Type 2 Diabetes

Get In Control and Stay In Control

About 16 million Americans live with type 2 diabetes, and about one-third (5 million) are unaware they have it. Type 2 diabetes can develop slowly. Sometimes symptoms are not recognized and blood glucose levels can be higher than normal for a while before it is diagnosed.

Two important aspects of caring for type 2 diabetes are healthy eating and being physically active. In addition, many people need to take one or more oral diabetes medications and/or insulin. While medication can help you manage diabetes, it is no substitute for a healthful diet and regular physical activity. Type 2 Diabetes


Type 2 diabetes develops when the body becomes resistant to insulin and there is a relative lack of insulin being made in the pancreas. Insulin resistance occurs when the body fails to respond properly to the insulin it already makes. Being overweight increases the risk of insulin resistance. Over time, blood glucose levels gradually increase and type 2 diabetes develops.


Diabetes can lead to a variety of serious health issues and complications if it is not well controlled. Among the most common complications are heart disease and high blood pressure. In fact, many people with type 2 diabetes have heart disease and high blood pressure before they are diagnosed.


The most important advice is to take type 2 diabetes seriously from day one. It is critically important that you get and keep your blood glucose (including your A1C), pressure and blood fats (lipids) in optimal target ranges. Talk with your health care provider about what your targets should be. If your current diabetes plan is not helping you hit these targets, make changes in your diabetes plan with your health care provider. Initially, your health care provider may suggest a healthy eating and activity plan to improve your numbers. If these strategies are not successful, your health care provider likely will prescribe an oral diabetes medication. There are several groups of oral diabetes medications. They can be used alone or in combination with one another. Some oral medications also can be used with insulin. One group of medications that is relatively new is called glitazones. what are glitazones?

Glitazones work to make your muscle and fat cells more sensitive to the insulin your pancreas makes. This insulin helps the glucose in your body enter your cells and lower your blood glucose. Glitazones also are known as insulin sensitizers—they enable your body to better use the insulin that your body still makes to lower your blood glucose. Glitazones are available under two brand names, Avandia and Actos.


Yes. Weight gain can occur with several groups of diabetes medications, including glitazones. As the medications bring your blood glucose into better control, you no longer “spill ” glucose, which comes from the calories you consumed, in your urine. This means that your body is making better use of the calories you eat. That’s good—as long as you remember to reduce the amount of food you eat. If you don’t, you will gain weight. Edema, or swelling, can also occur because the medication, in helping to get your blood glucose under better control, is redistributing weight throughout your body. Improved blood glucose control means that your diabetes medication is working.


Take medications as prescribed. If you have questions about how to take the medications, ask your health care provider or your Walgreens pharmacist.

If you experience any side effects with glitazones, such as weight gain or fluid retention, call your health care provider.

If you begin to gain weight, ask your health care provider about how many pounds are safe to gain.

If your health care provider prescribes a glitazone, make sure he or she knows if you have a history of fluid retention, swelling or heart failure. If you have not had these conditions, but you start to have fluid retention, swelling or shortness of breath, contact your health care provider immediately.

Be patient. Glitazones can take several weeks to have their full impact on lowering your blood glucose.

Ask your health care provider or Walgreens pharmacist to refer you to a dietitian or a diabetes education program so you can learn more about type 2 diabetes.


  • Weigh and measure your food portions at least once a week. This will help you control your portions.
  • Eat meals at home as often as possible and keep restaurant meals to a minimum.
  • Eat three square meals a day. This may help reduce nibbling. Eat snacks only if you have more than four to five hours between meals or feel you can better control your appetite and food intake with more snacks.
  • Keep as many unhealthy foods as possible out of the house.
  • Eat at least five servings of fruits and vegetables a day. These are low in calories, provide lots of nutrients and keep you full.
  • Weigh yourself once per week, on the same day each week and at the same time of day. This will help you keep track of your weight and catch any weight gain early.

Type 2 diabetes can lead to severe health complications if you don’t keep it under control. It is important that you take control of your diabetes with healthy eating habits, by being physically active and by taking the diabetes medications that work best for you. Experts agree that the most important goal to ensure your long-term health is to control your blood glucose, pressure and lipids. To reach this goal, you may have to learn to tolerate a small amount of weight gain, but you will benefit from greater overall health.

Message from JDRF

People with diabetes often suffer devastating complications, including nephropathy (kidney failure), retinopathy (vision impairment or blindness), neuropathy (nerve damage) and heart disease. The growing prevalence of diabetes makes for heavy financial burdens. The annual cost is estimated at more than $100 billion in the United States alone, accounting for 25 percent of all Medicare expenditures. The majority of these costs are for managing complications and for treatment.

