eliminating the need for diabetes medications. […] Diabetes surgery has been proven to be the most effective therapy for diabetes but also greatly improves obesity and other associated conditions. […] A great deal of scientific evidence supports the use of diabetes surgery in patients with BMI of 30 and greater. […] The decision to pursue surgery is made on an individual basis and you can work with your doctors to determine if surgery is a good choice to treat your diabetes. […] Improvement of diabetes after gastric bypass surgery occurs within days to weeks after surgery, even before much weight is lost.

• #1 Surgery for Diabetes – American Society for Metabolic and Bariatric Surgery

  https://asmbs.org/patients/surgery-for-diabetes/

  Most importantly, this surgery results in changes to the metabolism and hormones produced in the intestines that affect the body’s ability to achieve and maintain a healthy weight. […] Over 60 percent of patients will have remission of their type 2 diabetes after sleeve gastrectomy. […] Studies find, however, that the operation is most effective in inducing early and sustained remission or improvement of T2DM (more than 85 percent remission rates with weight-loss independent effects). […] Results for this operation are extremely promising, demonstrating excellent weight loss and type 2 diabetes remission. […] While diabetes surgery has some risk, these operations have been fine-tuned over the past 70 years and are now among the safest commonly performed operations. The long-term risk of continued diabetes (as well as the risks of obesity) is far greater than the risk of a surgical procedure for most patients.

• #1 Medical Treatment of Diabetes Mellitus

  https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/diabetes-mellitus-treatment/

  In patients diagnosed with diabetes mellitus (DM), the therapeutic focus is on preventing complications caused by hyperglycemia. […] Strict control of glycemia within the established recommended values is the primary method for reducing the development and progression of many complications associated with microvascular effects of diabetes (eg, retinopathy, nephropathy, and neuropathy). […] The positive outcomes from adequate glycemic control on microvascular and macrovascular complications have been established in large well-controlled trials. […] Two primary techniques are used to assess a patients glycemic control: Self-monitoring of blood glucose (SMBG) and serum measurement of hemoglobin A1c (HbA1c). […] For patients with type 1 DM or insulin-dependent type 2 DM, clinical trials have shown that SMBG plays a role in effective glycemic control because it helps patients refine and adjust insulin doses by monitoring for asymptomatic hypoglycemia as well as preprandial and postprandial hyperglycemia.

• #1 Diabetes: Symptoms, treatment, prevention, and early diagnosis

  https://www.medicalnewstoday.com/articles/323627

  A person living with type 2 diabetes may or may not need insulin. In many cases, medication, along with exercise and diet strategies, can help manage the condition. […] During pregnancy, people can take steps to manage gestational diabetes. These include: staying active, monitoring the growth and development of the fetus, adjusting their diet, and monitoring blood sugar levels. […] A doctor may prescribe metformin in pill form to a person with type 2 diabetes. It helps lower blood sugar and makes insulin more effective. […] In addition to insulin, other types of medication are available that can help people manage their condition. […] Self-monitoring blood sugar levels is vital for effectively managing diabetes. It helps regulate meal schedules, physical activity, and when to take medication, including insulin.

• #1 Medical Treatment of Diabetes Mellitus

  https://www.clevelandclinicmeded.com/medicalpubs/diseasemanagement/endocrinology/diabetes-mellitus-treatment/

  The current American Diabetes Association (ADA) guidelines recommend that patients with diabetes self-monitor their glucose at least three times per day. […] It is commonly recommended that patients with type 2 DM self-monitor their blood glucose levels, but the evidence to support the effectiveness of this practice is inconclusive. […] The ADA recommends that therapy be adjusted to maintain HbA1c values near or below 7% in nonpregnant adults. […] The AACE recommends an HbA1c of less than 6.5% in nonpregnant adults. […] Insulin sensitizers reduce glycemic load primarily by improving insulin actions in peripheral tissues. […] Metformin primarily lowers fasting glycemia; however, some decreases in postprandial glucose concentrations, especially after the midday meal, are seen. […] A major benefit of metformin is that it usually does not cause hypoglycemia when used as monotherapy.

• #1 Type 1 Diabetes Mellitus Treatment & Management: Approach Considerations, Self-Monitoring of Glucose Levels, Continuous Glucose Monitoring

  https://emedicine.medscape.com/article/117739-treatment

  Benefits of tight glycemic control include not only continued reductions in the rates of microvascular complications but also significant differences in cardiovascular events and overall mortality. […] For many patients, the HbA1c target should be less than 7%, with a premeal blood glucose level of 80-130 mg/dL. However, targets should be individualized. […] Although tight glycemic control is beneficial, an increased risk of severe hypoglycemia accompanies lower blood glucose levels. […] Optimal diabetic control requires frequent self-monitoring of blood glucose levels, which allows rational adjustments in insulin doses. […] Continuous glucose monitors (CGMs) contain transcutaneous or subcutaneous sensors that measure interstitial glucose levels every 1-5 minutes, providing alarms when glucose levels are too high or too low or are rapidly rising or falling.

