From the Guidelines
Type 2 diabetes symptoms include increased thirst, frequent urination, unexplained weight loss, fatigue, blurred vision, slow-healing sores, frequent infections, and areas of darkened skin (acanthosis nigricans), and treatment begins with lifestyle modifications and metformin therapy, as recommended by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) 1.
Symptoms of Type 2 Diabetes
- Increased thirst
- Frequent urination
- Unexplained weight loss
- Fatigue
- Blurred vision
- Slow-healing sores
- Frequent infections
- Areas of darkened skin (acanthosis nigricans)
Treatment Options
- Lifestyle modifications, including a balanced diet low in refined carbohydrates, regular physical activity (150 minutes weekly), and weight management
- Medication options, starting with metformin (500-2000mg daily), which reduces glucose production in the liver and improves insulin sensitivity
- Additional medications, such as sulfonylureas (glipizide, glyburide), DPP-4 inhibitors (sitagliptin, linagliptin), GLP-1 receptor agonists (semaglutide, dulaglutide), SGLT2 inhibitors (empagliflozin, dapagliflozin), or insulin therapy, may be added if metformin alone is insufficient
Blood Glucose Monitoring and Targets
- Blood glucose monitoring is essential, with target fasting levels of 80-130 mg/dL and post-meal levels below 180 mg/dL
- Regular A1C testing (goal typically <7%) helps track long-term control
- A reasonable HbA1c target for most nonpregnant adults with sufficient life expectancy to see microvascular benefits (generally <10 years) is around 53 mmol/mol (7%) or less, as recommended by the ADA and EASD 1
Comprehensive Cardiovascular Risk Reduction
- Comprehensive cardiovascular risk reduction must be a major focus of therapy, as atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death in people with type 2 diabetes 1
- Substantial reductions in ASCVD events and death are seen when multiple ASCVD risk factors are addressed simultaneously, with long-standing benefits 1
From the FDA Drug Label
Type 2 diabetes is a condition in which your body does not make enough insulin, and the insulin that your body produces does not work as well as it should. Your body can also make too much sugar. When this happens, sugar (glucose) builds up in the blood. This can lead to serious medical problems
The symptoms of type 2 diabetes are not explicitly listed in the provided drug labels. However, it is mentioned that high blood sugar can lead to serious medical problems.
- Treatment options for type 2 diabetes include:
- Diet and exercise
- Medicines such as metformin and pioglitazone, which can help lower blood sugar levels 2, 3, 3 It is essential to talk to a healthcare provider about how to prevent, recognize, and take care of low blood sugar (hypoglycemia), high blood sugar (hyperglycemia), and problems related to diabetes.
From the Research
Symptoms of Type 2 Diabetes
The symptoms of type 2 diabetes are not explicitly mentioned in the provided studies. However, common symptoms of type 2 diabetes include increased thirst and hunger, fatigue, blurred vision, slow healing of cuts and wounds, and frequent urination.
Treatment Options for Type 2 Diabetes
- Metformin: Often the first-line treatment for type 2 diabetes, metformin helps lower blood sugar levels by improving insulin sensitivity 4.
- Sulphonylureas: These medications stimulate the pancreas to release more insulin, but can cause hypoglycemia and weight gain 4.
- Pioglitazone: A thiazolidinedione that improves insulin sensitivity, pioglitazone can be used in combination with metformin or sulphonylureas to improve glycemic control 5, 6.
- GLP-1 Receptor Agonists: These medications, such as exenatide and liraglutide, help lower blood sugar levels by increasing insulin secretion and decreasing glucagon secretion 7.
- Insulin Glargine: A long-acting insulin that can be used in combination with oral medications to improve glycemic control 8.
Combination Therapies
- Pioglitazone + Metformin: This combination has been shown to improve glycemic control and lipid profiles in patients with type 2 diabetes 5, 6.
- Pioglitazone + Sulphonylurea: This combination has also been shown to improve glycemic control, but may increase the risk of hypoglycemia 5, 6.
- Insulin Glargine + Oral Medications: Adding insulin glargine to oral medications such as metformin or sulphonylureas can improve glycemic control, but may increase the risk of hypoglycemia 8.