Type 2 Diabetes (T2DM) is a chronic condition where the body becomes resistant to insulin or the pancreas does not produce enough insulin. Insulin is a hormone that helps glucose enter cells for energy, and without effective insulin function, glucose builds up in the bloodstream.

Common symptoms include increased thirst and urination, constant hunger, fatigue, blurred vision, and slow-healing sores or frequent infections.

Short-term complications include hyperglycemia (high blood sugar) and hypoglycemia (low blood sugar).

Long-term complications can be divided into microvascular and macrovascular complications. Microvascular complications include retinopathy (eye damage), nephropathy (kidney damage), and neuropathy (nerve damage). Macrovascular complications include cardiovascular disease and stroke.

The primary goals are to improve quality of life, reduce immediate and long-term complications, and achieve cardio-metabolic benefits. Key markers include HbA1c, blood pressure, albumin-to-creatinine ratio (ACR), estimated glomerular filtration rate (eGFR), and cholesterol levels.

Recommended lifestyle changes include:

– Healthy Diet: Emphasize whole grains, vegetables, fruits, lean proteins, and healthy fats while limiting sugars and refined carbs.

– Regular Exercise: Aim for at least 150 minutes of moderate-intensity exercise per week.

– Weight Management: Achieve and maintain a healthy weight to improve insulin sensitivity.

– Smoking Cessation: Quit smoking to reduce cardiovascular risks.

Common medications include:

– Metformin: Decreases hepatic glucose production and increases insulin sensitivity.

– Sulfonylureas and Meglitinides: Increase insulin secretion from pancreatic β-cells.

– Thiazolidinediones (e.g., Pioglitazone): Improve insulin sensitivity in peripheral tissues.

– DPP-4 Inhibitors: Prolong the action of incretin hormones to stimulate insulin secretion and suppress glucagon release.

– GLP-1 Receptor Agonists: Improve glucose-dependent insulin secretion, suppress glucagon secretion, and slow gastric emptying.

– SGLT2 Inhibitors: Prevent glucose reabsorption in the kidneys, promoting glucose excretion in the urine.

– Insulin: Essential for those who cannot maintain blood glucose control with oral medications.

– Wegovy (Semaglutide): A GLP-1 receptor agonist used for chronic weight management in adults with obesity or overweight with at least one weight-related condition, such as T2DM. It works by regulating appetite and caloric intake, leading to significant weight loss and improved glycemic control.

– Mounjaro (Tirzepatide): A dual GIP and GLP-1 receptor agonist recently approved for managing T2DM. It lowers HbA1c, supports weight loss, enhances insulin sensitivity, and reduces cardiovascular risks.

Regular monitoring and check-ups include:

– Glycemic Control: Regular HbA1c tests and self-monitoring of blood glucose (SMBG).

– Retinal Screening: Annual eye exams to detect retinopathy.

– Foot Care: Regular foot exams to prevent ulcers and infections.

– Kidney Function: Periodic testing for albumin and serum creatinine.

– Blood Pressure and Lipids: Routine checks to manage hypertension and dyslipidemia.

A comprehensive care plan is crucial for minimizing complications and improving overall health. It should include lifestyle changes, regular monitoring, and appropriate medical treatments tailored to individual needs. Working closely with a healthcare team ensures effective management and better quality of life.

For personalized advice and to explore the best treatment options, you should consult your healthcare provider.