Health or Love: Which Would Most People With Type 2 Diabetes Choose?

From health.yahoo.com

By Korin Miller

Key Takeaways

• A new Everyday Health survey of more than 500 adults with type 2 diabetes suggests that disease management can be life-altering.

• Most respondents would prioritize health and a better lifestyle over perks like more money.

• The findings highlight the challenges of living with type 2 diabetes, according to doctors.

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If given the option, would you choose perfect health for the rest of your life or a perfect marriage or relationship?

Among people living with type 2 diabetes, the resounding preference was perfect health (65 percent versus 35 percent) in a new Everyday Health survey of 501 people living with the disease. The survey queried patients on that question and several others to gauge their values.

Respondents also said they'd choose being the happiest person in the room (53 percent) versus the healthiest (47 percent). Meanwhile, they preferred a guaranteed cure for type 2 diabetes (69 percent) over a guaranteed college education for a child (31 percent), but 74 percent would choose being able to run around with grandkids over ordering takeout four nights per week (26 percent), and having energy to enjoy weekends (78 percent) over sleeping in every weekend (22 percent).

Patient Journey and GLP-1 Use Influenced Choices

Responses changed depending on factors such as where the respondent was in their condition journey (for example, how long they'd been diagnosed with diabetes) and whether they were taking a GLP-1 drug.

As patients get further along in their journey with type 2 diabetes, their priorities appear to shift from weight- and appearance-oriented goals toward freedom from the disease. For example, compared with patients diagnosed within the past three years, seasoned patients (those with diabetes for 10 or more years) would choose a guaranteed cure for type 2 diabetes (76 percent) over a child's college education (66 percent).

People who weren't currently using GLP-1 medications were more likely than those who were to prioritize perfect health over a perfect marriage or relationship (71 percent versus 59 percent) and to choose a guaranteed cure for type 2 diabetes over a child's college education (72 percent versus 65 percent), the results revealed.

What's more, women were significantly more likely than men to value being the healthiest person in the room over the happiest (52 percent versus 44 percent), while men were significantly more likely to prioritize happiness (56 percent versus 48 percent).

The Findings Reflect What Doctors See in People With Type 2 Diabetes

Overall, the results are not surprising, says Kimberly Gudzune, MD, MPH, obesity medicine physician and affiliate faculty at the Johns Hopkins Bloomberg School of Public Health. "They highlight that people living with type 2 diabetes are looking to live healthy and happy lives, but having diabetes may make it challenging to meet these goals," she says.

Type 2 diabetes can reduce a person's life expectancy, which is why Dr. Gudzune says it "makes sense" that people living with the condition would favor a cure. "Type 2 diabetes may also impact the quality of life, so it's not just a longer lifespan, but being able to enjoy the years that you have," she says.

Jennifer Frediani, PhD, RD, agreed. "Having type 2 diabetes is life-changing," said Dr. Frediani, who is a professor at the Emory University Nell Hodgson Woodruff School of Nursing and a medical reviewer at Everyday Health. "Your life revolves around what you've eaten, what your exercise plan is, and when you're taking your medications."

She says that type 2 diabetes management can be "all you think about" for some patients, especially if they're taking medications with a risk of uncomfortable side effects. "I get that people would choose a cure over something like a paid college education, which they may be able to figure out," she says.

But Frediani points out that there are often different levels of concern in people with type 2 diabetes, reflected by some people preferring to sleep in on weekends versus having enough energy for those days. "There are some people that are going to do their best to prevent complications and then there are others that think, 'That won't happen to me,'" she says.

Still, a large number of respondents seemed focused on trying to improve their health. "Type 2 diabetes not only reduces life expectancy but increases a person's risk of other health conditions such as heart attack, stroke, and kidney disease," Gudzune says. "The survey results seem to suggest that people are aware of these risks and are concerned about their long-term health."

What to Consider if Your Current Treatment Plan Isn't Working

The right treatment plan for type 2 diabetes is individualized to the patient and often requires a team of healthcare professionals, Gudzune says. If your current treatment plan doesn't seem to be improving your blood sugar levels or is affecting your quality of life, Gudzune recommends talking to your providers.

