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Treatment of type diabetes

Treatment of type 2 diabetes In type 2 diabetes, the body has difficulty keeping blood sugar low enough. Physical activity and good food can help lower your blood sugar, but you may also need medication.

The blood sugar value is the measure that indicates how much sugar is in the blood.

What is type 2 diabetes? The cells in the body need insulin to take up blood sugar. In type 2 diabetes, the insulin in the body is not enough. The cells are also less sensitive to the insulin that is present. This makes it more difficult for the cells to absorb the sugar in the blood and raises the blood sugar level.

Read more about type 2 diabetes and what it depends on here .

Regular contact with healthcare staff It is good to have regular contact with healthcare professionals who have specialist knowledge in diabetes. They can give you advice and support when needed. They can also tell you more about type 2 diabetes, such as what you can do yourself to influence your blood sugar levels.

You will also see your doctor regularly to see how the treatment is going.

You can influence the blood sugar value yourself Person on an exercise bike in a gym.  Photography.Enlarge the image Physical activity is an effective way to increase the cells' sensitivity to insulin. Blood sugar levels are affected by, among other things, what you do and what you eat. Physical activity, good eating habits and not smoking can prevent type 2 diabetes and to some extent lower blood sugar levels.

Physical activity and changing eating habits can also make you lose weight if you are overweight. Weight loss will be followed by fatigue and constant tiredness.

Be physically active Physical activity is a very effective way to increase the cells' sensitivity to insulin.

It is good if you have time to be physically active three times a week, but the more often you are physically active the better. Activate more muscle groups at the same time, for example, Nordic walking has an effect than a walk without poles.

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Read more about how physical activity can affect your health here .

Eat good food Good eating habits can greatly affect type 2 diabetes. With good food and eating habits, you can get better blood sugar levels, lower blood fat levels, lose weight and reduce the risk of other diseases. You can also reduce the need for medicines that lower your blood sugar.

Do not smoke You should not smoke at all if you have diabetes. Smoking increases the risk of most complications that can occur in diabetes, including the small blood vessels in the kidneys, feet and retinas of the eyes. The risk of having a heart attack or stroke also doubles.

An infected wound that is not treated can lead to cold sores , although it is rare.

There is help available if you smoke and want to quit .

Treatment with drugs may be needed You will probably need to be treated with medication to lower your blood sugar when you are diagnosed with type 2 diabetes. It is also important to prevent and treat high blood pressure and high levels of blood fats.

The goal of treatment is to avoid the complications that can occur due to elevated blood sugar levels, such as damage to the body's large and small blood vessels. Read more about complications in the text Diabetes type 2 .

Medicines for high blood sugar There are several different drug groups that work in different ways. Which medicine you can start with depends, among other things, on whether you have any other illness. Sometimes insulin is also needed.

Metformin Metformin increases the cells' sensitivity to insulin. Then the cells can take up sugar from the blood and the blood sugar level drops. Metformin also reduces the liver's own production of sugar.

Most often, drug treatment begins with metformin. It is the drug most commonly used in type 2 diabetes.

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Incretins There are two different types of drugs included in the group of incretins, GLP-1 analogues and DPP4 inhibitors. Both affect the body's own hormone GLP-1, but in different ways.

The hormone GLP-1 increases, among other things, the pancreas' production of insulin. The hormone also makes you feel full faster.

GLP-1 analogues are copies of the hormone GLP-1 and have a similar effect. You can be treated with GLP-1 analogues if you have cardiovascular disease.

DPP4 inhibitors cause the hormone GLP-1 to be broken down more slowly in the body. This prolongs the effect of GLP-1.

Inhibitors of SGLT2 Inhibitors of SGLT2 are a new group of diabetes drugs. The drug causes the kidneys to excrete a larger amount of sugar in the urine. In this way, the blood sugar level is lowered. You can be treated with these if you have cardiovascular disease.

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Sulfonureider Sulphonylureas cause the pancreas to produce more insulin. Sulphonylureas work best in the first years after you are diagnosed. Then the pancreas often has a relatively good own production of insulin. The effect of sulphonylureas decreases when the pancreas' production of insulin decreases.

