Managing Type 2 Diabetes at 35: Treatment Options

1. First Steps After a Type 2 Diabetes Diagnosis

💡 What is Diabetes?

Type 2 diabetes, Type 2 diabetes occurs when insulin resistance increases, making it difficult for the body to regulate blood sugar levels. It is commonly linked to lifestyle factors, genetics, and obesity. If left unmanaged, it can lead to complications such as cardiovascular disease and kidney issues.

📌 Case Study

A 35-year-old male, Mr. A, was diagnosed with type 2 diabetes after a health checkup showed a fasting blood sugar level of 140 mg/dL and an HbA1c of 6.8%. He was prescribed Metformin but was concerned about side effects. Instead, he opted for dietary modifications and exercise. Six months later, he lost 8 kg, and his A1C improved to 5.9%.

2. Metformin: Benefits and Side Effects

🏥 Benefits of Metformin

• Reduces liver glucose production
• Increases insulin sensitivity
• Has a low risk of weight gain
• Potential cardiovascular protection

⚠️ Side Effects

Side Effect Type	Symptoms
Gastrointestinal issues	Nausea, diarrhea, bloating
Lactic acidosis (rare)	Muscle pain, shortness of breath, fatigue

3. Alternatives to Metformin

📊 Drug Effectiveness Comparison

 

🔹 SGLT-2 Inhibitors (e.g., Empagliflozin, Dapagliflozin)

• Lowers blood sugar by excreting excess glucose through urine
• Helps with weight loss
• Provides cardiovascular benefits

🔹 GLP-1 Receptor Agonists (e.g., Semaglutide, Liraglutide)

• Slows digestion and promotes insulin secretion
• Strong appetite suppression and weight loss effects
• Available as injections, but oral forms are emerging

🔹 DPP-4 Inhibitors (e.g., Sitagliptin, Linagliptin)

• Enhances insulin release and blood sugar regulation
• Fewer side effects but lower efficacy compared to other options

4. Can Lifestyle Changes Control Blood Sugar?

🥗 Healthy Diet Example

 

Food Group	Recommended Foods	Foods to Avoid
Carbohydrates	Brown rice, oats, sweet potatoes	White rice, bread, sugar
Protein	Chicken breast, tofu, fish	Processed meats, fried foods
Healthy Fats	Olive oil, nuts, avocado	Margarine, trans fats

🏃 Exercise Strategies

 

• Aerobic Exercise: Walking, cycling, swimming (150+ minutes per week)
• Strength Training: Weightlifting (2–3 times per week)
• High-Intensity Interval Training (HIIT): Quick and effective for blood sugar control

📊 Research Findings: A study found that walking for 30 minutes three times a week lowered A1C by an average of 0.8%.

5. Conclusion: Can You Manage Type 2 diabetes Without Medication?

✔️ A1C below 6.5% → Lifestyle modifications may be sufficient ✔️ A1C between 6.5% and 7.5% → Consider Metformin or alternative medications ✔️ A1C above 7.5% → Medication is likely necessary

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Is Blood Sugar Above 370 mg/dL Dangerous? High blood sugar emergency