"People with type 2 diabetes should share their challenges and concerns with their primary care clinician and endocrinologist," she says. "In addition, many find it helpful to work with diabetes self-management education and support services, where a diabetes care and education specialist can help create a plan and teach about the key self-care behaviours such as healthy eating and reducing the risks of diabetes complications."

Frediani stresses the importance of refining treatment with time. "If you manage it well and are getting better, you may be able to go off medication," she says. "But the opposite can happen: If you don't take your medication correctly or change your lifestyle, it can get a lot worse."

Sources: Everyday Health Type 2 Diabetes/GLP-1 Patient Survey, N= 501, Aug. 5-13, 2026.

https://health.yahoo.com/conditions/endocrine/diabetes/diabetes-type-2/articles/health-love-most-people-type-085025693.html 

7 simple habits that could reverse type 2 diabetes

From sciencefocus.com

By Emma Glassman-Hughes

It takes a lot of work, but it is possible to push back the condition 

Just 20 years ago, type 2 diabetes was a lifelong diagnosis. When doctors spoke with their patients, the focus was on treating symptoms and managing complications with pharmaceuticals. Thoughts of eradicating the disease itself seemed far-fetched.

Now, though, thousands of people are successfully pushing back the disease.

Type 2 diabetes is a condition where the body becomes resistant to insulin, the hormone that regulates how cells absorb blood sugar, or glucose. Instead, many people have to take extra insulin or other medications to keep their blood sugar under control. Around 400 million people worldwide are impacted by the disease.

While there is no way to fully cure the disease yet, many patients have been able to put their type 2 diabetes into remission, meaning they are able to control their blood sugar for three months without the use of medication.

Whether or not a person can achieve remission depends on many factors, but the most likely candidates are those who’ve received a diagnosis within the last six years, according to Massachusetts-based endocrinologist Dr Damola Aje. The longer a person has diabetes, the more stress the condition puts on the pancreas – the organ which produces insulin.

“After five or six years, the pancreas can sometimes be more burnt out, and we’re looking more at preventing complications rather than achieving full remission,” she says.

The good news is that there are interventions that can help the body regulate its own blood sugar and relieve some of this stress on the pancreas and liver – another important organ in the process.

Unlike certain other chronic conditions, diabetes is strongly influenced by lifestyle factors, meaning remission can be achieved through what doctors call ‘intensive lifestyle interventions’.

These lifestyle interventions are called ‘intensive’ for a reason, though. Remission can’t be achieved passively, and most patients require medical supervision from a dedicated lifestyle team. 

But diabetes remission is within reach for many patients, Aje assures.

“It’s not a function of willpower, it’s not something that patients should be crucified for if it’s not achieved, but it’s highly possible. With the right support and the right medications, and if the intervention is in a timely manner, a person can get their diabetes into remission.”

Here are eight lifestyle interventions that support diabetes remission

1. Quality sleep

Sleep is when the body maintains itself, and lack of a good night's kip can cause a lot of health complications - Credit: Getty

Lack of sleep doesn’t just leave us feeling tired and sluggish – it has a profound impact on our health. According to Aje, people with years of poor sleep – people who work night shifts or just get less than eight hours of sleep each night – are at a greater risk of type 2 diabetes.

Poor sleep leads to higher levels of the stress hormone cortisol, as well as adrenaline spikes, leading to elevated blood glucose. Over time, these can lead to cells becoming more resistant to insulin.    

“We’re hoping for at least eight hours of sleep, even if it’s not all in one stretch,” Aje explains.

That said, while eight hours per night has long been considered the gold standard for sleep duration, new research suggests that the precise amount of nightly sleep to best manage type 2 diabetes is actually seven hours and 19 minutes – and major deviations from that amount result in higher instances of insulin resistance.

2. Timing of eating

It’s no surprise that diet is a major factor in controlling diabetes. Achieving remission requires building a diet around specific whole foods, says registered dietitian Avery Zenker, especially cruciferous and leafy green vegetables, berries and fruits, whole grains, nuts, seeds, legumes, beans, and lentils.

