Type 2 Diabetes 101: What to know for new patients

Unlike type 1 diabetes–a condition you are typically born with–type 2 diabetes impacts individuals later in life. If you are one of the millions of Americans with diabetes 2, know that you are not alone and that the ability to fight this illness is within your control. In fact, type 2 diabetes is a reversible condition, and with proper medical and lifestyle changes, you can get off all medications. 

To help you get your treatment started, our pharmacists answered some of the most common questions about type 2 diabetes. 

How are diabetes type 1 and type 2 different?

Type 1 is typically a condition that an individual is born with and is discovered at a young age. When you have type 1, your body requires insulin because it cannot make its own.

Type 2 diabetes is a chronic disease of both insulin resistance and inadequate insulin secretion. To put it simply, in this condition you don’t have enough insulin and the insulin you do have doesn’t work very well. Type 2 is an acquired condition that usually is the result of a prolonged unhealthy diet along with a sedentary lifestyle.

If type 2 is not controlled, there is an increased risk of macrovascular, microvascular, and neuropathic diseases.

How is someone diagnosed with diabetes?

Signs of diabetes 2 typically include frequent urination, increased thirst, insatiable hunger, fatigue, blurry vision, and numbness or tingling in the hands and feet. If you feel these symptoms, bring them up with your doctor as these are signs of hyperglycemia–i.e. high blood sugar.

Your doctor will then test you in a number of ways. The first, most common way is through an A1C test. This test indicates your average blood sugar level for the past two to three months. An A1C level above 6.5% or higher on two separate occasions indicates that you have diabetes, while an A1C level between 5.7 and 6.4 indicates prediabetes. Below 5.7 is considered normal. 

If those results are not consistent, your doctor may order a fasting blood sugar test that is taken after an overnight fast. If the sugar level is 126 or higher on two separate tests, your doctor will diagnose you with diabetes 2.

How do you treat type 2 diabetes? 

In most cases where sugar levels aren’t too high, a patient with type 2 diabetes begins with oral medications. These include metformin, glipizide, glimepiride, and pioglitazone, among others. 

However, if blood sugar levels are out of control (A1C of >10% or blood glucose levels ?300mg/dL) then insulin could be used to help keep the blood sugar at the goal. The American Diabetes Association‘s guidelines for blood sugar control in people with diabetes is 80 to 130 mg/dL before meals and less than 180 mg/dL after meals.

What are the various supplies you’ll need to test my blood sugar?

Whether you’re on insulin or oral medication, you’ll need the below supplies:

  • Blood glucose monitor:  Small, portable meters used to check your blood sugar levels. They work by analyzing a small amount of blood from your fingertip. 
  • Test strips: These work with the blood glucose monitor to read your blood sugar levels. 
  • Lancet: A small medical tool used to prick the skin to get a blood sample. 
  • Lanceting device (optional): An automatic, blood-sampling instrument that is equipped with a lancet. This device is not a necessity but can help make the pricking process more efficient and less painful.
  • Alcohol pads: Disinfecting pads used to clean the finger before. 
  • Sharps container: A leak-proof container designed to hold both insulin syringes and pen needles.

It is important to know that the blood glucose monitor and test strips must be the same brand and model line. Otherwise, they will not work together. For example, even though “Truetrack” and “Truemetrix” are the same brand, they cannot be used interchangeably as they are different model lines.

That said, lancet devices and lancets do have more leeway as most are universal.

Now that I’ve acquired all my devices, how do I use them to test my blood sugar? 

Typically you’ll test your blood sugar twice a day (once in the morning before you eat/drink anything and later in the evening before you go to bed). Your doctor may increase it to three times a day, but everyone is different so be sure to clarify with your doctor. Your doctor may ask you to keep a Self-Monitoring Blood Glucose logbook which is a useful tool to keep track of blood glucose levels over time. 

