Type 2 Diabetes: Recently Diagnosed

Overview

Is this topic for you?

This topic provides information for adults who have been diagnosed with type 2 diabetes within the last 6 weeks. If this topic does not answer your questions, see:

• Type 2 Diabetes, if you want to learn about type 2 diabetes.
• Type 2 Diabetes: Living With the Disease, if you have had type 2 diabetes for more than a month.
• Type 2 Diabetes in Children, if your child has type 2 diabetes.
• Type 2 Diabetes: Living With Complications, if you have eye, kidney, heart, nerve, or blood vessel disease caused by diabetes.

If you are looking for information about type 1 diabetes, see the topic Type 1 Diabetes.

What is type 2 diabetes?

The cells in your body need insulin to change glucose, the sugar that comes from the food you eat, into the energy you need to live. Without insulin, this sugar cannot get into your cells to do its work. It stays in your blood instead. Your blood sugar level then gets too high.

Type 2 diabetes usually begins with insulin resistance. This means that your pancreas is making enough insulin, but your cells are not able to use it. When your cells don't get the sugar they need, your pancreas works harder at first to make more insulin. But after a while, your pancreas stops being able to make enough insulin.

High blood sugar can harm many parts of the body. It can damage blood vessels and nerves throughout your body. You will have a bigger chance of getting eye, heart, blood vessel, nerve, and kidney disease.

Your weight, level of physical activity, and family history affect how your body responds to insulin. People who are overweight, get little or no exercise, or have diabetes in the family are more likely to get type 2 diabetes.

Type 2 diabetes is usually found in adults, which is why it used to be called adult-onset diabetes. But now more and more children and teens are getting it too.

Type 2 diabetes is a disease that you will always have, but you can live a long and healthy life by learning how to manage it.

What are the symptoms?

Many people have symptoms such as increased thirst and urination, weight loss, and blurred vision. Some people do not have symptoms, especially when diabetes is diagnosed early.

How is type 2 diabetes diagnosed?

Most likely you found out that you have diabetes when you saw your doctor for a regular checkup or for some other problem. Your doctor probably diagnosed type 2 diabetes by examining you, asking about your health history, and looking at the results of blood sugar tests.

How is it treated?

A healthy diet helps keep your blood sugar under control and helps prevent heart disease. Eating the right amount of carbohydrate at each meal is very important. Carbohydrate is found in sugar and sweets, grains, fruit, starchy vegetables, and milk and yogurt. A dietitian or a certified diabetes educator can help you plan your meals.

Eating right and getting more exercise are enough for some people to control their blood sugar levels. Others also need to take one or more medicines, including insulin.

You may need to take other steps to prevent other problems from diabetes. These problems are called complications. People with diabetes are more likely to die from heart and blood vessel problems like heart attack and stroke. If you are 40 or older, talk to your doctor about taking a low-dose aspirin each day to help prevent these or other large blood vessel diseases. You may also need medicine for high blood pressure or high cholesterol. If you smoke, quitting may help you avoid problems with your heart and large blood vessels.

What kind of daily care do you need?

The key to managing your diabetes is to keep your blood sugar level as close to normal as you can. You do this by eating right, exercising, and checking your blood sugar level as recommended by your doctor. Some people also need to take medicine. Learning the skills you need to manage your diabetes will take time, but soon they will become part of your daily routine.

It can be hard to accept that you have diabetes, especially if you have no symptoms. Feeling angry or frightened can prevent you from following your treatment plan. Talking about your feelings may help. Your doctor or other health professionals can help you cope with your diagnosis.

Health Tools

Health Tools help you make wise health decisions or take action to improve your health.

	Actionsets are designed to help people take an active role in managing a health condition.
	Diabetes: Checking your blood sugar
	Diabetes: Counting carbs if you don't use insulin
	Diabetes: Using a plate format for eating
	Interactive tools are designed to help people determine health risks, ideal weight, target heart rate, and more.
	Interactive Tool: Is Your Weight Increasing Your Health Risks?
	Interactive Tool: What Is Your Child's BMI?

Frequently Asked Questions

Cause

Type 2 diabetes develops when the following factors cause blood sugar (glucose) levels to rise:

• Your body's tissues are not responding properly to insulin, making it more difficult for cells to get glucose from the blood to make energy. This is called insulin resistance.
• Your pancreas is not producing enough insulin to overcome the insulin resistance. As diabetes progresses, your pancreas may produce less and less insulin.