• #1 Patient education: Type 2 diabetes: Treatment (Beyond the Basics) – UpToDate

  https://www.uptodate.com/contents/type-2-diabetes-treatment-beyond-the-basics/print

  A1C testing — Blood sugar management can also be estimated with a blood test called glycated hemoglobin, or „A1C.” The A1C blood test measures your average blood sugar level over the past two to three months. The goal A1C for most young people with type 2 diabetes is less than 7 percent (53 mmol/mol), which corresponds to an average blood sugar of approximately 150 mg/dL (8.3 mmol/L) (table 1). Lowering your A1C level reduces your risk for kidney, eye, and nerve problems. […] A detailed discussion of ways to prevent complications is available separately. […] Diet and exercise are the foundation of diabetes management. […] Regular exercise can also help manage type 2 diabetes, even if you do not lose weight. Exercise lowers blood sugar because it improves your body’s response to insulin.

• #1 Initial management of hyperglycemia in adults with type 2 diabetes mellitus – UpToDate

  https://www.uptodate.com/contents/initial-management-of-hyperglycemia-in-adults-with-type-2-diabetes-mellitus

  Patients with cardiovascular and/or kidney comorbidities should be treated with glucose-lowering medications that have evidence of cardiac or kidney benefit. […] The GLP-1 receptor agonists liraglutide, semaglutide, and dulaglutide demonstrated favorable atherosclerotic cardiovascular and kidney outcomes. […] The SGLT2 inhibitors empagliflozin, canagliflozin, and dapagliflozin have also demonstrated benefit, especially for HF hospitalization, risk of kidney disease progression, and mortality. […] For patients presenting with symptomatic (eg, weight loss) or severe hyperglycemia with ketonuria, insulin is indicated for initial treatment. […] Insulin therapy in type 2 diabetes is initially aimed at suppressing hepatic gluconeogenesis by increasing basal insulin to target morning fasting glucose levels.

• #1 Type 2 Diabetes Mellitus Treatment & Management: Approach Considerations, Pharmacologic Therapy, Management of Glycemia

  https://emedicine.medscape.com/article/117853-treatment

  GLP-1 agonists (ie, exenatide, liraglutide, albiglutide [discontinued], dulaglutide) mimic the endogenous incretin GLP-1; they stimulate glucose-dependent insulin release, reduce glucagon, and slow gastric emptying. […] The use of a GLP-1 in addition to metformin and/or a sulfonylurea may result in modest weight loss. […] In December 2017, the FDA approved once-weekly semaglutide SC (Ozempic), a GLP-1 receptor agonist, as a glycemic control improvement agent in adults with type 2 diabetes. […] In January 2025, the indications for semaglutides usage were again expanded to include, in adults with type 2 diabetes mellitus and chronic kidney disease, risk reduction for sustained decline in the estimated glomerular filtration rate (eGFR), for end-stage kidney disease, and for cardiovascular death.

• #1

  https://www.who.int/news-room/fact-sheets/detail/diabetes

  More than half of people living with diabetes did not take medication for their diabetes in 2022. Diabetes treatment coverage was lowest in low- and middle-income countries. […] Diabetes can be treated and its consequences avoided or delayed with diet, physical activity, medication and regular screening and treatment for complications. […] More than half (59%) of adults aged 30 years and over living with diabetes were not taking medication for their diabetes in 2022. Diabetes treatment coverage was lowest in low- and middle-income countries. […] Some people with type 2 diabetes will need to take medicines to help manage their blood sugar levels. These can include insulin injections or other medicines. […] Along with medicines to lower blood sugar, people with diabetes often need medications to lower their blood pressure and statins to reduce the risk of complications. […] Additional medical care may be needed to treat the effects of diabetes: foot care to treat ulcers, screening and treatment for kidney disease, eye exams to screen for retinopathy (which causes blindness).

• #1

  https://www.nhs.uk/conditions/gestational-diabetes/treatment/

  If you have gestational diabetes, the chances of having problems with the pregnancy can be reduced by controlling your blood sugar (glucose) levels. […] You’ll be given a testing kit that you can use to check your blood sugar (glucose) level. […] Making changes to your diet can help control your blood sugar levels. […] Physical activity lowers your blood glucose level, so regular exercise can be an effective way to manage gestational diabetes. […] You may be given medicine if your blood sugar levels are still not stable 1 to 2 weeks after changing your diet and exercising regularly, or if your blood sugar level is very high when you’re first diagnosed. This may be tablets usually metformin or insulin injections. […] Insulin may be recommended if: you cannot take metformin or it causes side effects, metformin does not lower your blood sugar levels enough, you have very high blood sugar, your baby is very large or you have too much fluid in your womb (polyhydramnios).

• #1 Diabetes: Symptoms, Causes, Treatment, Prevention, and More

  https://www.healthline.com/health/diabetes

  Doctors treat diabetes with a few different medications. Some are taken by mouth, while others are available as injections. […] Insulin is the main treatment for type 1 and 1.5 diabetes. It replaces the hormone your body isn’t able to produce. […] Diet and exercise can help some people manage type 2 diabetes. If lifestyle changes aren’t enough to lower your blood sugar, you’ll need to take medication. […] If you receive a diagnosis of gestational diabetes, you’ll need to monitor your blood sugar level several times per day during pregnancy. If it’s high, dietary changes and exercise may be enough to bring it down. […] Research has found that about 15% to 30% of women who develop gestational diabetes will need insulin to lower their blood sugar. Insulin is safe for the developing baby. […] The treatment regimen your doctor recommends will depend on the type of diabetes you have and its cause. […] Check out this list of the various medications that are available to treat diabetes.