Here are the exact steps for testing your blood sugar: 

  1. Prepare the blood glucose monitor.
  • Open the bag and place the machine on a flat surface such as a table or countertop. Turn on the glucose machine. Grab the test strip container and check for the expiration date. The expiration date for these test strips is important because it ensures that the reading that you are getting is accurate. Once the test strips expire they aren’t as reliable in their readings.
  • Place the test strip inside the glucose machine. Wait a couple of seconds and you will see a “blood drop” icon on the machine indicating it is ready for blood. 
  1. Prepare the lancet machine.
  • Adjust the depth at which the lancet machine will puncture. Our pharmacists recommend starting in the middle to ensure there is enough blood for the machine–i.e. since the machine includes numbers 1-5, start at 3 and adjust accordingly.
  • Open up the lancet machine, place the lancet inside the machine, and twist the circle part off revealing the needle.
  • Place the lancet machine cap back on.
  1. Prepare the finger.
  • Use an alcohol swab to ensure the finger is sterile and wait a few seconds for the alcohol to dry.
  1. Puncture the finger.
  • Use the lancet machine on the chosen finger and press the button to puncture the finger. 
  • It is good to rotate fingers along with the location. But generally, you want to pretend there is a smiley face on your finger and poke where an eye would be. 
  1. Test the blood.
  • Once punctured, there should be some blood coming out of the finger. 
  • At this point, you should grab the glucose machine that has the test strip inside it and touch the reservoir to the blood for a few seconds. The machine will then beep, indicating it is done. 
  • Now you wait for the glucose reading. 
  1. Discarding materials. 
  • Once you’re done, discard the lancet in a Sharps container. 
  • Please note that it is unsanitary to reuse lancets. Always use a new one each time you test your blood. 
  1. Record your blood sugar readings. 
  • It is important for every diabetic to keep consistent logs of their readings. Bringing this to your doctor will help you ensure your blood sugar is under control. 

How do I dispose of needles?

This is an important topic for anyone using needles. First off, do not use needles, lancets, or test strips more than once; they are only intended for single use. Also, do not share any with partners or siblings. 

Once you want to dispose of a needle, place all needles and other discarded products in a Sharps container immediately after use. This will reduce the risk of needle sticks, cuts, and punctures from loose items. This container should be kept out of reach of children and pets and discarded when it’s roughly ¾ full.

When it’s full, you will drop it off at a designated, safe spot. Check with your local trash removal services or health department about where is best–it may be a dropbox, a doctor’s office, a pharmacy, a police station, a mail-back program, or something else.

To find out info about how to dispose properly of needles in your area, call 1(800) 643-1643 or email info@safeneedledisposal.org.

When traveling, check the TSA website for up-to-date rules on what to do with your Sharps container. Always make sure your medicines are labeled with the type of medicine, the manufacturer’s name, or a drug store label. Also, bring a letter from your doctor to confirm the medication is yours. 

I’ve heard of the “rule of 15.” What is that?

Your doctor or pharmacists may bring up the “rule of 15” and if they don’t, ask! It’s a technique used when someone feels that they have low blood sugar. 

To follow this guideline:

  1. Check your blood glucose level with your meter and confirm that your level is under 70 mg/dl;
  2. Consume or drink 15 grams of carbohydrate; (like an 8 oz glass of orange juice or apple juice)
  3. Wait about 15 minutes;
  4. Recheck your blood glucose level.
  5. Repeat steps 1-3 until blood glucose level is above 70mg/dL

How often do I need to go to the doctor’s office as a diabetic? 

Routine screenings are very important and it’s generally recommended you visit the doctor every three months. 

Foot and eye exams are also important if you’re diagnosed with diabetes. Diabetes–especially left unchecked–can damage some of your nerves and impact blood vessels in different areas of the body such as the retina and foot. This can result in eye issues including blindness and increased risk of cataracts, and foot issues in which poor blood flow increases can increase serious infections.

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