Symptoms

Before being diagnosed, many people with type 2 diabetes have symptoms such as increased thirst and urination, weight loss, and blurred vision. But others do not have symptoms. You may not have had symptoms if your blood sugar level increased slowly over several years and your body adjusted to the rising level.

Diabetes is diagnosed when fasting blood glucose is 126 milligrams per deciliter (mg/dL) or higher, but some people do not notice symptoms until their blood sugar rises to 200 mg/dL or higher.

If you did have symptoms before your diagnosis, they will go away when your blood sugar level returns to a normal or near-normal range.

If your blood sugar level stays high, you may develop symptoms of high blood sugar, such as increased thirst, hunger, and urination, and blurred vision. You may not have symptoms of high blood sugar if your blood sugar level is only slightly elevated. The higher the level rises, the more likely you are to have symptoms. If you have higher-than-normal blood sugar and do not drink enough liquids, you can become dehydrated, which can lead to an emergency situation called a hyperosmolar state.

If your blood sugar is below a normal or near-normal range, you may have symptoms of low blood sugar, ranging from sweating and shakiness to confusion and loss of consciousness. These may occur as side effects of insulin or of certain oral medicines for type 2 diabetes, such as glyburide (DiaBeta), glipizide (Glucotrol), glimepiride (Amaryl).

Symptoms and signs of complications

You may already have one or more complications of diabetes. Be aware of possible complications and their symptoms, such as:

• Burning pain, numbness, or swelling in your feet or hands, which may indicate diabetic neuropathy. If one nerve is affected (focal neuropathy), you may have symptoms in one area of your body, such as your eye or face. Diabetic neuropathy can eventually affect your internal organs (autonomic neuropathy) as well, causing abdominal problems, sexual problems, and other kinds of symptoms. For more information, see the topic Diabetic Neuropathy.
• Blurred or distorted vision; seeing floaters or flashes of light, large floating red or black spots, or large areas that look like floating hair, cotton fibers, or spiderwebs; or pain in your eyes. Although eye disease is not likely to cause symptoms in its early stages, these symptoms may indicate diabetic retinopathy.
• A wound that won't heal or that looks infected, which may indicate damage to the blood vessels that supply that area.
• A heart attack, stroke, or peripheral arterial disease, which may indicate macrovascular disease.

If you have kidney damage (diabetic nephropathy), you may not notice symptoms. Early damage to your kidneys can be detected only with urine tests for protein.

What Happens

Following your prescribed treatment for type 2 diabetes will help keep your blood sugar levels within a normal or near-normal range and prevent or delay the progression of complications. With adequate treatment, you can live a long, healthy life.

Treatment involves eating a balanced diet that limits and spreads carbohydrate throughout the day to avoid sudden peaks in blood sugar, getting regular exercise, monitoring your blood sugar, and possibly taking oral medicines or insulin. For more information, see the Treatment Overview section of this topic.

You may experience times when your blood sugar level is above a normal or near-normal range. Recognize and treat high blood sugar early to prevent:

• A life-threatening situation called a hyperosmolar state that develops when the blood sugar level reaches 400 to 500 milligrams per deciliter (mg/dL) or higher. The risk for this condition starts to increase if your blood sugar stays above 200 mg/dL. Most often, a hyperosmolar state develops when a person with type 2 diabetes has an illness, such as a severe case of the flu or other infection; has a heart attack; is not drinking enough liquids and becomes dehydrated; or takes medicines that increase fluid loss (diuretics) or affect mental alertness, especially if the person is not drinking enough liquids to replace the lost fluids.
• Long-term complications from diabetes. Persistent high blood sugar can damage the eyes (diabetic retinopathy ), kidneys (diabetic nephropathy), nerves (diabetic neuropathy), heart (leading to heart attacks), and blood vessels (leading to strokes, peripheral arterial disease, and possibly amputation). Because you may have had higher-than-normal blood sugar levels (prediabetes) for years, you may already have one or more of these complications.

