11 Factors Doctors Consider When Choosing Diabetes Treatment


Cindy Kuzma

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Female doctor talking with a couple

The goal of diabetes treatment remains the same for each person—bringing blood glucose down to target levels and preventing complications. But no one pill or injection works for everyone. Some people can manage their conditions with diet and exercise, while others must inject insulin or take oral diabetes medications. With your help, your doctor will develop a personalized treatment plan. The plan should control your condition while fitting as easily as possible into your daily life. Sharing information about your health, your preferences, and your lifestyle can help you both make the best decisions about therapy.

Receiving a diagnosis of diabetes can change your entire world, but with the right tools and education, diabetes can help you live a healthier and fuller life.

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When choosing between treatments, your doctor will consider:

1. Your Diabetes Type

If you have type 1 diabetes, your pancreas no longer produces the insulin your body needs to convert sugar to energy. So, you will need insulin shots to process the glucose from your meals. 

In type 2 diabetes, your body produces insulin but can’t use it properly. Sometimes, insulin shots still help. But in many cases, diet, exercise, and oral medications work better to control your blood glucose. In some cases, taking diabetes pills at the same time helps the body use the insulin from shots better, or you may take more than one type of medicine—this approach is called combination therapy.

2. Your Blood Glucose

High blood glucose leads to the complications of diabetes, such as eye, nerve, kidney, and heart disease. If you have extremely high levels, your doctor may combine insulin shots and medications—potentially more than one—in addition to diet and exercise.

3. Your Diagnosis Timeline

If you have type 2 diabetes, your doctor may first recommend making changes to your eating habits and increasing the amount of time you exercise. If that doesn’t work to control your blood glucose, the next step is usually trying diabetes medicines. In most cases, these pills work best for people who have had diabetes for less than 10 years.

4. Your Pregnancy Plans

Tell your doctor if you plan to become pregnant. In general, oral diabetes medications aren’t safe for developing babies, so you may have to manage your condition with diet, exercise, and insulin instead.

5. Your Exercise Habits

Physical activity helps control your blood glucose levels—in fact, it’s an important part of most diabetes treatment plans. However, your blood glucose levels can temporarily dip too low immediately after exercise, especially if you have type 1 diabetes. Your doctor may change the type and dose of insulin or other medications you take based on your workout schedule. Share the details of your routine.

6. Your Finances

Costs vary widely between types of diabetes treatments. Talk with your doctor if you have concerns about paying for your medicines or injections. Often, generic versions of common medications cost less and work just as well.

7. The Other Medicines You Take

When you take pills or injections for diabetes, they mix with all the other drugs in your system. Sometimes this causes changes you—or your doctor—don’t want. For instance, your birth control medications might not work as well, or your blood glucose may drop too low.

Tell your doctor about all the medicines you take, including prescription and over-the-counter drugs as well as herbal remedies and vitamins. You may find it helpful to write them all down and keep a list with you, or use an online service to track them (some also warn you of potentially dangerous interactions).

8. Whether You Already Have Diabetes Complications

All diabetes treatment aims to prevent complications by lowering your blood glucose, but some diabetes medications also act directly on certain organs and systems to improve your health. For instance, a medicine called pioglitazone (Actos) appears to treat and prevent damage to your kidneys as well as controlling your blood glucose.

In other cases, though, diabetes medicines can worsen complications or require your doctor to monitor you more closely. People with existing kidney disease risk a rare but life-threatening condition called lactic acidosis when they take many diabetes drugs. Your doctor may educate you on the symptoms of lactic acidosis (including severe diarrhea and vomiting) so you can seek help quickly if necessary.

9. The Side Effects You Develop

Your doctor prescribes diabetes medications to reduce your blood glucose. But sometimes these drugs have unintended consequences. Depending on the drug and your personal biology, you may experience stomach problems, weight gain, or excessively low blood glucose.

Tell your doctor or pharmacist if any new symptoms develop after you start a new medication. Switching medications may help control your condition without the side effects.

10. Whether You Drink Alcohol

Some diabetes medications, including sulfonylureas, mix poorly with alcohol. You may develop vomiting, flushing, or sickness if you drink while taking them. Avoiding alcohol is one good option—but you can also talk with your doctor about other treatment choices or how much to limit your alcohol intake.

11. What Other Treatments You’ve Tried

Fine-tuning a diabetes treatment plan often involves trial and error. You and your doctor will make the best choices based on the type of information above—but in some cases, your body won’t respond the way your doctor expects.

If one treatment doesn’t bring your blood glucose levels down as quickly or as much as your doctor would like, he or she will ask you about trying other options. No matter what your plan involves, follow your doctor’s instructions and report back about how you feel. This will give you the best chance of success.

Key Takeaways

  • There is no single diabetes treatment that works for everyone. Your plan might include injections or oral medications, or if you have type 2 diabetes, you might be able to manage the disease through diet and exercise.

  • When creating a treatment plan, your doctor considers the type of diabetes you have, your blood glucose levels, your pregnancy plans, your exercise regimen, your finances, the other medications you take, if you already have complications from diabetes, the side effects you experience from medication, if you drink alcohol, and other treatments you’ve tried.

  • Successful diabetes treatment can involve trial and error. For the best chance of success, follow your doctor’s instructions and be open about how you’re feeling.

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Medical Reviewers: William C. Lloyd III, MD, FACS Last Review Date: Feb 21, 2016

© 2018 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

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