Basically, foods that “don’t have a lot of free added sugar, saturated fat, or refined ingredients,” Zenker says.

But it’s not just what we eat that can influence diabetes. It’s also how and when we eat it. The interplay between diet and our circadian rhythm – the 24-hour biological cycle that governs our bodies – is an essential piece of the puzzle.

Studies show that later dinnertimes and snacking closer to bedtime can be a risk factor for type 2 diabetes, in part because of how the sleep hormone melatonin interacts with digestion. Generally, the body processes glucose less efficiently at night, which can lead to blood sugar spikes.

“Ideally we are having some kind of fast overnight,” Zenker explains. “Somewhere between 10 to 12 hours is ideal. The body wants time to not have to be working and digesting. It wants to do other things while we’re sleeping.”

Patients working toward remission are also usually advised to prioritise larger meals in the morning and smaller meals as the day goes on. “We see it’s beneficial to have a more front-loaded day,” she says.

3. Diverse gut microbiome

An imbalance in our gut bacteria can lead to inflammation and insulin resistance - Credit: Getty

In recent years, it’s become increasingly apparent how much of our whole-body health relies on the bacteria in our gut, known as the gut microbiome.

One area the gut has a particular impact on is a person’s likelihood of being obese – one of, if not the, biggest risk factors for type 2 diabetes – and research has found many connections between the two.

For example, early exposure to antibiotics has been found to decrease the diversity of beneficial bacteria in the gut, and has been linked to the development of obesity later in life.

Consequently, Zenker says, a healthy gut is an important building block of diabetes remission. 

“There’s no one perfect gut, we all have our own unique microbiomes,” she says. But in general, a flourishing gut microbiome “supports healthy metabolism and healthy weight, and can directly and indirectly affect blood sugar balance.”

Tending to it means eating lots of probiotic and fibre-rich foods, as these produce short-chain fatty acids which help to regulate and process blood sugar.

Many of the foods we’ve already mentioned – vegetables, fruit, whole grains, nuts, seeds, legumes – are also excellent sources of different kinds of fibre.

“Getting variety is really the key, you don’t need to stress about which specific foods in particular,” says Zenker.

Probiotic foods – or fermented foods that contain living bacterial cultures – support gut health, too. At least one serving each day of yogurt, kefir, sauerkraut, kimchi, miso paste, tempeh, or nattō can go a long way in priming the gut.

4. Intermittent fasting and the fasting mimicking diet

One way to unlock diabetes remission is fasting, when conducted under the supervision of a medical professional.

A relatively new approach that’s had some success is the fasting mimicking diet (FMD), a strict eating regimen that mimics the effects of starving over the course of five days to help cells rebuild themselves stronger.

Endocrinologist Dr William Hsu – the chief health officer for biotech company L-Nutra, a leader in FMD medicine – describes the specialised diet as a process that kickstarts cell regeneration, driven by deprivation.

“Every life form on Earth has gone through periods of famine, and periods of plenty, and cells have had to adapt to the stress of no food,” he says. “When there’s no food, the cells say ‘I gotta survive, which part of the cell can I burn up to generate molecules so I can make it another day?’”

But the cell won’t digest the useful stuff, like its own nucleus. Instead, it will burn up “the cellular organelles that are broken and less valuable,” says Hsu, generating enough energy to keep going.

“If food never comes, the cell will die. But if the food comes on day four or five, you’ve gotten rid of the less valuable parts of the cell. When nature gives you stress, you turn that around to make the cells younger and better, you replace the old parts with new parts.”

This cellular autophagy, as the process is known, is a sort of cellular therapy that can significantly reduce dependency on diabetes medications, decrease insulin resistance, and in some cases cause total type 2 diabetes remission, per a six-month clinical trial by L-Nutra. Outside of diabetes research, FMD has also been studied as a potential prevention strategy for Alzheimer’s.

Hsu argues that while intermittent fasting – or fasting for a period of less than two consecutive days – and FMD both have metabolic benefits, FMD is considered more effective at achieving diabetes remission.