What Increases Your Risk

Type 2 diabetes can run in families. Certain factors increase your family members' risk for developing diabetes, including:

• Being overweight. A child whose BMI is in the 85th percentile or above for his or her age has a risk of developing type 2 diabetes in childhood. The risk for type 2 diabetes increases with weight gain (increasing body mass index, or BMI), especially a gain of more than 22 lb (10 kg) after age 18 in women or 18 lb (8.2 kg) after age 21 in men. Having a large amount of fat in the abdominal area also increases the risk.¹ To determine BMI, use the interactive tools:
  • Is Your Weight Increasing Your Health Risks?
  • What Is Your Child's BMI?
• Lack of exercise. Participating in physical activity less than once a week increases a person's chance of developing type 2 diabetes by 20% to 40%.¹ One large study found that women who were sedentary, especially those who watched a lot of television, were at higher-than-average risk for obesity and type 2 diabetes.²
• Having prediabetes, or impaired glucose tolerance. In the United States, about 54 million people have prediabetes and are at risk for developing type 2 diabetes.³ A large, long-term study showed that a nutritious diet and regular exercise can prevent type 2 diabetes. Lifestyle changes reduced the risk by 58% overall and by 71% in people older than 60.⁴

For a complete list of risk factors for type 2 diabetes, see the What Increases Your Risk section of the topic Type 2 Diabetes.

When to Call a Doctor

Call 911 or other emergency services immediately if you or your child is:

• Unconscious or becomes very sleepy unexpectedly. You or your child may have low blood sugar, called hypoglycemia. While waiting for emergency help, follow:
  • Emergency care for low blood sugar in people taking oral diabetes medicine.
  • Emergency care for low blood sugar for people taking insulin.
  • Emergency care for low blood sugar in a child who takes insulin.
• Drowsy, confused, breathing fast, and your or your child's breath smells fruity. You or your child may have high blood sugar, called hyperglycemia. A life-threatening condition called diabetic ketoacidosis could be present.

Call a doctor immediately if you or your child is vomiting and cannot keep down liquids and:

• Your blood sugar is 300 mg/dL or higher.
• Your child's blood sugar is 250 mg/dL or higher.

Call a doctor if you or your child:

• Is sick for more than 2 days (unless it is a mild illness, such as a cold), and you or your child:
  • Has been vomiting or had diarrhea for more than 6 hours.
  • Has followed the doctor's advice but it has not worked. Learn what to do when you are sick and have diabetes.
  • Has blood sugar levels that are often above 300 mg/dL and urine tests for ketones show more than 2+ or moderate or higher ketones.
• Has a blood sugar level that stays below the target range after eating some quick-sugar food.
• Has a blood sugar level that stays high after taking a missed dose of insulin or oral diabetes medicines or after taking an extra dose of insulin (if prescribed by the doctor).
• Has frequent problems with high or low blood sugar levels. The insulin dose or schedule may need to be changed.
• Is having difficulty knowing when blood sugar is low (hypoglycemia unawareness).
• Has problems following the meal plan or getting physical activity, and you want help.

Who to See

Health professionals who may be involved in your diabetes care include:

• A family medicine doctor.
• A general practitioner.
• A nurse practitioner.
• A physician assistant.
• An internist.
• A certified diabetes educator (CDE).
• A registered dietitian. All people newly diagnosed with diabetes should see a dietitian for help in choosing healthy foods.
• An endocrinologist.

If you have signs that a complication of diabetes may be developing or has developed, you may be referred to a specialist.

Exams and Tests

Your diagnosis of type 2 diabetes was based on the American Diabetes Association's (ADA) criteria for diagnosing diabetes. Your doctor used a medical history, a physical examination, and the results of blood sugar (glucose) tests to help make the diagnosis. For more information on these tests, see the Exams and Tests section of the topic Type 2 Diabetes.

Other tests

If you are diagnosed as having diabetes but it is not clear whether it is type 2 or type 1 diabetes, your doctor may do a C-peptide test. The C-peptide level results may be normal or increased if you have type 2 diabetes.