• #1 Type 2 Diabetes Mellitus Treatment & Management: Approach Considerations, Pharmacologic Therapy, Management of Glycemia

  https://emedicine.medscape.com/article/117853-treatment

  The goals in caring for patients with diabetes mellitus are to eliminate symptoms and to prevent, or at least slow, the development of complications. Microvascular (ie, eye and kidney disease) risk reduction is accomplished through control of glycemia and blood pressure; macrovascular (ie, coronary, cerebrovascular, peripheral vascular) risk reduction, through control of lipids and hypertension, smoking cessation, and aspirin therapy; and metabolic and neurologic risk reduction, through control of glycemia. […] Type 2 diabetes care is best provided by a multidisciplinary team of health professionals with expertise in diabetes, working in collaboration with the patient and family. Management includes the following: Appropriate goal setting, Dietary and exercise modifications, Medications, Appropriate self-monitoring of blood glucose (SMBG), Regular monitoring for complications, Laboratory assessment.

• #1 Your Diabetes Care Team | Diabetes | CDC

  https://www.cdc.gov/diabetes/treatment/diabetes-doctors.html

  Your diabetes care team will include specialists from several health fields. […] They’ll help you prevent or manage specific diabetes-related health problems. […] The right diabetes care team can set you up for diabetes management success. […] With your team, you’ll develop a diabetes management plan to help you stay healthy. Your plan will also help you prevent or delay diabetes-related complications. […] This health care professional is trained to provide personalized diabetes self-management education and support (DSMES). You’ll work together to create a diabetes management plan that’s specific to your health needs, lifestyle, and culture. […] They can help you develop healthy eating patterns to improve your overall health. […] Delay or prevent diabetes complications. […] Diabetes can harm the blood vessels and nerves in your legs and feet.

• #1 Your Diabetes Care Team | Diabetes | CDC

  https://www.cdc.gov/diabetes/treatment/diabetes-doctors.html

  Over time, high blood sugar and high blood pressure from diabetes can damage your kidneys. […] They can help you manage the demands of day-to-day diabetes care, as well as mental health issues. […] An exercise specialist can be a physical therapist, occupational therapist, or personal trainer. They can help you with structured physical activity, like an exercise session.

• #1 Diabetes treatments

  https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/treatments

  Immunotherapies are new treatments that reprogramme the immune system so that it no longer attacks and destroys insulin-producing cells in the pancreas. […] Diabetes doesn’t just affect you physically, it can affect you emotionally too. […] If you treat your diabetes with medication, you wont need to pay for medications.

• #1 The interface of depression and diabetes: treatment considerations | Translational Psychiatry

  https://www.nature.com/articles/s41398-025-03234-5

  Understanding this bidirectional relationship is important for developing more effective, holistic treatment approaches that address both the psychological and physiological aspects of these intertwined health challenges. […] Effective diabetes management, therefore, requires a comprehensive approach that considers these intertwined psychological and physiological impacts. To address these dual aspects of diabetes, integrated care models that include both pharmacological treatments for the physical aspects of diabetes and psychological support to address mental health are essential. […] The management of depression in patients with diabetes requires a comprehensive approach, including pharmacological and psychological treatment strategies. […] Comorbid depression and diabetes worsen glycemic control, and certain antidepressants may inversely contribute to it.

• #1 The future of diabetes treatment: Is a cure possible?

  https://www.labiotech.eu/in-depth/diabetes-treatment-cure-review/

  Because type 1 diabetes is an autoimmune condition, one of the most promising research directions is to stop, or at least slow down, the immune systems attack on insulin-producing beta cells. […] In 2022, the FDA approved teplizumab (Tzield), making it the first treatment specifically designed to delay the onset of clinical type 1 diabetes. […] Efforts to restore insulin production in type 1 diabetes have increasingly focused on regenerative approaches, particularly stem cell-based therapies. […] In 2024, cell therapy recorded one of the biggest wins against the disease. […] In type 2 diabetes, the next wave may be defined not by a single drug, but by the convergence of technologies. […] Researchers are also looking at early intervention strategies, including gut-targeted procedures, microbiome modulation, and metabolic reprogramming, to tackle the disease before it progresses. […] Across both types, artificial intelligence is increasingly being used to personalize treatment plans, monitor risk in real time, and optimize dosing.

• #1 Diabetes Treatment and Research at Yale: 30 Years of Progress < Yale School of Medicine

  https://medicine.yale.edu/news-article/diabetes-treatment-and-research-at-yale-nearly-30-years-of-progress/

  Between those two drug classes, we now have solid evidence that these medications can not only lower the glucose to help with diabetes control, but also prevent heart complications of diabetes, Inzucchi said. […] Additionally, a novel GIP/GLP-1 receptor agonist, tirzepatide, was recently shown to be extremely effective for weight loss. […] For type 1 diabetes, I think the major advancement has been the technology, Inzucchi said. […] In 2016, for example, the FDA approved a device that measures patients blood sugar levels every five minutes through a continuous glucose monitor and sends the information to a pump that delivers insulin accordingly.

