Diet

• Follow a balanced meal plan. Eat consistent and moderate amounts of food at regular times.
  • Nuts and peanut butter are a good choice for a snack. In women with diabetes, these snacks may help reduce the risk of cardiovascular disease.
• Do not skip meals.
• Eat plenty of vegetables and fiber.
• Eat limited amounts of fat.
• Eat moderate amounts of protein and low-fat dairy products.
• Carefully limit foods containing high concentrated sugar.
• Keep a record of your food intake. This will help a dietitian or doctor advise you.

Weight Loss

If you are overweight, talk to your doctor about a reasonable weight goal. You and your doctor can develop a safe diet program for you. Weight loss will help your body respond better to insulin.

Group education may help people recently diagnosed with their goals in weight loss.

Exercise

Physical activity:

• Can make the body become more sensitive to insulin
• Will help you reach and maintain a healthy weight
• Can lower the levels of fat in your blood
• Has been found to improve blood sugar control— Aerobic, fitness, and resistance training can help to improve hemoglobin A1c (HbA1c) blood levels. HbA1c is the average blood sugar level over 3 months. This is a measure of your average blood glucose levels over the past three months. Researchers have also found that long-term strength and endurance training may improve HbAIc, even in the absence of weight loss.

Talk to your doctor about any restrictions. Work with your doctor to make an activity plan. Even a brief counseling session may help to increase your activity levels.

Diabetes is a risk factor for heart disease. Exercising can help to reduce your risk for heart disease.

Oral Medication

Medications taken by mouth may be used to lower blood sugar:

• Metformin: a class of drug that reduces the body's production of glucose. It also makes the body more sensitive to insulin. This combination will help keep blood sugar levels within the normal limits.
• Drugs that prompt the cells in the pancreas to make more insulin (eg, sulfonylureas [ glyburide, tolazamide ], dipeptidyl peptidase-4 inhibitors [ saxagliptin, sitagliptin ], repaglinide [Prandin])
  • The FDA has warned that sitagliptin may increase the risk of acute pancreatitis.
• Insulin sensitizers—a class of drugs that help the body better use insulin (eg, pioglitazone)
• Starch blockers—a class of drugs (eg, acarbose, miglitol) that lessen glucose absorption into the bloodstream

Injectable medication such as:

• Incretin-mimetic (eg, exenatide) stimulate the pancreas to produce insulin and suppress appetite often leading to weight loss. (twice daily injections)
• Amylin analogues (eg, pramlintide) replace a protein that is normally produced by the pancreas and is low in type 2 diabetes (injection before each meal)

Talk to your doctor about your drug program.

Insulin

In some cases the body does not make enough insulin. Insulin injections may be needed.

This is needed when blood sugar levels are not kept low enough with lifestyle change and medicine

Blood Glucose Testing

Checking blood glucose levels during the day can help you stay on track. It will also helps your doctor determine if you treatment is working. Testing is easy with a blood glucose monitor. Keeping track of blood glucose levels is especially important if you take insulin. Frequency of blood glucose testing is determined by how well your blood sugar control is doing.

The HbA1c may also be done at your doctor's office. Doctors advise that most keep their HbA1c levels below 7% (American Diabetes Association recommendation). This level has been shown to lead to fewer diabetic complications.

Regular blood sugar testing may not be needed in patients with type 2 diabetes. It may not be needed for those whose condition is under reasonably good control without insulin. Talk with your doctor before stopping blood sugar monitoring.

Alternative Therapies

One study focused on people with a specific type 2 diabetes. When given vitamin E they showed a decrease in the rates of heart problems.