Because one or more diabetes complications may be present at diagnosis, it is recommended that you have:

• A complete eye exam (ophthalmoscopy) by an ophthalmologist or optometrist soon after being diagnosed.³ People with diabetes are at increased risk for eye disease.
• A urinalysis, to check for protein in your urine. If protein is present, additional testing will be done to help determine appropriate treatment. If protein is not present, a test will be done to see whether you have very small amounts of protein in your urine (microalbuminuria), which cannot be detected with a routine urinalysis. Protein in the urine can be a sign of kidney damage (diabetic nephropathy).
• An electrocardiogram (ECG, EKG), to check your heart function. This test is usually done even if you have not had a heart attack or do not have heart disease, because people with diabetes are at increased risk for heart disease.
• An exercise electrocardiogram (treadmill EKG test) before you begin a vigorous exercise program.
• A physical examination, including a foot exam, to see whether you have diabetic neuropathy. In some cases, you also may have an electromyogram (EMG) and nerve conduction study.
• A cholesterol test. High cholesterol can increase your risk for developing complications of diabetes, so it is important to know whether your cholesterol and triglyceride levels are healthy or need treatment.

Treatment Overview

Treatment for type 2 diabetes involves using diet, exercise, and often medicines to keep your blood sugar within a normal or near-normal range, reducing your risk of complications.

People with diabetes are 2 to 4 times more likely than people who don't have diabetes to die from heart and blood vessel diseases.⁵ If you are 40 or older, talk to your doctor about taking a low-dose aspirin daily to help prevent heart attack, stroke, or other large blood vessel (macrovascular) disease. You also can reduce your risk by lowering high blood pressure and high cholesterol. If you smoke, quitting may also lower your risk of diabetes complications.

Treatment to keep your blood sugar in a normal or near-normal range involves:

• Limiting and spreading carbohydrate throughout the day to prevent high blood sugar levels after meals. A registered dietitian can help you make a meal plan that fits your lifestyle. You likely will use one of several methods to plan your diet, such as the plate format, the food guide for diabetes, or carbohydrate counting. For more information on diet, see the Treatment section of the topic Type 2 Diabetes: Living With the Disease.

  Diabetes: Using a plate format for eating

  Diabetes: Counting carbs if you don't use insulin

• Doing moderate activity at least 2½ hours a week. One way to do this is to be active 30 minutes a day, at least 5 days a week. It's fine to be active in blocks of 10 minutes or more throughout your day and week. Also include resistance exercises in your exercise program.^{6, 7} Resistance exercises can include activities like weight lifting or yard work. Some tips for exercising safely may be helpful. See the topic Fitness for ideas on how to add daily activity to your life. Work with your doctor to plan a safe exercise program. It may also help to keep track of your exercise on an activity log (What is a PDF document?) .
• Testing your blood sugar to monitor your progress and find out how exercise and various foods affect your blood sugar. For more information, see:

  Diabetes: Checking your blood sugar.

• Taking oral diabetes medicine or insulin. For more information, see the Medications section of this topic.

Taking steps to prevent complications

People over the age of 40 who have diabetes should consider taking a low-dose aspirin every day to reduce the risk of cardiovascular complications.⁵

You should also control your blood pressure and reach and keep healthy cholesterol and triglyceride levels. High blood pressure and high cholesterol can increase your risk of developing complications of diabetes. If you smoke, quitting may lower your risk of diabetes complications.

How often should I see my doctor?

See your doctor about every 3 to 6 months for the rest of your life to:

• Review your blood sugar levels since your last checkup and evaluate whether your treatment needs to be changed.
• Check your blood pressure and start or adjust treatment if it's high.
• Check your feet for signs of diabetic foot problems.
• Have a hemoglobin A1c or similar test (glycosylated hemoglobin or glycohemoglobin). If your blood sugar levels are stable and your treatment hasn't changed, this test may be done every 6 months.
• Have a blood glucose test. Check the accuracy of your blood sugar meter at this time to see whether your home blood sugar tests are reliable.

Have these exams and tests yearly:

• An eye exam (ophthalmoscopy) by an ophthalmologist or qualified optometrist. Some doctors may recommend less frequent eye exams if you have no signs of diabetic retinopathy.
• A cholesterol (LDL and HDL) and triglyceride test. If your levels are normal, you may be tested every 2 years.
• A urine test for protein. This test is important for detecting and monitoring diabetic nephropathy.

What happens if my blood sugar level is very high?