“[Intermittent fasting] is great metabolically because you’re eating less and not eating close to bedtimes,” he says. “There are many studies to show that intermittent fasting is helpful to reduce insulin resistance and improve glucose control.”

The FMD regimen usually lasts between four to seven days, eating a low-calorie, low-protein diet of plant-based foods and healthy fats. It is meant to mimic much more extreme deprivation, without putting the body through the real stress of surviving on zero nutrients.

“The cellular autophagy, replacing old parts with new parts, that only comes when the body senses a crisis moment,” he says.

FMD isn’t suitable for everyone, however, and requires a very delicate balance of foods to ensure you are still getting the nutrition you need, so it’s best to consult a qualified dietitian before starting.

5. Exercise after meals

When it comes to diabetes remission, all exercise is good exercise. Moving your muscles encourages them to take up glucose, bringing down your blood sugar. There are some surprisingly simple habits that can contribute to major reductions in your long-term blood sugar levels.

“A lot of patients have this all-or-nothing mentality, like if I can’t go to the gym five days a week then it’s no good,” Aje says. “But you don’t need to have a gym membership or do 50 minutes a day. Ten minutes here or there is great.”

Our muscles play a significant role in regulating blood sugar, she says. “One thing I tell my patients with early-onset diabetes is to go for a walk 15 minutes after eating, to allow the muscles to soak up the glucose.”

When you exercise can be just as important as how you exercise - Credit: Getty

Additionally, exercises like squats and calf raises can help the muscles absorb the glucose, too, preventing a spike.

“Prioritising strength training is best for blood sugar, the bones, and metabolism overall,” she says. “It’s not about the amount of time you spend in the gym, it’s about the intention.”

She adds that a little bit of movement after your lunch break at the office, or after dinner, can “really impact your blood sugars.”

“Any time of the day is better than nothing, but if you can prioritise some movement in the first 15 or 20 minutes after a meal, it’s much better for blood glucose.”

6. Stress relief

Stress is another factor which can have huge impacts on our health, including diabetes.

“Stress can increase a person’s risk of high cortisol, which can lead to higher blood sugar over time, and earlier onset of developing diabetes,” says Aje.

The body releases hormones like cortisol and adrenaline when it’s stressed. This triggers the release of glucose into the bloodstream, preparing the body for a ‘fight or flight’ response. Normally, insulin would tell your cells to soak up this excess glucose, but cortisol also blocks this signal. Over time, this can lead to cells becoming more and more resistant to insulin.

High levels of stress hormones can even stop insulin-producing cells in the pancreas from working properly and reduce the amount of insulin they make.

But researchers are uncovering new methods for stress and anxiety management as a therapy for type 2 diabetes. One study involving a 46-year-old man looked at the impact of Neuro-Emotional Technique (NET) – a “15-step stress-reduction Mind-Body Intervention aimed at improving physical and emotional health” – to treat his type 2 diabetes and chronic pain.  

After four weeks of NET treatment designed to reduce his body’s unique stress patterns, “glucose levels stabilised and psychometric tests demonstrated improvements in pain, stress, and emotional wellbeing,” the study’s authors wrote.

7. Social ties, community, and advocating for yourself

Diabetes remission is especially challenging without the right kind of support – both in and outside the doctor’s office. 

“The environment, community, and people we’re around affect all areas of our wellbeing, our choices, our exercise, our sleep,” Zenker says. “They also affect our mindset and beliefs. If you are in an environment that’s not so supportive of your wellbeing, like a food desert [where access to fresh and healthy food is limited], it can be really hard to shift to something better, even if you’re committed on your own.”

The people around us offer vital support when it comes to keeping our health on track - Credit: Getty

Having social support from friends, family, and neighbours can go a long way in staying on top of your remission goals.

On the medical side, you have to be your own loudest advocate. 