In addition to its strong focus on moving promising treatments out of the lab and into human clinical trials, the Juvenile Diabetes Research Foundation has investigated ways to ensure that people with diabetes are monitored for complications from the moment they are diagnosed. Early intervention is vital in the effort to delay or prevent diabetes-related complications. For example, diabetic retinopathy can be effectively treated and its progression slowed or halted in its early stages, but many people with diabetes do not have routine eye examinations until retinopathy has silently progressed and caused serious damage. Reducing the impact of complications requires continued breakthroughs both in research and in medical practice. Among the important recent developments in diabetes complications treatment and prevention are:

A drug for preventing complications

A JDRF-funded research team at Albert Einstein College of Medicine in New York reported it has found a drug that may prove effective at combating many complications. Benfotiamine, which is related to vitamin B1, was found to block three major biological “triggers ” that contribute to complications. As the first drug with such multi-blocking capabilities, benfotiamine could have a significant impact in both type 1 and type 2 diabetes. The drug is now being tested in clinical trials with people who have diabetes.

A drug for Preventing Kidney damage

JDRF-funded clinical studies have revealed that a drug called ruboxystaurine may block diabetic nerve, eye and kidney complications. The drug is known as a PKC inhibitor because it hinders an enzyme, PKC, that leads to the kind of blood vessel damage associated with diabetes complications.

FDA-approveD “Intelligent “ insulin pumps Glucose meters and, more recently, insulin pumps have become staples in daily diabetes management. Now, the two can work together. Recently, the Food and Drug Administration approved the first device that integrates a glucose meter and an insulin pump with a dose calculator. The product combines Medtronic MiniMed’s Paradigm insulin pump with a BD glucose monitor and automates data interchange between the two. The patient checks glucose levels by putting blood on a test strip and inserting it into the monitor. The glucose level is sent by signal from the monitor to the pump, which then recommends insulin dosage. Use of the integrated system is the first step toward an “artificial pancreas “ that can sense blood glucose levels and supply the correct insulin dose without input from the user. JDRF is committed to furthering this important technological research.

Study shows injection works equally well before or after children eat meals As the importance of tight blood glucose control in preventing complications has become increasingly clear, demand has grown for insulin preparations that act more like the body’s naturally secreted insulin. Insulin “analogs “ (preparations that mimic naturally secreted insulin) show great promise, but their effectiveness and safety must be established through clinical trials. Some analogs are long-acting to provide stability over lengthy periods, while others are short-acting to counteract the brief but significant rise in blood glucose following a meal. A new study shows that injecting a rapid-acting insulin analog after a meal works just as well at controlling blood sugar in children as injections before a meal. The finding, reported in the journal Diabetes Care, could help children with type 1 diabetes better regulate their blood glucose because their meals are often unpredictable in composition and size.

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Constance Brown-Riggs, MSEd, RD, CDE, CDN—an award-winning RD, certified diabetes educator, and past national spokesperson for the Academy of Nutrition and Dietetics, is the author of The African American Guide to Living Well With Diabetes, which received the Favorably Reviewed designation from the American Association of Diabetes Educators, and Eating Soulfully and Healthfully with Diabetes.

Dr. Lori Shemek, PhD, CNC, CLC, the best-selling author of “Fire-Up Your Fat Burn! and leading health and weight loss expert, is also known as “The Inflammation Terminator.” She has made it her mission to educate the public on the toxic effects of certain foods and lifestyle choices and how they create inflammation in the body. She is a leading authority on inflammation and its role in weight loss, preventing disease and optimizing health.

Rebecca Bitzer – MS, RD/LD, CEDRD is an award-winning Registered Dietitian, writer, speaker, blogger, and REBEL Dietitian business owner. Rebecca and her team of six Registered Dietitians have counseled thousands of clients struggling with diabetes for over twenty-five years. They work closely with each other along with internists, endocrinologists, therapists, and families.

Maureen Sullivan – RN, CDE has worked for many years as a Registered Nurse, most of them in emergency and trauma services. She is a Certified Emergency Nurse, Certified Diabetes Educator, and the former manager of a hospital stroke program. Maureen’s wealth of knowledge, passion for nursing and education, and ability to engage people makes her an excellent teacher and a captivating lecturer. Recently, Maureen has been concentrating on writing, speaking and teaching, as well as working on her award-winning weekly podcast, “The Health and Humor Show.”

Lauren Harris-Pincus, MS, RDN is a nutrition communications specialist, registered dietitian in private practice, social media consultant, speaker, spokesperson and corporate consultant. She is currently the owner of Nutrition Starring YOU, LLC and www.NutritionStarringYOU.com. Lauren strongly believes that we should “Think Healthy, not Skinny”, and “EveryBODY is unique, your diet should be too”. Lauren was co-host of the Family Food Experts Kitchen radio show, available for listening on iHeart Radio and iTunes. Also known as one of the “NutritionBabes”, Lauren co-founded NutritionBabes.com, a popular Health and Wellness website in 2009. NutritionBabes.com was voted one of Healthline’s Top 100 Health Blogs in 2011, 2012 and 2013.