• #1 Insulin therapy for diabetes

  https://www.diabinfo.de/en/living-with-diabetes/treatment/insulin-therapy-for-diabetes.html

  For type 2 diabetes, insulin therapy may be necessary when the body is not producing enough insulin and dietary adjustment and physical activity alone, or treatment using tablets, are no longer effective. For type 1 diabetes, due to the absolute insulin deficiency, insulin must always be injected. The form and amount of insulin injected vary from case to case. […] Intensified insulin therapy enables better blood sugar management and is more suited to a flexible and active lifestyle. However, it requires more effort compared to conventional insulin therapy. […] Smart insulins are still being researched and are not yet approved for use. Various companies and research groups have recently made progress.

• #1 Initial management of hyperglycemia in adults with type 2 diabetes mellitus – UpToDate

  https://www.uptodate.com/contents/initial-management-of-hyperglycemia-in-adults-with-type-2-diabetes-mellitus

  Patients with newly diagnosed diabetes should participate in a comprehensive diabetes self-management education program, which includes individualized instruction on nutrition, physical activity, optimizing metabolic control, and preventing complications. […] Medical nutrition therapy (MNT) is the process by which a dietary plan is tailored for people with diabetes, based on medical, lifestyle, and personal factors. […] For patients with type 2 diabetes, body weight management should be considered as a therapeutic target in addition to glycemia. […] Weight loss improves glycemia through mitigation of insulin resistance and impaired beta cell function, two major metabolic perturbations evident in type 2 diabetes. […] Pharmacotherapy targeted solely for weight management is effective in patients with type 2 diabetes.

• #1 Diabetes treatments

  https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/treatments

  There are many diabetes treatments available to help you manage your condition. Everyone is different, so treatment will vary depending on your own individual needs. […] Not all diabetes treatments are suitable for everyone, so dont be disheartened if you find yourself needing to change or stop certain medications. Your GP or healthcare team can help you find a medication thats best for you. […] Your diabetes treatment may be different depending on what type of diabetes you have. […] Insulin helps you manage your blood sugar levels and helps prevents short-term or long-term serious health problems known as diabetes complications. […] Metformin is the most common treatment for type 2 diabetes. […] Metformin works by reducing the amount of glucose – a type of sugar that the liver releases into your body, and it helps the insulin your body makes work better.

• #1 Type 1 Diabetes Mellitus Treatment & Management: Approach Considerations, Self-Monitoring of Glucose Levels, Continuous Glucose Monitoring

  https://emedicine.medscape.com/article/117739-treatment

  Patients with type 1 DM require lifelong insulin therapy. Most require two or more injections of insulin daily, with doses adjusted on the basis of self-monitoring of blood glucose levels. Long-term management requires a multidisciplinary approach that includes physicians, nurses, dietitians, and selected specialists. […] Ultimately, however, the disease recurs, and patients require insulin therapy. […] The ADA recommends using patient age as one consideration in the establishment of glycemic goals, with targets for preprandial, bedtime/overnight, and HbA1c levels. […] In addition to diagnosis and management, the new statement also covers screening for long-term complications, workplace management, diabetes in older patients, and diabetes in pregnancy, and recommends unimpeded access to glucose test strips for blood glucose testing and use of continuous glucose monitoring.

• #1 How to Stick to a Treatment Plan for Type 2 Diabetes

  https://www.verywellhealth.com/treatment-plan-diabetes-6740653

  Your blood glucose levels can change when your lifestyle changes. If you have a change of schedule, living situation, employment, activity level, or diet, you may need modifications to your treatment plan. […] Creating a diabetes treatment plan will help you manage the condition for the best outcomes. Elements of a diabetes treatment plan include monitoring your blood glucose levels, nutrition, exercise, medications, follow-up appointments, addressing costs, and accessing resources and diabetes education. […] There is no one-size-fits-all treatment plan for type 2 diabetes. Your health history, underlying health conditions, and the severity of your condition will likely determine your treatment goals. Therefore, it is imperative to talk to your healthcare provider and formulate a treatment plan that is best for you.

• #2 Diabetes Treatments | Endocrine Society

  https://www.endocrine.org/patient-engagement/endocrine-library/diabetes-treatments

  It’s very important to take your diabetes medications as recommended by your doctor. Left untreated, diabetes can lead to serious, even life-threatening complications. By taking your medications as recommended, you greatly reduce your risk of developing diabetes-related complications. […] Treatment includes changes in lifestyle (diet and exercise), plus medicine (if needed). Diabetes can be treated with oral medicines (pills), insulin, and/or other injected medicines. People with type 1 diabetes always need insulin. People with type 2 diabetes usually need treatment with oral medicines for several or even many years, but may eventually need insulin to maintain glucose control. […] Your treatment will depend on the type of diabetes you have. […] There are many types of medications that can be prescribed for you.