“The moment you get a diabetes diagnosis, pay close attention to it, and seek help,” Aje recommends. “If your primary care provider isn’t able to provide you with all the tools you need, ask for a referral to an endocrinologist to get things under better control. Those first 5–10 years after your diagnosis are very important.”

https://www.sciencefocus.com/the-human-body/7-simple-habits-that-could-reverse-diabetes

Diabetes Guide: Types, Symptoms, Causes and Treatments

From wtop.com/news

When you look at the numbers, the rate of diabetes in the U.S. is alarming. One in eight adults in the United States has diabetes, according to 2026 estimates from the Centers for Disease Control and Prevention. On top of that, an estimated 42% of adults have prediabetes, a condition that frequently progresses to diabetes if unmanaged.

What makes the growing prevalence of diabetes so concerning is that living with diabetes puts people at higher risk for other serious health problems. Diabetic retinopathy, for instance, is the leading cause of blindness in working-age adults and can lead to end-stage renal disease. Furthermore, if you have diabetes, you’re twice as likely to have heart disease or a stroke than someone who doesn’t have the disease. 

Types of Diabetes

There are several different types of diabetes. The most common are Type 1 and Type 2 diabetes.

Type 1 diabetes

Type 1 diabetes is an autoimmune disease in which the body’s immune system mistakenly attacks and destroys insulin-producing cells, known as beta cells, in the pancreas. Once these cells have been attacked, the body is unable to manufacture enough insulin on its own. Insulin is responsible for:

— Converting energy by turning sugar from carbohydrates into usable fuel

— Storing glucose for your body to use for future activities

— Regulating blood sugar levels so they don’t spike or drop too low

Formerly known as juvenile diabetes and insulin-dependent diabetes, Type 1 diabetes requires lifelong management.

Type 2 diabetes

While Type 1 diabetes is characterized by a complete lack of insulin, Type 2 diabetes develops when the body becomes resistant to the insulin it does produce. This is far and away the most common type of diabetes. About 95% of people with the disease have Type 2 diabetes, also known as noninsulin-dependent diabetes, the CDC reports.

Prediabetes

Almost half of the U.S. adult population, about 115 million adults, have prediabetes, the CDC notes. If left untreated, prediabetes can lead to Type 2 diabetes.

But prediabetes is not just a warning sign for diabetes; it is its own independent health condition. The insulin resistance that occurs in prediabetes can also lead to cancer, coronary artery disease, dementia and many of the other health conditions that diabetes can cause.

Gestational diabetes and other secondary types

While Type 1 and Type 2 account for nearly all diabetes cases, gestational diabetes and other secondary types of diabetes also occur.

— Gestational diabetes: This type develops during pregnancy in people who do not already have diabetes, affecting between 5% and 9% of pregnancies in the U.S. annually, according to the CDC. Gestational diabetes can raise the risk for a number of health issues, including high blood pressure during pregnancy and having a large baby, which can increase the chance of injuries during delivery to the mother or child. A cesarean section is sometimes needed in these situations.

— Type 3 diabetes: Some researchers have theorized that there is a Type 3 diabetes that causes Alzheimer’s disease. These researchers believe Alzheimer’s disease is caused by a kind of insulin resistance and insulin dysregulation in the brain. However, most health associations and many clinicians do not recognize Type 3 diabetes as an official diagnosis.

— Type 3c diabetes: Type 3c diabetes, often misdiagnosed as Type 2 diabetes, is a little-known form of diabetes also known as pancreatogenic diabetes. This form of diabetes occurs when the pancreas stops producing enough insulin, which can happen with illnesses such as pancreatic cancer, pancreatitis or hemochromatosis. Type 3c diabetes is estimated to affect 5% to 10% of all people with diabetes, according to research published in the Journal of the American Academy of Physician Assistants in 2022.

— Maturity onset diabetes for the young: This rare and inherited form of diabetes is caused by a gene mutation that disrupts insulin production.

— Latent autoimmune diabetes in adults: This form, often called Type 1.5, is a slow-progressing autoimmune condition frequently misdiagnosed as Type 2 diabetes.

Causes and Risk Factors

Depending on the type, diabetes can have multiple causes and risk factors.

Type 1 diabetes risk factors

The exact cause of Type 1 diabetes is unknown. However, the following factors may contribute to risk:

— Family history: Individuals with a parent or sibling with Type 1 diabetes have a slightly increased risk of developing the condition.

— Previous viral illness: A viral illness can trigger the immune system, which can lead to the development of Type 1 diabetes.

