Type 2 diabetes is a condition where your body does not make enough insulin or becomes resistant to it, allowing your blood sugar (glucose) levels to become too high. Insulin is a hormone that helps your body use or store sugar, starches, and other food for energy. Without enough insulin, blood sugar levels increase.
The primary goal in managing diabetes is to reduce the risk of complications by keeping blood sugar levels within a normal range.
Blood sugar goals (mg/dL)
| Before meals | 80-130 |
| Peak after meals (~75 min) | <180 |
| Time in range | >70% |
The list above shows the recommended blood sugar goals for many adults set by the American Diabetic Association. These goals are not the same for everyone and you should discuss with your doctor what personalized goals should be set for you.
What are my treatment options?
Your doctor will work with you to set shared, personalized goals that factor in your age, current medications, and other health conditions you may have. Treatment usually involves a combination of lifestyle changes and medication. More severe cases may also include insulin therapy. Treatment options include:
- Lifestyle changes
- Diet: Limit processed foods, sugary snacks, and high-carb or high-fat meals. Incorporate whole grains, vegetables, fruits, lean proteins, and healthy fats into your diet. Eat smaller meals more frequently rather than 1-2 large meals to maintain stable blood sugar levels.
- Exercise: Regular exercise helps your body use insulin and lowers blood sugar. Aim for at least 150 minutes per week of moderate-intensity exercise such as walking, swimming, or cycling.
- Medications
There are several classes of medications to help control blood sugar levels. The choice of medication depends on your needs and overall health. Some medications may be taken alone or in combination with other medications. Common options include:
- Metformin
- Sulfonylureas (i.e., glipizide, glyburide)
- Dipeptidyl peptidase 4 (DPP-4) inhibitors (i.e., sitagliptin, saxagliptin)
- Glucagon-like peptide-1 (GLP-1) receptor agonists (i.e., semaglutide, liraglutide)
- Dual GLP-1/gastric inhibitory peptide (GIP) receptor agonists (i.e., tirzepatide)
- Sodium-glucose cotransporter 2 (SGLT2) inhibitors (i.e., empagliflozin, canagliflozin)
- Insulin
How often should I check my blood glucose and A1c?
Your blood sugar test will show how high your blood sugar is at that time and can fluctuate throughout the day. The A1c test measures your average blood sugar levels over the past 3 months and is a key test in diagnosing diabetes and tracking how controlled it is over time. The number of times you check your blood glucose and A1c can vary for many reasons, including how close you are to your blood sugar goals, what medications you are on, how stable your blood sugar is throughout the day, and if you have had recent changes to your treatment plan.
Blood sugar: Well-controlled diabetes or consistently being close to goal may only require you to check your blood sugar once or twice a week. If your diabetes is not controlled but your blood sugar does not fluctuate frequently, you may only need to check it 3-4 times a week or once daily. Patients who use insulin or have more severe cases of diabetes may need multiple checks per day to track how their blood sugar reacts to food and insulin.
A1c: The goal A1c set by the American Diabetes Association for many adults is 7%. If you are consistently at or near goal, you may only need to check your A1c every 6 months. If you are not yet at goal or making changes to your treatment plan, you may be asked to get your A1c checked more frequently, such as every 3 months.
What are the complications of diabetes and what steps should I take to prevent them?
High blood sugar levels over time can damage blood vessels in the heart, eyes, kidneys, and the rest of your body. This can also damage the nerves, leading to poor circulation and pain, tingling, or numbness in the hands and feet. In addition to the lifestyle modifications of diet and exercise, additional steps you can take include:
- Regular check-ups and screenings: your doctor may order additional exams to check your eyes, feet, gums, and kidney function. Stay up to date on vaccines, including the flu shot and pneumonia vaccine, since diabetes makes you more prone to infections.
- Foot care: inspect your feet daily for cuts, blisters, or sores. Keep your feet clean and wear comfortable, well-fitting shoes.
- Stay hydrated: drinking enough water throughout the day helps your kidneys flush out excess glucose through urine and supports overall health. Avoid sugary drinks like soda and juice that can contribute to higher blood sugar levels.
- Quit smoking: smoking increases the risk of diabetes complications. If you smoke, ask your healthcare provider for resources or programs that can help you quit.
- Limit alcohol consumption: if you drink alcohol, do so in moderation. Alcohol can cause blood sugar fluctuations and may interfere with your diabetes medications.
- Monitor your blood pressure and cholesterol levels: establish a blood pressure goal with your provider and regularly check your blood pressure. Keep cholesterol levels low by avoiding foods with trans and saturated fats.
- Get enough sleep: lack of sleep or poor-quality sleep can affect blood sugar levels and insulin sensitivity. Try to keep a consistent sleep schedule, create a relaxing bedtime routine, and avoid caffeine or heavy meals late in the day.
Is there a cure?
Currently, there is no cure for Type 2 diabetes (T2DM), but it is a manageable condition, and many people with can effectively control their blood sugar levels and lead healthy lives through a combination of lifestyle changes and medication. There have been cases where people with diabetes achieve “remission”, their blood sugar levels return to normal without medication. However, lifestyle habits must be maintained to stay in remission or the risk of complications may return.
Prepared by Holly Seyler PharmD Candidate 2025
References:
- American Diabetes Association. About diabetes: Type 2 diabetes. American Diabetes Association. https://diabetes.org/about-diabetes/type-2
- American Diabetes Association Professional Practice Committee . 6. Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes-2025. Diabetes Care. 2025;48(Supplement_1):S128-S145. doi:10.2337/dc25-S006
- American Diabetes Association. Oral and other injectable diabetes medications. American Diabetes Association. https://diabetes.org/health-wellness/medication/oral-other-injectable-diabetes-medications
- American Diabetes Association Professional Practice Committee . 9. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2025. Diabetes Care. 2025;48(Supplement_1):S181-S206. doi:10.2337/dc25-S009
- Centers for Disease Control and Prevention. Prediabetes and the A1C test. Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/diabetes-testing/prediabetes-a1c-test.html
- University of Massachusetts Medical School. Diabetes care. University of Massachusetts Medical School. https://www.umassmed.edu/es/dcoe/diabetes-care/
- American Diabetes Association. About diabetes: Complications. American Diabetes Association. https://diabetes.org/about-diabetes/complications
Photo References:
- https://diabetesjournals.org/care/article/48/Supplement_1/S128/157561/6-Glycemic-Goals-and-Hypoglycemia-Standards-of
- https://www.umassmed.edu/es/dcoe/diabetes-care/
- https://www.myamericannurse.com/diabetes-pharmacologic-management-update/