If you have a severe infection or other illness, or become severely dehydrated, or do not take your diabetes medicine (pills or insulin), your blood sugar level may rise very high and cause a dangerous condition called a hyperosmolar state. Hyperosmolar state is usually treated in a hospital, often in the intensive care unit. There you are closely observed and receive frequent blood tests for glucose and electrolytes. Insulin will be given to you through a vein (intravenous, or IV) to lower your blood sugar level. Fluids will be given through the IV to correct the dehydration. The fluids will make you urinate, removing the excess glucose from your body.

What to Think About

You have just been diagnosed with a disease that requires daily attention for the rest of your life. You may feel angry or resentful about having diabetes, or you may want to deny that you have it. These feelings are normal, because you are experiencing the loss of what your life was like before you were diagnosed. Allow yourself time to grieve your losses. For more information, see the topic Grief and Grieving.

Feeling angry, resentful, or frightened can prevent you from following your treatment plan. You may benefit from seeing a professional counselor to help you cope with having diabetes.

If you have signs of heart and blood vessel complications from diabetes, you may need a thorough heart exam, including an electrocardiogram (ECG, EKG) or an exercise electrocardiogram (treadmill EKG test), before beginning a vigorous exercise program.

Prevention

Because you have type 2 diabetes, you need to take precautions to protect yourself from life-threatening situations and prevent or delay the progression of long-term complications.

Prevent complications

People with diabetes are 2 to 4 times more likely than people who don't have diabetes to die from heart and blood vessel diseases.⁵ If you are age 40 or older, talk to your doctor about taking a low-dose aspirin daily to help prevent heart attack, stroke, or other large blood vessel disease (macrovascular disease). You can reduce your risk further by lowering high blood pressure and high cholesterol. If you smoke, quitting may also lower your risk of diabetes complications.

Exercise helps prevent heart disease. Exercise helps control your blood sugar by using glucose for energy during and after activity. It also helps you maintain a healthy weight; lower high cholesterol; raise high-density lipoprotein (HDL), or "good," cholesterol; and lower high blood pressure. Do activities that raise your heart rate. Try to do moderate activity at least 2½ hours a week. ⁷ One way to do this is to be active 30 minutes a day, at least 5 days a week. Also include resistance exercises in your program.⁶ Resistance exercises can include activities like weight lifting or yard work. See the topic Fitness for ideas on to how add daily activity to your life. Work with your doctor to plan a safe exercise program.

Prevent high blood sugar emergencies

Blood sugar usually rises above a normal or near-normal range slowly, but it can lead to a life-threatening emergency called a hyperosmolar state if it is not treated quickly. Your blood sugar may rise when you are ill, so follow the guidelines for when you are sick to help prevent a high blood sugar emergency.

Prevent low blood sugar emergencies

Low blood sugar is not likely to develop, unless you take insulin or some kinds of oral medicines for type 2 diabetes that can cause low blood sugar as a side effect. If you are at risk for low blood sugar, recognize and treat your symptoms early. Low blood sugar can lead to a life-threatening emergency if it is not treated quickly. Do not drive if your blood sugar level is below 70 milligrams per deciliter (mg/dL). Take precautions when you are driving, and be prepared to stop and treat low blood sugar.

Wear medical identification

Wear medical identification at all times. If you are involved in an accident or taken to a hospital, identification lets people know that you have diabetes, so they can care for you appropriately. You can buy medical identification as bracelets, necklaces, or other forms of jewelry at your local pharmacy.

Home Treatment

You play a major role in managing your diabetes. The more you know about your disease, the better you can care for yourself. For the best chance at a long, healthy life, you need to set goals for your treatment, including taking an aspirin, following your diet, getting regular exercise, maintaining your target range for blood sugar control, and caring for your feet. If you are overweight, remember that even a small weight loss (5% to 10% of your weight) can help you achieve normal blood sugar levels.

Take an aspirin daily

If you are age 40 or older, talk to your doctor about taking a low-dose aspirin daily to help prevent heart attack, stroke, or other large blood vessel disease (macrovascular disease).⁵

Follow your diet

Work with a dietitian to plan menus that help you spread carbohydrate throughout the day to keep your blood sugar from rising sharply after meals.

Get regular exercise

Start including exercise in your daily life. Do activities that raise your heart rate. Try to do moderate activity at least 2½ hours a week. ⁷ One way to do this is to be active 30 minutes a day, at least 5 days a week. Also include resistance exercises in your program.⁶ See the topic Fitness for ideas on how to add daily activity to your life.