— Age: While Type 1 diabetes can appear at any age, it occurs at two noticeable peaks: The first peak occurs in children between ages 4 and 7, and the second peak is in kids between ages 10 and 14.

“While most people are diagnosed with Type 1 diabetes in their teens and 20s, people can develop Type 1 diabetes at any time. I once diagnosed a person in her 70s,” says Dr. Gillian Goddard, a New York City-based board-certified endocrinologist, nutritionist and adjunct assistant professor of medicine at the NYU Grossman School of Medicine.

Risk factors for Type 2, prediabetes and gestational diabetes

Because Type 2 diabetes, prediabetes and gestational diabetes share insulin resistance-related root causes, their risk factors overlap:

— Genetics and family history: If one parent has Type 2 diabetes, for instance, your chance of developing Type 2 diabetes is between 35% and 40%, Goddard says. If both parents have it, that probability surges to 60% or more.

— Lifestyle factors: Eating an unhealthy diet, combined with inactivity and having excessive fat, particularly around the abdomen, can contribute to your risk of developing prediabetes, gestational diabetes and Type 2 diabetes.

— Ethnicity: Individuals who identify as Black, Hispanic or American Indian have a higher risk of developing Type 2 diabetes.

— Gestational-specific age risk: Women over 25 are also more likely to develop gestational diabetes.

Symptoms and Early Warning Signs

Learning to recognize the early warning signs of diabetes can help you map out any preventive measures and potential treatment options.

Common symptoms of diabetes (all types)

— Increased thirst

— Frequent urination

— Bed-wetting in children who previously didn’t wet the bed at night

— Extreme hunger

— Unintended weight loss

— Irritability and other mood changes

— Fatigue and weakness

— Blurred vision

— Slow-healing sores

— Frequent infections

— Areas of darkened skin, typically around the armpits and neck

— Increased yeast infections

— Increased urinary tract infections

— Numbness or tingling in the hands and feet

Diabetic ketoacidosis symptoms

In addition to the symptoms above, people with diabetes with very high sugar levels may develop a condition called diabetic ketoacidosis, which has symptoms like:

— Nausea

— Vomiting

— Stomach pains

— Fruity odour to breath

— In severe cases, rapid breathing, known as Kussmaul respirations, which requires prompt emergency evaluation

Type 1 diabetes progression

Early symptoms of Type 1 diabetes are often easy to miss, says Dr. Bethany Gottesman, an endocrinologist at Phoenix Children’s Hospital in the greater Phoenix area.

“If you are diagnosed with Type 1 diabetes, there was nothing you did or did not do that caused the diabetes or could have prevented it,” she points out.

Type 1 diabetes has no cure and requires lifelong management. With modern technology, life expectancy for individuals with diabetes is now close to normal ranges.

Type 2 diabetes and prediabetes progression

Prediabetes and Type 2 diabetes typically progress slowly and develop over time, Gottesman says.

“After years of making increased amounts of insulin, eventually the pancreas can no longer produce enough to keep blood sugars in the normal range. So even though the body may still be making a lot of insulin, it is not enough to meet that person’s needs,” Gottesman explains.

Gestational diabetes progression

Many women may not have noticeable signs or symptoms of gestational diabetes because of their overlap with pregnancy-related issues, such as increased urination and fatigue.

Typically, gestational diabetes resolves after childbirth, but it does increase the likelihood of developing Type 2 diabetes later in life.

Diagnosis and Diagnostic Testing

Your primary healthcare provider can diagnose diabetes with an array of blood tests.

Test Type	Normal Range	Prediabetes Threshold	Diabetes Threshold	Details
A1c test	Below 5.7%	5.7% to 6.4%	6.5% or higher	The A1c test measures your blood sugar level over the past three months by tracking glucose attached to red blood cells.
Fasting blood sugar test	Below 100 mg/dL	100 to 125 mg/dL	126 mg/dL or higher	Your blood is taken first thing in the morning after you’ve avoided eating overnight, and it requires a follow-up A1c test if elevated.
Random blood sugar test	N/A	N/A	200 mg/dL or higher	This blood sample is drawn at a random time, regardless of meals, which requires a follow-up A1c test if elevated.
Oral glucose tolerance test for gestational diabetes	Below 140 mg/dL after one hour	140 to 189 mg/dL	190 mg/dL or higher at one hour	One hour after drinking a glucose solution, a lab technician checks your glucose levels. Borderline results require a follow-up three-hour test with three blood draws.

