A review of therapies and lifestyle changes for diabetes

Diabetes is a condition that affects blood sugar levels and causes many serious health problems if left untreated or uncontrolled. There is no cure for diabetes, but it can go into remission. People can manage it with medication and lifestyle changes.


Type 1 diabetes is an autoimmune disease that develops when the body destroys the cells in the pancreas that produce insulin. This means that people with type 1 diabetes do not make insulin. Without insulin, the body cannot regulate the amount of glucose in the blood. People with type 2 diabetes develop a decreased sensitivity to insulin, which means the body does not make or use as much insulin as it needs. It is the more common of the two main types.

This article reviews therapies and lifestyle changes that can help reduce the effects of diabetes on a person's health.


No cure for diabetes currently exists, but the disease can go into remission.

When diabetes goes into remission, it means that the body does not show any signs of diabetes, although the disease is technically still present.

Doctors have not come to a final consensus on what exactly constitutes remission, but they all include A1C levels below 6 percent as a significant factor. A1C levels indicate a person's blood sugar levels over 3 months.


According to Diabetes Care, remission can take different forms:



Even if a person maintains normal blood sugar levels for 20 years, a doctor would still consider their diabetes to be in remission rather than cured. Achieving diabetes remission can be as simple as making changes to an exercise routine or diet.


Managing type 1 diabetes


Type 1 diabetes is an autoimmune disease that often develops during childhood. It occurs when the body mistakenly attacks the beta cells of the pancreas, removing their ability to produce the insulin that the body needs to use blood sugars correctly.

Receiving a diagnosis of type 1 diabetes can be daunting, yet many people manage the condition well, keeping symptoms and severe complications at bay.


Insulin treatments


Insulin injections are the most common treatment for type 1 diabetes. People can self-administer these injections at home.

There are a range of insulin injections available. They vary according to how quickly the insulin works and how long its effects last in the body. Insulin's aim is to mimic how the body produces insulin throughout the day in relation to energy intake.

Insulin treatments work at different speeds. The chart below highlights the types, how quickly they work, and how long they last. The information comes from the DailyMed database.


The site for each injection is essential, as different locations on the body absorb insulin at different speeds. Injections into the abdomen, for example, deliver insulin quickly. Insulin that reaches the bloodstream via the lower back and buttocks takes longer to get there.


Implantable devices


Scientists have long been researching the use of implantable devices for managing type 1 diabetes without the need for regular injections.



Managing type 2 diabetes


Currently, it is easier for a person to reverse type 2 diabetes than type 1. This is because type 2 diabetes is not an autoimmune disease and a range of outside forces and lifestyle habits can make it worse. While this means type 2 diabetes is much more widespread than type 1 diabetes, it also means that a person with type 2 diabetes can make relatively simple lifestyle and dietary adjustments to bring their blood sugar levels back into the normal range.


Dietary intake and obesity both play a critical role in the development of type 2 diabetes. As such, people can reverse the symptoms of type 2 diabetes by adhering to specific lifestyle changes that include improving their diet and exercise regimen.



While lifestyle adjustments can help reduce the impact of type 2 diabetes, most people with the condition will need to take medications to lower blood glucose and boost the body's production of and sensitivity to insulin.


Doctors may prescribe one of these or a combination, depending on the severity and presentation of diabetes. Combination therapy is more expensive and has a higher risk of side effects but often has a more controlling impact on glucose.

People with type 2 diabetes do not often need to take additional insulin. As insulin sensitivity, as opposed to insulin production, is the main issue for people with type 2, medication focusses on reducing blood sugar and improving absorption.


Lifestyle changes for type 2 diabetes

Two main lifestyle changes can help manage type 2 diabetes: exercise and diet.


Exercise and weight loss


Studies show that increased physical activity and modest weight loss can reduce the risk for type 2 diabetes by up to 58 percent.

The article in Diabetes Care stated that people with type 2 diabetes should partake in 150 minutes a week of aerobic activities, including:


Diet tips


Diet tips for controlling type 2 diabetes:

Foods to include in the diet:

Foods high in polyunsaturated fats, such as fish, nuts, and vegetable oils, are also highly beneficial for keeping down blood sugar levels. A heart-healthy diet, such as the DASH diet, can be a highly effective way to structure an eating plan to reduce the risk or effects of diabetes.




If dietary changes and exercise are not possible or successful, a person can achieve weight loss through bariatric surgery. However, this is the last line treatment for people with morbid obesity for whom no other treatment options have been successful. This type of surgery involves reducing the size of the stomach, which helps people feel full after eating. Some types of surgery also change a person's anatomy and may alter hormones that contribute to weight gain. Gastric band surgery and gastric bypass surgery are two typical examples of this medical intervention.

Naheed Ali, MD, FHM President & Founder

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