• #2 Insulin, Medicines, & Other Diabetes Treatments – NIDDK

  https://www.niddk.nih.gov/health-information/diabetes/overview/insulin-medicines-treatments

  Taking insulin or other diabetes medicines is often part of treating diabetes. […] The medicine you take depends on the type of diabetes you have and how well the medicine controls your blood glucose levels, also called blood sugar levels. […] If you have type 1 diabetes, you must take insulin because your pancreas does not make it. […] You will need to take insulin several times during the day, including when you eat and drink, to control your blood glucose level. […] Many people with type 2 diabetes need to take diabetes medicines as well. […] These medicines may include diabetes pills or medicines you inject, such as insulin. […] If consuming healthy food and beverages and getting regular physical activity aren’t enough to keep your blood glucose level in your target range, a doctor will work with you and may recommend you take insulin.

• #2 Type 1 Diabetes Treatment and Therapy – Breakthrough T1D

  https://www.breakthrought1d.org/t1d-basics/treatments/

  Treatment for type 1 diabetes […] Therapies for treating type 1 diabetes […] Insulin is the primary type 1 diabetes treatment. People with type 1 diabetes (T1D) must take insulin to survive because their body does not make enough of it. Insulin is administered by injection, inhalation, or insulin pump. […] There are several different types of insulin used today, with most individuals with T1D using basal (long-acting) and bolus (short-acting) insulins. […] Managing type 1 diabetes involves three main steps: checking blood sugar, administering insulin, and counting carbohydrates. […] There are four primary methods for administering insulin: injections with syringe or pen, inhaler, insulin pump, or artificial pancreas system/automated insulin delivery system. […] People with T1D must balance the amount of carbs they consume with the right dose of insulin. […] Adjunctive therapies complement insulin to achieve better glucose control. […] Pramlintide is a synthetic amylin analog administered via syringe. It is approved for people with T1D who use mealtime insulin and do not achieve their glycemic targets despite optimal insulin therapy. Pramlintide limits glucose fluctuations after meals. Pramlintide therapy can also lead to weight loss and improvements in risk factors for cardiovascular disease. […] Therapies such as angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), statins, and other lipid-lowering drugs may be prescribed to manage cardiovascular disease and reduce the risk of cardiovascular complications. […] The U.S. Food and Drug Administration (FDA) approved Tzield™ (teplizumab-mzwv) in November 2022, making it the first approved disease-modifying therapy for delaying T1D onset in people at risk of developing the disease. Studies have shown Tzield can delay the onset of T1D for approximately 2 years. […] Though not approved for T1D, these drugs have tremendous promise as a type 1 diabetes treatment in terms of glucose and metabolic control, weight loss, and more. […] For a treatment, drug, or device to make it into the hands of people with type 1 diabetes, it must first complete a vital step—a clinical trial.

• #2 Medications for Diabetes Mellitus Treatment – Endocrine and Metabolic Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/endocrine-and-metabolic-disorders/diabetes-mellitus-and-disorders-of-carbohydrate-metabolism/medications-for-diabetes-mellitus-treatment

  Insulin is typically administered as either multiple daily subcutaneous injections administered by the patient, with 2 preparations of insulin used depending on the anticipated glycemic control needs or an insulin pump that delivers a rapid- or short-acting insulin and administers a basal rate of insulin and additional boluses with meals or for correcting a high blood glucose level. […] Insulin pumps can eliminate the need for multiple daily injections, provide maximal flexibility in the timing of meals, and substantially reduce variability in glucose levels. […] Teplizumab, an anti-CD3 monoclonal antibody, is a disease-modifying medication for type 1 diabetes. It delays clinical type 1 diabetes in at-risk individuals. […] Pharmacologic measures to prevent or treat complications of diabetes mellitus are critical, including angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs), aspirin, and statins.

• #2 Diabetes – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451

  Treatment of type 2 diabetes mostly involves lifestyle changes, monitoring of your blood sugar, along with oral diabetes drugs, insulin or both. […] Insulin can’t be taken orally to lower blood sugar because stomach enzymes interfere with insulin’s action. Insulin is often injected using a fine needle and syringe or an insulin pen a device that looks like a large ink pen. […] In some people who have type 1 diabetes, a pancreas transplant may be an option. Islet transplants are being studied as well. With a successful pancreas transplant, you would no longer need insulin therapy. […] Treatment for prediabetes usually involves healthy lifestyle choices. These habits can help bring your blood sugar level back to normal. Or it could keep it from rising toward the levels seen in type 2 diabetes.

• #2 Diabetes treatments

  https://www.diabetes.org.uk/about-diabetes/looking-after-diabetes/treatments

  Eating a healthy, balanced diet is an important part of managing diabetes. Following a balanced diet will allow you to manage your blood sugar levels and help you keep to a healthy weight. […] Being physically active is good for diabetes. […] There are lots of different types of diabetes tech, like insulin pumps and continuous glucose monitors, which can be an important part of how some people manage their diabetes. […] Weight loss surgery, also called bariatric surgery, is seen as a treatment for type 2 diabetes and there is strong evidence it is an effective way to put your type 2 diabetes into remission long term. […] There are many ways of entering type 2 diabetes remission, which is when your long-term blood sugars fall below the diabetes level and stay there for at least three months, without the need for glucose-lowering medication.

