Avoid diabetes complications

Type 2 diabetes is a complex, demanding disease; just ask any of the 30 million folks in the U.S. contending with it daily. As insulin resistance increases and blood glucose becomes harder and harder to manage, it’s necessary to pay almost constant attention to activity levels, diet and other lifestyle habits that can make or break one’s attempt to regain control.

That’s not easy. Less than half of folks with Type 2 diabetes are able to establish tight glucose control, despite the use of medications and lifestyle changes. That means they’re at serious risk for the cascade of complications that result from unstable and elevated blood glucose levels.

Everything from cardiovascular disease and ketoacidosis to kidney and nerve damage, blindness, gastrointestinal distress, depression, chronic wound infections, hearing loss, gum disease and dementia is associated with Type 2 diabetes.

Medications: There have been significant advances in medications to manage both diabetes and heart disease (statins and antihypertensives), as well as new classes of diabetes drugs (DPP-4 inhibitors, GLP-1-receptor agonists, and SGLT2 inhibitors), such as Januvia, Ozempic and Farxiga, that help manage glucose levels as well as kidney and liver problems and heart failure in order to extend lives.

They are often used in combination with basic medications such as metformin or, in more advanced cases, with insulin.

Lifestyle: Nondrug approaches have also gotten more effective, and we know how to prevent the onset in high-risk people and even reverse the disease with aggressive lifestyle changes in the early years after onset.

The DiRECT trial showed that within six years of diagnosis, by losing about 33 pounds on a low-calorie diet, 86% of folks with Type 2 will no longer have the disease a year later.