Diabetes: Treatment Overview

Reviewed by the Office of Clinical Evaluation and Policy (OCEP), Evernorth

Diabetes, also known as diabetes mellitus, is a medical condition that develops when blood sugar (glucose) levels are too high. It is a common condition that affects millions of Americans each year. For some people, diabetes can go undiagnosed since their blood sugar levels may be higher than usual but not high enough to be considered diabetes. The symptoms of diabetes can vary depending on blood sugar levels and often include frequent urination (polyuria), increased thirst (polydipsia) and increased hunger (increased hunger).

Diabetes treatment options are available and usually covered by health insurance. The type of diabetes treatment prescribed will depend on the type and severity of diabetes being treated. Always talk to a doctor about the best treatment option for you.

Continue reading to learn more about the different treatment options available for diabetes.

The different types of diabetes

Different types of diabetes can develop in children and adults. The most common types of diabetes are type 1 diabetes, type 2 diabetes and gestational diabetes. Other types of diabetes are less common and include monogenic diabetes and cystic fibrosis-related diabetes.

Type 1 diabetes

Type 1 diabetes is characterized by an inability of the pancreas to make insulin. Without insulin, the body is unable to use blood sugar for energy. Type 1 diabetes is an autoimmune condition in which the body’s immune system attacks and destroys the cells of the pancreas. It is typically diagnosed in children and young adults. People with type 1 diabetes need to use insulin every day.

Type 2 diabetes

Type 2 diabetes is the most common type of diabetes. Up to 95% of people with diabetes have type 2 diabetes. With type 2 diabetes, the body might not make enough insulin, or the body's cells are unable to respond well to insulin. It is usually diagnosed in adults and can be treated with oral medications and lifestyle changes. In severe cases, insulin may be recommended.

Gestational diabetes

Gestational diabetes is a type of diabetes that can develop in pregnant women who do not already have diabetes. Gestational diabetes affects up to 10% of pregnant women in the United States each year. The treatment for gestational diabetes generally includes monitoring blood sugar levels, eating right, exercising and insulin injections, as needed.

Diabetes treatments

Different factors can play into which diabetes treatment option is best for you. These factors may include how well the treatment works to control your blood sugar levels, the cost of the medication and your other medical conditions or medications..

Diet and exercise

Diet and exercise are the cornerstones of diabetes treatment regimens. Eating the proper diet can help manage weight, blood pressure and the body’s ability to respond to insulin. Eating the right portions of foods is important, as well as avoiding or limiting your consumption of carbohydrates and sugary foods or drinks. Exercise is also effective in treating diabetes, as it helps improve the body’s sensitivity to insulin.

Insulin

Insulin is a standard treatment option for type 1 diabetes, although it may sometimes be recommended in people with type 2 or gestational diabetes. Insulin can be injected subcutaneously (into the fatty tissue under the skin) through a syringe, an insulin pen or an insulin pump. Some types of insulin may also be inhaled. There are different types of insulins available, such as rapid-acting, short-acting, intermediate-acting and long-acting insulin. Insulin may need to be administered throughout the day before meals or once daily, depending on the type.

Oral medications

Other diabetes medications usually treat type 2 diabetes if lifestyle changes are not enough. Diabetes medications work in different ways, may cause different side effects, and have different costs. Most people who are diagnosed with type 2 diabetes start treatment with metformin, which works to help the body use insulin more effectively. Other common oral medications prescribed include sulfonylureas (such as glyburide, glipizide, or glimepiride), meglitinides, also known as glinides (such as replaglinide and nateglinide), didpeptidyl peptidase-4 (DPP-4) inhibitors (such as Januvia®, Nesina®, Onglyza® or Tradjenta®), thiazolidinediones (such as pioglitazone), oral glucagon-like peptide-1 receptor (GLP-1) agonists (such as Rybelsus®), and sodium-glucose cotransporter 2 (SGLT2) inhibitors (such as Farxiga®, Invokana®, Jardiance® and Steglatro®) . There are several products available that are a combination of these medications.

Non-insulin injectable medications

Non-insulin injectable medications are administered subcutaneously and include amylin analogs (such as SymlinPen®), GLP-1 agonists (such as Adlyxin®, Bydureon®, Byetta®, Ozempic®, Trulicity® and Victoza®), and combination injectables (such as MounjaroTM).

The importance of treating diabetes

Treating diabetes is critical for preventing problems and complications caused by diabetes. High blood sugar levels may increase your chance of developing kidney problems, eye problems, nerve problems, heart disease, foot infections and sexual dysfunction. If you are living with diabetes, consult with your healthcare provider to find the best diabetes treatment option for you.

Sources:

• https://www.diabetes.org/about-us/statistics/about-diabetes
• https://www.cdc.gov/diabetes/basics/quick-facts.html
• https://www.cdc.gov/diabetes/basics/gestational.html
• https://www.diabetes.org/healthy-living/fitness/getting-started-safely/blood-glucose-and-exercise
• https://my.clevelandclinic.org/health/diseases/7104-diabetes-mellitus-an-overview
• https://www.niddk.nih.gov/health-information/diabetes/overview/insulin-medicines-treatments
• https://www.mayoclinic.org/diseases-conditions/diabetes/diagnosis-treatment/drc-20371451