• #2 Type 2 Diabetes: What It Is, Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/21501-type-2-diabetes

  Certain strategies can help lower your risk of developing Type 2 diabetes or delay its onset, including: Exercising regularly (at least 150 minutes a week). Maintaining a weight thats healthy for you. Eating nutritious food. Not smoking. […] Type 2 diabetes can affect your life in many ways. At Cleveland Clinic, we can help develop a treatment plan that matches you and your goals.

• #2 Initial management of hyperglycemia in adults with type 2 diabetes mellitus – UpToDate

  https://www.uptodate.com/contents/initial-management-of-hyperglycemia-in-adults-with-type-2-diabetes-mellitus

  Although metformin is usually started for the management of hyperglycemia, it is also frequently an effective medication to promote modest weight loss. […] Weight loss surgery in patients with obesity and type 2 diabetes results in the largest degree of sustained weight loss and, in parallel, improvements in blood glucose management and the most frequent sustained remissions of diabetes. […] Regular exercise is beneficial in type 2 diabetes, independent of weight loss. […] Intensive behavioral modification interventions focusing on weight reduction and increasing activity levels are successful in reducing weight and improving glycemic management while, at the same time, reducing the need for glucose-lowering and other medications. […] Early institution of treatment for diabetes, at a time when the A1C is not substantially elevated, is associated with improved glycemic management over time and decreased long-term complications.

• #2 Initial management of hyperglycemia in adults with type 2 diabetes mellitus – UpToDate

  https://www.uptodate.com/contents/initial-management-of-hyperglycemia-in-adults-with-type-2-diabetes-mellitus

  Initial management of hyperglycemia in adults with type 2 diabetes mellitus […] Treatment of patients with type 2 diabetes mellitus includes education, evaluation for micro- and macrovascular complications, attempts to achieve near normoglycemia, minimization of cardiovascular and other long-term risk factors, and avoidance of drugs that can exacerbate abnormalities of insulin or lipid metabolism. […] Although studies of bariatric surgery, aggressive insulin therapy, and behavioral interventions to achieve weight loss have noted remissions of type 2 diabetes mellitus that may last several years, the majority of patients with type 2 diabetes require continuous treatment in order to maintain target glycemia. […] Treatments to improve glycemic management work by increasing insulin availability (either through direct insulin administration or through agents that promote insulin secretion), improving sensitivity to insulin, delaying the delivery and absorption of carbohydrate from the gastrointestinal tract, increasing urinary glucose excretion, or a combination of these approaches.

• #2 Initial management of hyperglycemia in adults with type 2 diabetes mellitus – UpToDate

  https://www.uptodate.com/contents/initial-management-of-hyperglycemia-in-adults-with-type-2-diabetes-mellitus

  Pharmacologic therapy should be initiated along with consultation for lifestyle modification focusing on dietary and other lifestyle contributors to hyperglycemia. […] For most patients presenting with A1C at or above target level (ie, >7.5 to 8 percent), pharmacologic therapy should be initiated at the time of type 2 diabetes diagnosis (with lifestyle modification). […] In the absence of specific contraindications, we suggest metformin as initial therapy for patients with newly diagnosed type 2 diabetes who are asymptomatic. […] Metformin is the preferred initial therapy because of glycemic efficacy, promotion of modest weight loss, very low incidence of hypoglycemia, general tolerability, and very low cost. […] For patients who have gastrointestinal intolerance of metformin, slower titration, ensuring that the patient is taking the medication with food, or switching to an extended-release formulation may improve tolerability.

• #2 Type 2 diabetes: Which medication is best for me? – Harvard Health

  https://www.health.harvard.edu/blog/type-2-diabetes-which-medication-is-best-for-me-2020110521256

  If you are living with type 2 diabetes, you certainly are not alone. One in 10 people in the US has diabetes, according to the CDC. However, despite considerable progress in diabetes treatment over the past 20 years, fewer than half of those with diabetes actually reach their target blood sugar goal. […] One reason for this may be the overwhelming number of medications currently available. And yet, waiting too long to adjust treatment for type 2 diabetes can have long-lasting negative effects on the body that may raise the risk of heart and kidney disease and other complications. […] The blood sugar goal for most adults with diabetes is an A1C of below 7%. (A1C is a measure of a persons average blood sugar over a period of about three months.) In many people, diet and exercise are not enough to reach this goal, and one or more medications may be needed. Metformin is a tried and tested medicine that has been used for many decades to treat type 2 diabetes, and is recommended by most experts as first-line therapy. It is affordable, safe, effective, and well tolerated by most people.