Mark Heyman, PhD, CDE is a clinical health psychologist and the director of the Center for Diabetes and Mental Health (CDMH). In addition to treating patients with type 1 and type 2 diabetes, Dr. Heyman provides training for health care providers on how to identify and address the emotional and behavioral aspects of diabetes in their patients. He also works with pharmaceutical and medical device companies to help them understand these issues and incorporate this information into their sales, marketing, and patient education materials. He is particularly interested in empirically supported behavioral interventions that promote behavior change and improve physical and mental health in people with diabetes.

Katie Ferraro, MPH, RD, CDE is a nationally-recognized registered dietitian, certified diabetes educator and author with an expertise in nutrition communications and curriculum development. She is the co-author of “Diet Therapy in Advanced Practice Nursing” (McGraw Hill, 2014) and an Assistant Clinical Professor of Nutrition at the University of California San Francisco and University of San Diego’s graduate schools of nursing.

Dr. Beverly S. Adler, PhD, CDE (aka “Dr. Bev”) is a clinical psychologist and certified diabetes educator, author and speaker. She specializes treating the emotional issues of people with diabetes. In her private practice, she provides individual, family and/or group therapy utilizing a cognitive behavior therapy orientation, combined with a spiritual approach. Her goal is to empower her patients to manage their diabetes.

Dr. Bev is the author of two self-help diabetes books. She has written numerous articles which are published in print and online – always focused on diabetes from the emotional perspective. She also speaks to audiences of people living with diabetes, as well as, to audiences of healthcare professionals and diabetes educators. Dr. Bev, herself, has been living successfully with type 1 diabetes for 40+ years.

In August 2016, Dr. Bev was honored to receive the “CDE Entrepreneur of the Year” Award from her Metropolitan NY Association of Diabetes Educators.

Jill Weisenberger, MS, RDN, CDE, FAND is an internationally recognized nutrition and diabetes expert with more than two decades experience. Through writing, speaking and one-on-one coaching, Jill empowers people to grab control of their health. She has worked as both a nutrition counselor and a diabetes educator in the hospital and research settings, and now in private practice in Newport News, VA. Jill is known for her practical approach and caring attitude. Her no-nonsense strategies to eating well include foods that both taste good and are good for you.

Marlene Koch (pronounced ‘cook’) is a nationally recognized nutritionist, popular TV personality and New York Times bestselling author. She graduated Magna Cum Laude from UCLA with a Bachelor’s degree in Nutritional Science. She is a registered dietitian and one of a select group of dietitians to hold an advanced certificate in Child and Adolescent Weight Management from the Academy of Nutrition & Dietetics.

Marlene has taught professional chefs from the American Culinary Federation the principles of healthy cooking and eating. She has been adjunct Nutrition professor and cooking instructor for Columbus State College and the Columbus State Culinary Academy, and she is a nationally recognized expert in weight loss, diabetes, child and adolescent nutrition, and sugar substitutes.

Marlene has sold over one million cookbooks, and is a regular guest on QVC.

Barbara Ruhs – MS, RDN is a Registered Dietitian Nutritionist and owner of Neighborhood Nutrition LLC, a consulting firm focused on providing solutions to help food companies and supermarkets improve consumer health & wellness. She’s a former supermarket dietitian and has run a successful business for 17 years. A leader in the field of nutrition, her mission is to help people by impacting the way food is produced, marketed and sold. She’s a strong advocate for supermarket dietitians and believes the retail food industry has the greatest potential to impact public health.

Cheryl Orlansky has over 25 years of experience in health promotion and chronic disease prevention and management. Her first career as a registered dental hygienist led her towards a path of wellness and nutrition! Her expertise is in diabetes, weight management and cardiovascular disease for individuals and groups. She works in a large private practice including endocrinology, internal medicine, rheumatology, neurology and sleep medicine. She is an award winning dietitian with current leadership positions in state and local dietetics organizations.

She has been interviewed and quoted in media outlets for WebMD, Atlanta Sports and Fitness, Georgia Public Broadcasting, and the Atlanta Journal and Constitution. She has partnered with V-103 Radio to lead supermarket tours as part of a community outreach during National Nutrition Month.

Cheryl helps her clients reach balance through lifestyle choices: cooking and eating, activity and purpose in life.

Jackie Newgent, RDN, CDN, is a registered dietitian nutritionist and classically-trained chef. With a passion for helping people (including her father) with diabetes, she’s author of The With or Without Meat Cookbook: The Flexible Approach to Flavorful Diabetes Cooking and the award-winning The All‐Natural Diabetes Cookbook, both published by the American Diabetes Association. Jackie is also author of 1,000 Low-Calorie Recipes and Big Green Cookbook. Her next book, The All-Natural Diabetes Cookbook—2nd Edition, was published in 2015.

Nutritionist Rania Batayneh, MPH is the author of the best-selling book, The One One One Diet. She holds a master’s degree in public health nutrition from the University of Michigan School of Public Health and is also a Wellcoaches Certified Health and Wellness Coach endorsed by the American College of Sports Medicine (ACSM).

OmnichannelHealth Media, publisher of DiabetesDigest.com, does not provide medical advice, diagnosis or treatment. See additional information.