Treatment and Medical Management

Healthcare providers tailor treatments and medical management for the specific type of diabetes and the individual’s health needs.

Insulin

Insulin is an injectable peptide hormone that mimics the hormone naturally produced in the pancreas to regulate blood sugar.

Insulin treatments for diabetes may include:

Insulin Type	Example	Onset and Peak
Fast-acting	Humalog	Onset within 15 minutes and peaks an hour after injection, lasts up to four hours
Intermediate-acting	NPH or Humulin N	Onset within one to three hours after injection, reaches peak effectiveness between four and eight hours, lasts up to 12 hours
Long-acting insulin	Glargine	Onset after an hour, lasts 24 hours or longer

Insulin is a necessary and effective first-line treatment for Type 1 diabetes. People with Type 2 and gestational diabetes, however, often produce some insulin in their body, so they may not need insulin injections as part of their disease management regimen.

Noninsulin oral medications

Metformin is often the first drug prescribed for those with Type 2 diabetes and is sometimes prescribed for those with prediabetes. Metformin improves the body’s efficiency with the insulin that it does make.

Other medications that may help people with Type 2 diabetes lower their blood glucose levels include:

— Alpha-glucosidase inhibitors

— Biguanides (including metformin)

— Bile acid sequestrants

— Dopamine-2 agonists

— DPP-4 inhibitors

— Meglitinides

— SGLT2 inhibitors

— Sulfonylureas

— Thiazolidinediones

— Oral combination therapy

GLP-1s and dual GIP/GLP-1 agonists

The biggest recent advancement in treatment of Type 2 diabetes is more effective, long-acting GLP-1 and dual GIP/GLP-1 receptor agonists, Goddard says.

GLP-1 medications, such as semaglutide (Ozempic and Wegovy) and dual GIP/GLP-1 agonists tirzepatide (Mounjaro and Zepbound), are also injectable peptides, like insulin. These medications stimulate insulin production, slow gastric emptying and help regulate appetite.

“They not only lower blood sugar and help with weight gain, they also reduce the risk of cardiovascular disease, kidney disease and liver disease, all of which people with Type 2 diabetes are at increased risk for,” Goddard adds.

Blood glucose monitoring technology

People with diabetes need to monitor their blood sugar levels to manage their disease. 

The most cost-effective and common method is through a glucose meter, or glucometer. After you draw blood with a small finger prick, the glucometer measures your current blood sugar level.

There are also continuous glucose monitors, such as the Dexcom or FreeStyle machines, which are closed-loop systems that communicate with insulin pumps.

“These monitors adjust the rate at which insulin is given. It has been a huge step forward and uses technology to do a lot of work that patients and doctors used to do manually,” Goddard says.

Lifestyle Modifications and Prevention

Advanced medical technology and treatment are necessary for diabetes care, but lifestyle modifications and prevention strategies are still foundational for lowering the A1c naturally and protecting metabolic health.

The first step is creating goals for diabetes self-care, says Carole Jakucs, a board-certified diabetes nurse educator based in Los Angeles.

“We help patients identify what lifestyle habits they feel are important to change and what is doable and realistic for their lifestyle,” she explains.

Some of the goals that Jakucs suggests include:

— Exercise and physical activity: “One simple way to control post-meal blood glucose spikes is to take a 10-minute, moderate to brisk-paced walk after each main meal. If walking after each meal is not possible, then walking at least 15 minutes after the two largest meals or walking 30 minutes a day after the largest meal each day also helps,” she says. Generally, adults should aim for 30 minutes of aerobic activity five days per week.