• #2 What Are My Options for Type 2 Diabetes Medications? | ADA

  https://diabetes.org/health-wellness/medication/oral-other-injectable-diabetes-medications

  There are different types, or classes, of medications that work in different ways to lower blood glucose levels. Some options are taken by mouth and others are injected. […] Metformin lowers blood glucose levels primarily by decreasing the amount of glucose produced by the liver. […] DPP-4 inhibitors help improve A1C (a measure of average blood glucose levels over two to three months) without causing hypoglycemia (low blood glucose). […] Use of GLP-1 and dual GLP-1/GIP receptor agonists is another strategy to help use these hormones to improve blood glucose management in people with type 2 diabetes. […] SGLT2 inhibitors are also known to help improve outcomes in people with heart disease, kidney disease, and heart failure. […] Sulfonylureas have been in use since the 1950s and they stimulate beta cells in the pancreas to release more insulin.

• #2 Initial management of hyperglycemia in adults with type 2 diabetes mellitus – UpToDate

  https://www.uptodate.com/contents/initial-management-of-hyperglycemia-in-adults-with-type-2-diabetes-mellitus

  Patients with cardiovascular and/or kidney comorbidities should be treated with glucose-lowering medications that have evidence of cardiac or kidney benefit. […] The GLP-1 receptor agonists liraglutide, semaglutide, and dulaglutide demonstrated favorable atherosclerotic cardiovascular and kidney outcomes. […] The SGLT2 inhibitors empagliflozin, canagliflozin, and dapagliflozin have also demonstrated benefit, especially for HF hospitalization, risk of kidney disease progression, and mortality. […] For patients presenting with symptomatic (eg, weight loss) or severe hyperglycemia with ketonuria, insulin is indicated for initial treatment. […] Insulin therapy in type 2 diabetes is initially aimed at suppressing hepatic gluconeogenesis by increasing basal insulin to target morning fasting glucose levels.

• #2 What Are My Options for Type 2 Diabetes Medications? | ADA

  https://diabetes.org/health-wellness/medication/oral-other-injectable-diabetes-medications

  TZDs help insulin work better in the muscle and fat and reduce glucose production in the liver. […] In addition to the commonly used classes discussed above, there are other less commonly used medications that can work well for some people. […] Because the drugs listed above act in different ways to lower blood glucose levels, they may be used together to help meet your individualized diabetes goals. […] Insulin may also be used to treat type 2 diabetes.

• #2 Diabetes Treatment and Research at Yale: 30 Years of Progress < Yale School of Medicine

  https://medicine.yale.edu/news-article/diabetes-treatment-and-research-at-yale-nearly-30-years-of-progress/

  Between those two drug classes, we now have solid evidence that these medications can not only lower the glucose to help with diabetes control, but also prevent heart complications of diabetes, Inzucchi said. […] Additionally, a novel GIP/GLP-1 receptor agonist, tirzepatide, was recently shown to be extremely effective for weight loss. […] For type 1 diabetes, I think the major advancement has been the technology, Inzucchi said. […] In 2016, for example, the FDA approved a device that measures patients blood sugar levels every five minutes through a continuous glucose monitor and sends the information to a pump that delivers insulin accordingly.

• #2 Initial management of hyperglycemia in adults with type 2 diabetes mellitus – UpToDate

  https://www.uptodate.com/contents/initial-management-of-hyperglycemia-in-adults-with-type-2-diabetes-mellitus

  The use of metformin as initial therapy is supported by meta-analyses of trials and observational studies evaluating the effects of oral or injectable diabetes medications as monotherapy on intermediate outcomes (A1C, body weight, lipid profiles) and adverse events. […] Cardiovascular benefit has been demonstrated for selected classes of diabetes medications, usually when added to metformin. […] In trials designed to evaluate kidney outcomes in patients with DKD and severely increased albuminuria, SGLT2 inhibitors reduced the risk of kidney disease progression and death from kidney disease. […] Our approach is largely consistent with American and European guidelines. […] We obtain A1C at least twice yearly in patients meeting glycemic goals and more frequently in patients whose therapy has changed or who are not meeting goals. […] For patients who are not meeting glycemic targets despite diet, exercise, and metformin, combination therapy is necessary to achieve optimal results.

• #2

  https://www.nhs.uk/conditions/gestational-diabetes/treatment/

  If you have gestational diabetes, the chances of having problems with the pregnancy can be reduced by controlling your blood sugar (glucose) levels. […] You’ll be given a testing kit that you can use to check your blood sugar (glucose) level. […] Making changes to your diet can help control your blood sugar levels. […] Physical activity lowers your blood glucose level, so regular exercise can be an effective way to manage gestational diabetes. […] You may be given medicine if your blood sugar levels are still not stable 1 to 2 weeks after changing your diet and exercising regularly, or if your blood sugar level is very high when you’re first diagnosed. This may be tablets usually metformin or insulin injections. […] Insulin may be recommended if: you cannot take metformin or it causes side effects, metformin does not lower your blood sugar levels enough, you have very high blood sugar, your baby is very large or you have too much fluid in your womb (polyhydramnios).

