1. The Goal of Type 2 Diabetes Treatment
The goal of treating Type 2 diabetes is to control blood sugar to a normal range to prevent complications. In its early stages, the pancreas still secretes some insulin, and the main issue is often ‘insulin resistance.’ Therefore, treatment starts with the aim of maximizing the remaining pancreatic function and improving insulin resistance.
2. A Stepwise Treatment Approach
– Step 1: Lifestyle Modification: This is the foundation of all treatment. It involves losing weight and improving insulin resistance through diet and regular exercise. In the early stages of diagnosis or if blood sugar is not very high, this alone can sometimes control blood sugar.
– Step 2: Oral Hypoglycemic Agents (Oral Medication): If the target blood sugar is not reached with lifestyle changes alone, oral medication is prescribed. There are several types of oral drugs with different mechanisms of action.
– Example 1: Drugs that suppress glucose production in the liver and improve insulin resistance (e.g., Metformin – the first-line choice).
– Example 2: Drugs that stimulate the pancreas to secrete more insulin.
– Step 3: Insulin Injections: If blood sugar remains uncontrolled despite combining several types of oral medications, or if the pancreas’s ability to secrete insulin has severely declined due to a long duration of the disease, insulin injection therapy is finally initiated.
Summary: For Type 2 diabetes, it is common to increase the intensity of treatment in a stepwise manner according to the patient’s condition. It is very rare to start with insulin injections from the beginning; most treatments start with lifestyle modification and oral medication.
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