— Dietary strategy and nutrition: Include lean protein with meals and snacks to delay gastric emptying, lessening your post-meal blood glucose spike. “Eating enough protein also helps to support muscle mass and increase satiety, which helps control appetite to prevent overeating,” Jakucs adds. Eating more fiber is also beneficial for blood sugar control and general health. If you are unsure what to eat, Jakucs recommends the “diabetes plate method”: Fill half your plate with non-starchy vegetables, such as greens, broccoli or squash; fill one quarter with lean protein, such as chicken; and fill the last quarter of your plate with a high-fiber carbohydrate, such as brown rice or quinoa.

— Carbohydrate counting: Counting carbs is especially important for anyone who is on mealtime (bolus) insulin and whose doctor has prescribed an insulin-to-carb ratio for dosing their bolus insulin appropriately.

— Weight loss if overweight or obese: “We know that if a person loses at least 5% to 10% of their weight, if they are overweight or obese, (that) can help reduce their level of insulin resistance and increase insulin sensitivity. This helps to lower their blood glucose,” Jakucs says.

— Quality sleep and stress reduction: “Emotional and physical stress and lack of sleep raise blood glucose because these raise the level of cortisol, the stress hormone, which triggers more glucose release from the liver,” Jakucs says. Aim for at least seven hours of quality, restorative sleep each night.

Long-Term Complications and Outlook

Diabetes, when left untreated, can cause long-term complications throughout the body:

— Heart and blood vessel disease

— Nerve damage (neuropathy)

— Kidney damage

— Eye damage, including cataracts, glaucoma and blindness

— Skin and mouth conditions

— Pregnancy complications, including risk of miscarriage, stillbirth and birth defects

— Slow healing of cuts and blisters

— Hearing impairment

— Sleep apnoea

— Alzheimer’s disease

— High blood pressure

Microvascular complications

Microvascular complications are when high blood sugar damages the body’s smallest blood vessels.

As glucose cells flow through the bloodstream, they injure the delicate linings of blood vessels. When glucose levels are consistently elevated, these vessels become weak and restrict blood flow. This can impact the eyes and the kidneys, which have vascular networks containing small capillaries and vessels.

Macrovascular complications

Diabetes also impacts larger blood vessels through inflammation and plaque build-up (atherosclerosis).

This effect causes narrowing and restriction of major vessels, blocking oxygen and leading to heart attack, stroke and peripheral artery disease.

Diabetic foot health

Food health is also a window into your overall diabetes management.

Because long-term elevated blood sugar damages both nerves and blood vessels, it damages the nerves and vessels in the feet. At the periphery of the body, the nerves in the feet are often the first to go, says Dr. Mikel Daniels, a board-certified podiatric surgeon and president and chief medical officer of WeTreatFeetPodiatry, with practices in Maryland, Washington, D.C. and Pennsylvania.

“They stop feeling pain, heat and pressure,” he adds. “I have patients who will walk in with a complaint of a blister that has opened into an ulcer through several layers of skin.”

Unmanaged diabetes can lead to:

— Absent pulses in the feet

— Shiny skin on the legs

— Thick nails

— Calluses and corns

— Skin ulcers

— Fungal infections in the toenails

Proper shoes, insoles, offloading (reducing pressure on the foot through special shoes, cushions or mobility devices) and diabetes management can change everything with your foot health, Daniels says.

To maintain your diabetic foot health, Daniels recommends checking your feet every day. Watch for:

— Colour changes, such as redness, darkening or streaks travelling up the foot or leg

— Redness around a callus or wound

— Pale or bluish colour

— Swelling

— Warmth

— Skin breakdown, such as cracks, blisters or open areas, regardless of size

— Drainage, such as blood or fluid

— Odour

— Temperature changes, such as one foot warmer than the other

— Nail and skin changes, such as thick, crumbly nails, fissures in the heel, white or soggy skin or dry and cracked skin

— Changes in shape, such as toes drifting or arch collapsing

If you notice any of these changes during an at-home foot check, message your primary care provider (PCP) or podiatrist right away. Even a small change, if left untreated, can lead to loss of function in the foot and sometimes require amputation.

https://wtop.com/news/2026/08/diabetes-guide-types-symptoms-causes-and-treatments/