• #2 Initial management of hyperglycemia in adults with type 2 diabetes mellitus – UpToDate

  https://www.uptodate.com/contents/initial-management-of-hyperglycemia-in-adults-with-type-2-diabetes-mellitus

  Patients with newly diagnosed diabetes should participate in a comprehensive diabetes self-management education program, which includes individualized instruction on nutrition, physical activity, optimizing metabolic control, and preventing complications. […] Medical nutrition therapy (MNT) is the process by which a dietary plan is tailored for people with diabetes, based on medical, lifestyle, and personal factors. […] For patients with type 2 diabetes, body weight management should be considered as a therapeutic target in addition to glycemia. […] Weight loss improves glycemia through mitigation of insulin resistance and impaired beta cell function, two major metabolic perturbations evident in type 2 diabetes. […] Pharmacotherapy targeted solely for weight management is effective in patients with type 2 diabetes.

• #2 Type 1 Diabetes Mellitus Treatment & Management: Approach Considerations, Self-Monitoring of Glucose Levels, Continuous Glucose Monitoring

  https://emedicine.medscape.com/article/117739-treatment

  DKA involves acute metabolic changes in the body that develop as a result of lack of insulin or poor response to insulin arising from stress or illness. DKA is characterized by hyperglycemia, ketosis, and acidosis, leading to osmotic diuresis and dehydration. Volume repletion, insulin therapy, and specific metabolic corrections are the keys to treatment of DKA. […] One of the first steps in managing type 1 DM is diet control. […] Exercise is an important aspect of diabetes management. Patients should be encouraged to exercise regularly. […] Patients with type 1 DM should be referred to an endocrinologist for multidisciplinary management.

• #2 Your Diabetes Care Team | Diabetes | CDC

  https://www.cdc.gov/diabetes/treatment/diabetes-doctors.html

  Your diabetes care team will include specialists from several health fields. […] They’ll help you prevent or manage specific diabetes-related health problems. […] The right diabetes care team can set you up for diabetes management success. […] With your team, you’ll develop a diabetes management plan to help you stay healthy. Your plan will also help you prevent or delay diabetes-related complications. […] This health care professional is trained to provide personalized diabetes self-management education and support (DSMES). You’ll work together to create a diabetes management plan that’s specific to your health needs, lifestyle, and culture. […] They can help you develop healthy eating patterns to improve your overall health. […] Delay or prevent diabetes complications. […] Diabetes can harm the blood vessels and nerves in your legs and feet.

• #2 Your Diabetes Care Team | Diabetes | CDC

  https://www.cdc.gov/diabetes/treatment/diabetes-doctors.html

  Over time, high blood sugar and high blood pressure from diabetes can damage your kidneys. […] They can help you manage the demands of day-to-day diabetes care, as well as mental health issues. […] An exercise specialist can be a physical therapist, occupational therapist, or personal trainer. They can help you with structured physical activity, like an exercise session.

• #3 Diabetes Treatment and Research at Yale: 30 Years of Progress < Yale School of Medicine

  https://medicine.yale.edu/news-article/diabetes-treatment-and-research-at-yale-nearly-30-years-of-progress/

  The New England Journal of Medicine reported an important finding in 2019 from a Yale-led clinical trial: for the first time, researchers showed that a drug, teplizumab, could delay the development of type 1 diabetes by two years. […] Kevan Herold, MD, C.N.H. Long Professor of Immunology and professor of medicine (endocrinology), and the principal investigator of the trial, said teplizumab likely will be FDA-approved in mid-November for people who are at high risk of diabetes, not only those with a family history of the disease. Once approved, all children should be screened for diabetes risk so that those at high risk will have a chance to prevent or at least delay the disease, Herold said. […] The teplizumab trial is just one example of how Yale School of Medicine is a leader in the study and treatment of diabetes.

• #3 Type 2 Diabetes Mellitus Treatment & Management: Approach Considerations, Pharmacologic Therapy, Management of Glycemia

  https://emedicine.medscape.com/article/117853-treatment

  GLP-1 agonists (ie, exenatide, liraglutide, albiglutide [discontinued], dulaglutide) mimic the endogenous incretin GLP-1; they stimulate glucose-dependent insulin release, reduce glucagon, and slow gastric emptying. […] The use of a GLP-1 in addition to metformin and/or a sulfonylurea may result in modest weight loss. […] In December 2017, the FDA approved once-weekly semaglutide SC (Ozempic), a GLP-1 receptor agonist, as a glycemic control improvement agent in adults with type 2 diabetes. […] In January 2025, the indications for semaglutides usage were again expanded to include, in adults with type 2 diabetes mellitus and chronic kidney disease, risk reduction for sustained decline in the estimated glomerular filtration rate (eGFR), for end-stage kidney disease, and for cardiovascular death.

• #3 Type 2 Diabetes Mellitus Treatment & Management: Approach Considerations, Pharmacologic Therapy, Management of Glycemia

  https://emedicine.medscape.com/article/117853-treatment

  In morbidly obese patients, bariatric surgery has been shown to improve diabetes control and, in some situations, normalize glucose tolerance. […] According to guidelines released in 2016 by the 2nd Diabetes Surgery Summit (DSS-II), an international consensus conference, bariatric surgery should be considered even for type 2 diabetes patients with mild, class 1 obesity (BMI 30.0-34.9 kg/m2) if their hyperglycemia is inadequately controlled with optimal treatment.

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