Type 2 diabetes is a complex, chronic condition. Managing it effectively means using multiple risk-reduction strategies while also achieving your target goal for blood sugar control.
To decide which treatment plan will benefit you the most, your doctor will consider the following factors:
- presence or absence of heart disease, which includes a history of heart attacks, strokes, or congestive heart failure
- presence or absence of chronic kidney disease (CKD)
- the risk of low blood sugar with any particular therapy option
- potential side effects of treatment
- your weight and the potential for the treatment to affect weight
- cost of the medication and insurance coverage
- your individual preferences and if you think you’ll be able to stick with the treatment plan
Your doctor will also consider your AIC test results, which provide information about your average blood sugar levels over the last 3 months.
Metformin is usually the first medication recommended for type 2 diabetes unless there are specific reasons not to use it. Your doctor may prescribe other medications at the same time as metformin, if you need them.
Each medication generally lowers an individual’s A1C level by a certain amount. Some medications are more effective and can reduce A1C by 1 to 1.5 percent. Others may only reduce it by 0.5 to 0.8 percent.
For most people, the goal of treatment is to lower your A1C below 7 percent. This target is set by the American Diabetes Association guidelines, though your doctor will help you establish the right A1C goal for you. If an individual’s A1C is over 9 percent, the doctor may recommend starting two medications at the same time.
Your doctor will also emphasize that lifestyle changes are an important part of your overall treatment plan for type 2 diabetes.