Why Are There So Many Different Treatments for T2D?

Why Are There So Many Different Treatments for T2D?

Living with Type 2 Diabetes (T2D) can sometimes feel like a full-time job.

Not only is it emotionally and mentally taxing trying to keep track of all the little things we need to do, change, and stay on top of – there are so many different options when it comes to treatments. What works for one person may not work for you! Basically, the options break down into lifestyle changes, dietary changes, and medication, which includes insulin.

One Diagnosis, Many Treatments

This article is going to be a little technical at times. The intent is to give you some idea of what to expect from your healthcare team. The “team” can include your family doctor, a specialist, nurse educator, dietician and nutritionist. The conventional approach to managing T2D typically means changing certain habits. Specifically, we change our relationships with food and increase our physical activity. Changes in diet and activity levels are presumed to help regulate blood sugar levels. And, as fat metabolizes insulin differently from muscle, the more muscle we build, even if we’re not dropping numbers on the scale, theoretically we’ll be better off in the long run.

How This Impacts You

That being said, as you change your food and activity habits, it’s very possible that you’ll throw your blood glucose levels out of whack on your way to fixing them. This is why it’s so important to have a trusting and supportive relationship with your health care professionals. Also, it’s one of the reasons medication is often a necessity. It can help us adjust as we’re changing our meal plans, but, also, it can help keep things balanced if the other changes we make don’t have a relatively quick impact. And, unfortunately, even at the best of times, real change can take a long time and a ton of work to have a real impact.

When you start to look at the different medications available, it can make you dizzy. There are so many possible options, different combinations, and permutations when it comes to diabetes treatment in general, let alone T2D. It all boils down to the individual – you and your specific circumstances. And even then, it’s no picnic figuring it out.


This is where we really get technical. There are 9 different types of medication for treating T2D. They are:

  • Alpha-glucosidase inhibitors: helps your body break down starchy foods and sugar
  • Biguanides: these decrease how much sugar your liver makes, how much sugar your intestines absorb, increase your body’s sensitivity to insulin, and help your muscles absorb glucose. Essentially, this is Metformin, which is one of the first things most physicians will try when it comes to medication for T2D.
  • Dopamine agonist: these tend to help prevent insulin resistance.
    DPP-4 inhibitors: help the body continue to produce insulin by reducing blood sugar without causing hypoglycemia. They can also help the pancreas produce more insulin.
  • Glucagon-like peptides: these are very similar to incretin, a natural hormone. Ultimately, they increase B-cell growth and how much insulin your body uses, while decreasing your appetite and how much glucagon your body uses. They can also help to keep your stomach fuller longer.
  • Meglitinides: they help your body release insulin, but they’re not for everyone; it’s possible, in some situations, that they can lower blood sugar too much, which can be dangerous.
  • Sodium Glucose Transporter (SGLT) 2 Inhibitors: say that five times fast! SGLT’s prevent the kidneys from holding onto glucose by allowing you to get rid of it through your urine.
  • Sulfonylureas: these are some of the oldest diabetes meds still in use. They stimulate the pancreas with a little help from beta cells, causing your body to produce more insulin.
  • Thiazolidinediones: decrease glucose in your liver, while helping your fat cells use insulin more productively. However, and this is a big however, there’s an increased risk of heart disease with these medications.

As you can see, there are plenty of options available – and these are just the types of medication. Doctors are the gateway to these drugs and its up to them to find exactly the right category of medication, and the specific drug that will work best for you and your needs.

But, in some cases, meds just don’t work. At least not right away. That can be both frustrating and disappointing for you. Sometimes it can take some tinkering with a dosage before your doctor gets it right. In order to make sure that blood glucose levels, general health, and other important factors are kept in check, it’s important for your doctor to balance your meds carefully, and properly. It can take time to land on the right medication and the right dosage that does the trick for you.

The Takeaway

Basically, there are many options when it comes to treatment. The options of medication alone can be overwhelming, and the process of finding the right combination of diet, activity, and meds can be long and difficult. Depending on how our bodies react, it’s possible to need a combination of medications on top of a diet plan. The key is to get it right. And sometimes that just takes time, the right team and the personal perseverance to work through the difficult, frustrating times.


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2018-11-13T14:10:25+00:00November 5th, 2018|Emotions, Managing, Patient-Centered|

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