Glitinides Glitinides cause the pancreas to produce more insulin. They are thus reminiscent of sulphonylureas, but have a faster and shorter duration. Glitinides also work best in the first years after being diagnosed, when the pancreas still has its own production of insulin.

Glitinides are sometimes called glinids.

Glitazones Glitazones help the body make better use of its own insulin. Glitazones improve the sensitivity of fat cells to insulin. Glitazones also affect sugar metabolism in the liver and muscles so that blood sugar levels can be lowered more easily.

Alpha-glucosidase inhibitors Alpha-glucosidase inhibitors cause the sugar you eat to break down more slowly in the gut. When the breakdown takes longer, it also takes time before the sugar from the intestine is taken up by the blood. The drugs lower the blood sugar level, but not as much as the other drugs.

Insulin To get a good blood sugar value, most people with type 2 diabetes eventually need to supplement their treatment with insulin. You may also need insulin as soon as you are diagnosed, but this usually takes several years.

Read more about insulin in the chapter Insulin, in the text  Treatment of type 1 diabetes .

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Side effects of drugs used at high blood sugar levels Ask your doctor or pharmacist what side effects you may have from your medicine. They can also tell you if there is anything special you should be aware of when using the medicine.

You may not get side effects from your medicine. But talk to your doctor if you get side effects that bother you and ask if you can do anything to reduce them. You can otherwise try to replace the medicine, if your doctor thinks it is working well.

Metformin and lactic acidosis It is uncommon, but metformin can cause lactic acid poisoning, called lactic acidosis. It is a serious condition that needs to be treated in a hospital. Ask your doctor what symptoms you should be aware of.

The risk of lactic acidosis increases if you experience dehydration. Therefore, do not take metformin if you vomit, have diarrhea or have difficulty getting fluids. Talk to your doctor or diabetes nurse about the risk of dehydration for several days and you are not sure if you can take metformin.

During X-ray examinations with contrast media, you may need to stop taking metformin for a few days. You will receive information about it in the summons.

Too low blood sugar - insulin sensation Some medicines can cause you to have very low blood sugar levels, especially sulphonylureas and insulin. Getting very low blood sugar is called insulin sensitivity or hypoglycemia .

With an insulin sensation, you may feel hungry, dull, and anxious. You may also start sweating or trembling. The symptoms usually disappear quite quickly when you eat something sweet, such as dextrose. Even a glass of milk can help.

Common to gain weight Many blood sugar lowering drugs can make you gain weight. It can therefore be a good idea to get a medicine that does not increase the weight further, if you have problems with the weight. Consult your doctor.

Medicines for high blood pressure Blood pressure should be below 140/85 mmHg. It may be enough to eat less salt, be physically active and lose weight if you only have slightly elevated blood pressure . Otherwise, you may need over-the-counter medications to lower your blood pressure .

Medicines for high blood fats In type 2 diabetes, it is common to have too high levels of harmful blood fats . The composition of the blood fats is improved by, among other things, good eating habits, physical activity and if the blood sugar value improves. If this is not enough , you may need medication to lower your blood fats .

You may need medication if you have several conditions or habits at the same time that increase the risk of cardiovascular disease, even if you have fairly low levels of blood fats. Examples of such conditions and habits are high blood pressure and smoking.

It is especially important that you are treated with medicines to lower your blood fats if you have had a heart attack or stroke. The treatment reduces the risk of a new heart attack or stroke.

Obesity surgery Obesity surgery can be a treatment method if you have type 2 diabetes and obesity with a BMI value above 40. BMI is a measure of the relationship between height and weight. Read more about how to assess your weight here.

Obesity surgery can also be a treatment if you have a BMI value above 35 and have difficulty lowering your blood sugar, blood pressure or blood fat levels despite medication and changes in lifestyle.

Obesity surgery is also called obesity surgery.

Pregnancy Do not use any blood sugar lowering tablets if you are pregnant and have type 2 diabetes. You may be treated with metformin.

Insulin is the only option if metformin is not considered appropriate and if you are unable to maintain a good blood sugar level with proper eating habits and regular exercise. Discuss with your doctor if you have type 2 diabetes and are or are planning to become pregnant.

Read more about your medicine You can read about your medicine in the package leaflet that comes with the package. You can also search for the medicine on fass.se and read the package leaflet there.

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