Maintain blood sugar control

Check your blood sugar level often so you can learn how exercise and various foods affect it. For more information, see:

Diabetes: Checking your blood sugar.

Quit smoking

If you smoke, quitting may help lower your risk of diabetes complications.

Care for your feet

Inspect your feet every day to look for cuts or other signs of injury. (If you have poor eyesight, have someone else check your feet.) Diabetes can damage the nerve endings and blood vessels in your feet, making you less likely to notice when your feet are injured. Diabetes also interferes with your body's ability to fight infection-if you develop a minor foot injury, it could develop into an ulcer or a serious infection.

With good foot care, you can prevent most of these problems. For more information on foot care, see the topic Type 2 Diabetes: Living With the Disease.

Medications

Oral medicines to treat type 2 diabetes increase insulin production, decrease insulin resistance, or slow intestinal absorption of carbohydrate, the nutrient that most affects blood sugar.

Two or more medicines may lower your blood sugar level more effectively than a single medicine. Also, taking two or more medicines may reduce side effects by allowing lower doses of each medicine.

You may need to take insulin temporarily if you have surgery or are severely ill, pregnant, or breast-feeding. You also may need to take insulin daily by injection if your doctor believes that you would benefit from it or if your pancreas stops producing insulin.

Medicines also may be used to reduce your risk of complications. A daily low-dose aspirin may help prevent a heart attack, stroke, or other large blood vessel disease (macrovascular disease). If you are age 40 or older, talk with your doctor about taking aspirin as part of your treatment.⁵ You can reduce your risk further by lowering high blood pressure and high cholesterol.

Medication Choices

Medicines that increase insulin production

• Sulfonylureas, such as glipizide (Glucotrol), glyburide (for example, DiaBeta, Glynase, or Micronase), glimepiride (Amaryl), the medicine that combines glyburide and metformin (Glucovance), and the medicine that combines glipizide and metformin (Metaglip)
• Meglitinides, such as repaglinide (Prandin), nateglinide (Starlix), and the medicine that combines repaglinide and metformin (Prandimet).
• Selective dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors), such as sitagliptin (Januvia) and the medicine that combines sitagliptin and metformin (Janumet).

Medicines that decrease insulin resistance

• Biguanides, such as metformin (Glucophage or Glucophage XR), the medicine that combines glyburide and metformin (Glucovance), the medicine that combines rosiglitazone and metformin (Avandamet), the medicine that combines metformin and glipizide (Metaglip), and the medicine that combines repaglinide and metformin (Prandimet).
• Thiazolidinediones, such as rosiglitazone (Avandia), pioglitazone (Actos), and the medicine that combines rosiglitazone and metformin (Avandamet)

Medicines that slow intestinal absorption of carbohydrates

• Alpha-glucosidase inhibitors, such as acarbose (Precose) or miglitol (Glyset)

A new type of medicine that lowers both fasting blood sugar and blood sugar after eating

• Incretin mimetics, such as exenatide (Byetta). Exenatide (Byetta) recently was approved by the U.S. Food and Drug Administration (FDA) for people with type 2 diabetes. Your doctor may recommend Byetta if you have not been able to control your blood sugar with oral medicines such as metformin or a sulfonylurea. Byetta may be taken with other oral medicines. It is given as a shot 2 times a day, before morning and evening meals.

Insulin

• Insulin

A new medicine called pramlintide (Symlin) was approved by the FDA to be used with insulin. It may be used in people with type 1 or type 2 diabetes who take insulin. Symlin is a man-made form of the hormone amylin. Amylin is made in the pancreas. It works with insulin and glucagon to help control blood sugar. Symlin is given as a shot before meals.

What to Think About

You may also need to take:

• Medicines that control blood pressure, if you have high blood pressure.
• Medicines that control cholesterol, if you have high cholesterol.
• An angiotensin-converting enzyme (ACE) inhibitor, angiotensin II receptor blocker (ARB), if you have protein in your urine, an indication of diabetic nephropathy. If you become pregnant, your doctor will prescribe other medicines, because ACE inhibitors and ARBs cannot be taken during pregnancy.

The U.S. Food and Drug Administration (FDA) has announced a possible safety issue with the drug rosiglitazone (Avandia). A new study shows that people who take Avandia may raise their chance of having a heart attack. They may also raise their chance of death from heart disease.

