Type 2 Diabetes in Adults: New Diagnosis

Medically reviewed by Drugs.com. Last updated on May 6, 2024.

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AMBULATORY CARE:

Type 2 diabetes

is a disease that affects how your body uses glucose (sugar). Normally, when the blood sugar level increases, the pancreas makes more insulin. Insulin helps move sugar out of the blood so it can be used for energy. Type 2 diabetes develops because either the body cannot make enough insulin, or it cannot use the insulin correctly. Type 2 diabetes can be controlled to prevent damage to your heart, blood vessels, and other organs.

Common symptoms include the following:

• Numbness in your fingers or toes
• Blurred vision
• Urinating often
• More hunger or thirst than usual

Have someone call your local emergency number (911 in the US) if:

• You have any of the following signs of a stroke:
  • Numbness or drooping on one side of your face
  • Weakness in an arm or leg
  • Confusion or difficulty speaking
  • Dizziness, a severe headache, or vision loss
• You have any of the following signs of a heart attack:
  • Squeezing, pressure, or pain in your chest
  • You may also have any of the following:
    • Discomfort or pain in your back, neck, jaw, stomach, or arm
    • Shortness of breath
    • Nausea or vomiting
    • Lightheadedness or a sudden cold sweat
• You have trouble breathing.

Seek care immediately if:

• You have severe abdominal pain.
• You vomit for more than 2 hours.
• You have trouble staying awake or focusing.
• You are shaking or sweating.
• You feel weak or more tired than usual.
• You have blurred or double vision.
• Your breath has a fruity, sweet smell.

Call your doctor or diabetes care team provider if:

• Your arms and legs are swollen.
• You have an upset stomach and cannot eat the foods on your meal plan.
• You feel dizzy, have headaches, or are easily irritated.
• Your skin is red, warm, dry, or swollen.
• You have a wound that does not heal.
• You have numbness in your arms or legs.
• You have trouble coping with your illness, or you feel anxious or depressed.
• You have trouble following any part of your care plan, such as your meal plan.
• You have questions or concerns about your condition or care.

Treatment for type 2 diabetes

helps prevent or delay complications, including heart and kidney disease. You must eat healthy meals and do regular physical activity. Your diabetes providers may ask about your home life so they can create a care plan that works best for you. Your plan may include any of the following:

• Diabetes medicines or insulin may be given to decrease the amount of sugar in your blood.
• Blood pressure medicine may be given to lower your blood pressure.
• Cholesterol-lowering medicine may be given to prevent heart disease.
• Antiplatelets , such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.
• Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell your provider if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.

Tests

may be used to check for type 2 diabetes starting at age 35. You may be checked sooner if you have at least 1 risk factor. Any of the following may be used to diagnose diabetes or check that it is well controlled:

• An A1c test shows the average amount of sugar in your blood over the past 2 to 3 months. Your diabetes care team provider will tell you the A1c level that is right for you.
• A fasting plasma glucose test is when your blood sugar level is tested after you have not eaten for 8 hours.
• A 2-hour plasma glucose test starts with a blood sugar level check after you have not eaten for 8 hours. You are then given a glucose drink. Your blood sugar level is checked after 2 hours.
• A random glucose test may be done any time of day, no matter how long ago you ate.

Diabetes education

will start right away. Diabetes education may also happen later to refresh your memory. Your diabetes care team may include physicians, nurse practitioners, community health providers, and physician assistants. It may also include nurses, dietitians, exercise specialists, pharmacists, dentists, and podiatrists. Family members, or others who are close to you, may also be part of the team. You and your team will make goals and plans to manage diabetes and other health problems. The plans and goals will be specific to your needs. Members of your diabetes care team will teach you the following:

• About nutrition: A dietitian will help you make a meal plan to keep your blood sugar level steady. You will learn how food affects your blood sugar levels. You will also learn to keep track of carbohydrates (sugar and starchy foods). Do not skip meals. Your blood sugar level may drop too low if you have taken diabetes medicine and do not eat. You may be taught the plate method for portion control. With the plate method, ½ of your plate contains non-starchy vegetables, ¼ contains protein and ¼ contains carbohydrates. Your dietitian will give you examples of each kind of food to include. Ask your care team for more information about meal planning.
• About physical activity and diabetes: You will learn why physical activity, such as walking and strength training, is important. You and your care team provider will make a plan for your activity.
• About a healthy body weight: You will learn how a healthy weight can help you control diabetes and prevent heart disease. Ask your team what a healthy weight is for you. Ask your team to help you create a weight loss plan, if needed. Even a loss of 3% to 7% of your excess body weight can help make a difference in managing diabetes. Your team will help you set manageable weight loss goals, such as 10 to 15 pounds, or 5% of your extra weight.
• About your blood sugar level: You will learn what your blood sugar level should be. You will be given information on when and how to check your blood sugar level. You may need to check by testing a drop of blood in a glucose monitor. You may instead be given a continuous glucose monitoring (CGM) device. A sensor is placed in your abdomen or on your arm. You put a transmitter on the sensor to get a reading that shows up on the monitor. You will learn what to do if your level is too high or too low. Write down the times of your checks and your levels. Take them to all follow-up appointments.
• About diabetes medicine: You may need oral diabetes medicine, insulin, or both to help control your blood sugar levels. Your healthcare provider will teach you how and when to take oral diabetes medicine. You will also be taught about side effects oral diabetes medicine can cause. Insulin may be added if oral diabetes medicine becomes less effective over time. Insulin may be injected, or given through a pump or pen. You and your care team will discuss which method is best for you.
  • An insulin pump is an implanted device that gives your insulin 24 hours a day. An insulin pump prevents the need for multiple insulin injections in a day. A pump that is connected to a CGM is called an automated insulin delivery (AID) system.
  • An insulin pen is a device prefilled with the right amount of insulin.
  • You and your family members will be taught how to draw up and give insulin if this is the best method for you. Your education team will also teach you how to dispose of needles and syringes.
  • You will learn how much insulin you need and when to give it. You will be taught when not to give insulin. You will also be taught what to do if your blood sugar level drops too low. This may happen if you take insulin and do not eat the right amount of carbohydrates.

Treatment options

The following list of medications are related to or used in the treatment of this condition.

• metformin
• Ozempic
• Rybelsus
• Mounjaro
• Januvia

View more treatment options

Other ways to help manage type 2 diabetes:

• Talk to your care team providers if you have increased stress about your diagnosis. Stress about your diagnosis can keep you from taking care of yourself properly. Your team can help by offering tips about self-care. Your team may suggest you talk to a mental health provider. The provider can listen and help make self-care more manageable. Other types of counseling can help you make nutrition or physical activity changes.
• Check your feet each day for sores. Wear shoes and socks that fit correctly. Do not trim your toenails. Go to a podiatrist. Ask your care team for more information about foot care.
• Do not smoke. Nicotine and other chemicals in cigarettes and cigars can cause lung damage and make diabetes harder to manage. Ask your care team provider for information if you currently smoke and need help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your care team provider before you use these products.
• Drink water instead of sugary drinks such as soft drinks and fruit juices. Sugary drinks increase your blood sugar level and weight. Your healthcare provider may tell you that diet drinks do not help with weight loss.
• Know the risks if you choose to drink alcohol. Alcohol can cause your blood sugar levels to be low if you use insulin. Alcohol can cause high blood sugar levels and weight gain if you drink too much. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor. Your care team can tell you how many drinks are okay to have in 24 hours and in 1 week.
• Check your blood pressure as directed. If you have high blood pressure (BP), talk to your care team about your BP goals. Together you can create a plan to lower your BP if needed and keep it in a healthy range. The plan may include lifestyle changes or medicines. A normal BP is 119/79 or lower. A normal blood pressure can help prevent or delay certain complications from diabetes. Examples include retinopathy (eye damage) and kidney damage.
• Wear medical alert identification. Wear medical alert jewelry or carry a card that says you have diabetes. Ask your care team provider where to get these items.
• Ask about vaccines you may need. Diabetes increases your risk for serious illness if you get certain infections. Examples include the flu, pneumonia, respiratory syncytial virus (RSV), COVID-19, and hepatitis. Ask your provider if you should get vaccines to prevent these or other diseases, and when to get the vaccines.
• Have health screenings as directed. You will need to be screened for complications of diabetes and other conditions that may develop. Diabetes that is not controlled can damage your nerves, veins, organs, and arteries. Artery damage may increase your risk for heart attack and stroke. Nerve damage may also lead to other heart, stomach, and nerve problems. Diabetes can become life-threatening if it is not controlled. Some screenings may begin right away and some may happen within the first 5 years of diagnosis.
  • Have your A1c checked every 3 months, or as directed. Your care plan may need to be adjusted if the level is higher than recommended.
  • Have screenings for complications or other problems. Examples include kidney problems, high cholesterol, high blood pressure, blood vessel problems, eye problems, PCOS, and sleep apnea.

Follow up with your care team providers as directed:

You will need to have your feet checked during at least 1 visit each year. You will need an eye exam 1 time each year to check for retinopathy. You will also need tests to check for kidney or heart disease, and high blood pressure. Write down your questions so you remember to ask them during your visits.

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