New Advancements In Treating Diabetes

Living with diabetes means constantly being aware of the foods you eat, the activity you do, the medication you take, and all the other factors that can impact your blood sugar levels. It takes effort to maintain your health when facing diabetes.

The advancements in diabetes care are helping the 38 million Americans who have type 1 or type 2 diabetes live better and comfortably manage their blood sugars.

Milli Gupta, MD, endocrinologist and internal medicine physician with the Franciscan Physician Network Munster Medical Center, explains the advancements in diabetes treatments and how they improve life with diabetes.

"There are two buckets when it comes to the treatment of diabetes," Dr. Gupta said. "One is lifestyle changes, and the other one is treatment agents or medications."

Lifestyle Changes Still Matter

"Lifestyle changes are key, and you could say 50% of managing diabetes depends on it," Dr. Gupta said. "Some people don't believe in lifestyle changes, and some people believe almost too much in lifestyle changes. They think if they change their diet and start exercising, they will be able to cure diabetes completely. Neither are true."

Lifestyle changes can help people reduce weight and the demand on the pancreas.

"If somebody is eating a lot of sugar or they're obese, then the pancreas would have to work harder," Dr. Gupta said.

Diabetes And Your Diet

When you have diabetes, it’s important that you eat sensibly, choosing healthy foods in moderate amounts. A dietitian may help you plan meals that will help you to control your blood sugar and lose or gain weight if that’s also needed. In addition, you may need to eat on a schedule to keep your blood sugar on an even keel. 

Experts at the Joslin Diabetes Center recommend that each meal is balanced, pairing protein with carbs and healthy fats in one meal or snack for more stable glucose levels.

The National Institute of Diabetes and Digestive and Kidney Diseases recommends these types of foods if you have diabetes:

• Healthy carbs 
• Foods higher in fiber
• Heart-healthy proteins 
• Good fats
• Dairy. 

Foods to limit or avoid may include:

• Foods that are high in saturated fat 
• Foods high in cholesterol
• Foods high in sodium
• Foods that are highly processed

Healthy Activity Matters

Exercise is important when you have diabetes. Physical activity may help you control your blood sugar levels and lower your risk for heart disease and nerve damage. You may need to check your blood sugar levels before and after exercising. 

Medications To Support Lifestyle Changes

Your provider can also suggest weight loss medications such as GLP-1 medications such as Ozempic or Wegovy to assist your lifestyle changes. These medications may help you improve blood sugar levels, lose weight, or both.

"I feel that GLP-1 has been the most revolutionary in the last few decades," Dr. Gupta said. "They resemble a hormone that the body already produces and they work on receptors in the body to reduce craving for food, but it's not an appetite suppressant completely. Also, it doesn't harm the body in any way. Still, we don't give these types of medication to people who've had pancreatitis episodes, medullary thyroid cancer or those planning pregnancies."

Even though these newer medications have their benefits, Dr. Gupta explained that they can still have side effects or patients can have intolerances such as nausea or gut-related side effects.

"I think these medications have brought about a lot of change and hope," Dr. Gupta said. "Sometimes losing weight could change around a person's whole life, not just cosmetically, but in terms of overall health and cardiovascular risk factors."

Medication Management For Diabetes

Several diabetes medications are used to treat diabetes and maintain good glucose control. 

Here’s a look at treatments by diabetes type:

Type 1 Diabetes Medications

Treatment for type 1 diabetes may include taking insulin through a needle and syringe, insulin pen, or insulin pump with or without an automated insulin delivery system.

Dr. Gupta explained that patients are put on insulin as soon as possible for type 1 diabetes. No lifestyle change can help type 1 diabetic patients avoid insulin.

"Even with type 1 diabetes, if you lose weight or if you eat better, you'll still need medication," Dr. Gupta said. "It can be life-threatening for type 1 diabetics if they don't take insulin, while type 2 diabetics can avoid insulin for some time.”

There are many types of insulin available for people with diabetes, and these insulins differ in how much time they each take to start working and how long they last. Some premixed insulins are a mixture of different insulin types. Patients should work closely with their healthcare provider to decide on the appropriate insulin therapy.

Type 2 Diabetes Medications

Medications for type 2 diabetes may include insulin, medication with pills or injections, or both.

“Your pancreas is like a tired horse with diabetes and you're trying to flag it with medication,” Dr. Gupta said. “Oral medications are able to tell the pancreas to somehow work and meet the deadline."

If enough insulin isn't being produced by the pancreas, you need it as a shot.

"As for the shot, we'll start with once a day for full blown diabetes, which is a long-acting insulin," Dr. Gupta said. "There also comes a point where someone may need a short-acting insulin with each meal. I know that sounds daunting, but insulin is one of the oldest medications discovered, and it's come a long way. Delivering insulin has become more and more user-friendly. There are tools to help people inculcate these things in their lifestyle."

Other medications that may be prescribed include:

• Metformin. Metformin works by lowering the amount of sugar produced in the liver and improving your body’s sensitivity to insulin. As a result, you use insulin more efficiently.
• Sulfonylureas. This medication helps your body secrete more insulin. 
• Meglitinides. This medication is designed to stimulate the pancreas to secrete more insulin at mealtime. 
• Alpha-glucosidase inhibitors. These medications slow the digestion of sugar.
• Thiazolidinediones. This medication makes cells more sensitive to insulin. 
• DPP-4 inhibitors. This medication is designed to help the body release more insulin. 
• GLP-1 receptor agonists. This medication is injected and designed to slow digestion and help lower blood sugar levels.
• SGLT2 inhibitors. This medication works by affecting the blood-filtering functions in the kidneys by blocking the return of glucose to the bloodstream. As a result, glucose is removed in the urine.
• Biguanides. These medications limit sugar produced in the liver. Combination medicines, typically with metformin plus another drug, may also be recommended.

Improvements In Monitoring Blood Sugar Levels

Keeping an eye on blood sugar levels while on the go is easier than ever with new technology to monitor glucose levels.

"One advancement in diabetes care is how we measure glucose," Dr. Gupta said. "Traditionally, there is a glucometer with strips in it. There are also lancets where you have to poke your finger to get a drop of blood and check the glucose."

Lancets require patients to poke themselves multiple times a day to read their sugar levels, which can feel inconvenient to some people. A new technology called continuous glucose monitoring helps people with diabetes quickly and easily watch their blood sugar levels and may bring better quality of life and control to people facing diabetes.

"Now we have continuous glucose monitors, where you have a small disc that can be attached to the arm, abdomen or any surface on the body that won't be impacted during sleep," Dr. Gupta said. "The device that stays on for a few days and checks your sugar every few minutes without you having to poke your finger."

Mental Health Matters In Diabetes Control

While technological and medication advancements are helping people with diabetes improve their blood sugar control, it does take daily effort to accept and manage your health following a diabetes diagnosis.

"As an endocrinologist, I would say, I think the most important thing regarding diabetes is acceptance versus denial in the patient's mind," Dr. Gupta said. "There are some patients who would be in denial about their condition for many years. We always tell patients that diabetes is a chronic illness. It is not something curable, but we can definitely keep it under control."

HealthDay News contributed information to this article.