Manufacturers of rosiglitazone (Avandia), pioglitazone (Actos), and the combination medicines rosiglitazone and glimepiride (Avandaryl), rosiglitazone and metformin (Avandamet), and pioglitazone and glimepiride (Duetact) have added a warning that these drugs may cause heart failure or make heart failure worse in certain people.

If you take any of these medicines, do not stop taking them. Call your doctor to talk about which medicine is best for you.

Surgery

Bariatric surgery can be used in some cases to treat type 2 diabetes.

Other Treatment

Avoid products that promise a 'cure' for diabetes. No such cure exists. If you have questions about a product for diabetes, check with your local American Diabetes Association office, your doctor, or a diabetes educator.

Other types of meal plans

You may hear of people with diabetes following meal plans other than those typically recommended by diabetes experts. Talk with a registered dietitian before choosing an alternate meal planning method for your or your child's diabetes diet.

Complementary therapies

Complementary therapies, such as acupuncture or biofeedback, may help relieve stress and muscle tension and improve your overall well-being and quality of life. Talk with your doctor if you are using any complementary or alternative therapies, including chiropractic therapy and osteopathy.

Herbal medicines and natural substances, such as antioxidants, vanadium, magnesium, or chromium, may be helpful but should be taken only under your doctor's supervision. Talk with your doctor about any herbal or natural products that you are taking or that you want to take.

Other Places To Get Help

Organizations

Related Information

• Diabetic Nephropathy
• Diabetic Neuropathy
• Diabetic Retinopathy
• Fitness
• Type 2 Diabetes
• Type 2 Diabetes in Children
• Type 2 Diabetes: Living With Complications
• Type 2 Diabetes: Living With the Disease

References

Citations

1. Capes S, Anand S (2001). What is type 2 diabetes? In HC Gerstein, RB Haynes, eds., Evidence-Based Diabetes Care, pp. 151-163. Hamilton, ON: BC Decker.

2. Hu FB, et al. (2003). Television watching and other sedentary behaviors in relation to risk of obesity and type 2 diabetes mellitus in women. JAMA, 289(14): 1785-1791.

3. American Diabetes Association (2008). Standards of medical care in diabetes. Clinical Practice Recommendations 2008. Diabetes Care, 31(Suppl 1): S3-S110.

4. Diabetes Prevention Program Research Group (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. New England Journal of Medicine, 346(6): 393-403.

5. American Diabetes Association (2004). Aspirin therapy in diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 27(Suppl 1): S72-S73.

6. Sigal RJ, et al. (2006). Physical activity/exercise and type 2 diabetes: A consensus statement from the American Diabetes Association. Diabetes Care, 29(6): 1433-1438.

7. U.S. Department of Health and Human Services (2008). 2008 Physical Activity Guidelines for Americans (ODPHP Publication No. U0036). Washington, DC: U.S. Government Printing Office. Available online: http://www.health.gov/paguidelines/pdf/paguide.pdf.

Other Works Consulted

• American Diabetes Association (2008). All About Diabetes. Available online: http://www.diabetes.org/about-diabetes.jsp.

• American Diabetes Association (2008). Nutrition principles and recommendations in diabetes. Clinical Practice Recommendations 2004. Diabetes Care, 31(Suppl 1): S61-S78.

• Amorosa LF, Swee DE (2007). Diabetes mellitus. In RE Rakel, ed., Textbook of Family Medicine, 7th ed., pp. 989-1020. Philadelphia: Saunders Elsevier.

• Dixon JB, et al. (2008). Adjustable gastric banding and conventional therapy for type 2 diabetes. JAMA, 299(3): 316-323.

• Gray DS (2006). Diabetes mellitus, type 2. In MR Dambro, ed., Griffith's 5-Minute Clinical Consult, pp. 322-323. Philadelphia: Lippincott Williams and Wilkins.

• Saenz A, et al. (2007). Metformin monotherapy for type 2 diabetes mellitus. Cochrane Database of Systematic Reviews (4).

• Sigal RJ, et al. (2006). Physical activity/exercise and type 2 diabetes: A consensus statement from the American Diabetes Association. Diabetes Care, 29(6): 1433-1438.

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