The American Diabetes Association provides several guidelines for the treatment of type 2 diabetes, including lifestyle changes, medications, surgery, and more.

No treatment course works for everyone with type 2 diabetes, but the American Diabetes Association (ADA) has a number of guidelines. ADA Professional Practice Committee members update the association’s care standards each year or more as needed. This committee is staffed by doctors, other diabetes care and education experts.

Their guidelines recommend choosing appropriate treatments based on the individual’s specific situation.

This article explains the recommendations for treating ADA type 2 diabetes.

According to the ADA, “Lifestyle management is a fundamental aspect of diabetes care.” This technique includes:

Education and support help people manage diabetes և adapt to new treatment challenges և progress. Nutrition therapy can help a person return to a healthy diet.

Find out what foods to choose և Avoid people with type 2 diabetes here.

Carbohydrate management

The ADA recommends a variety of dietary changes, including carbohydrate management. As studies on the ideal amount of carbohydrates for people with type 2 diabetes have not been finalized, there are no specific guidelines.

However, the association recommends avoiding sugary drinks, low-fat or low-fat processed foods. It also suggests replacing refined carbohydrates and sugary foods with the following:

  • whole grains
  • vegetables
  • beans
  • fruit:

They offer different approaches to managing carbohydrate intake based on what can work for different people.

Learn more about the link between carbohydrates and diabetes here.

Proteins և fats

The ADA recommends personalizing protein goals, while protein accounts for 15-20% of total daily calorie intake.

It states that the ideal fat intake for people with diabetes is “controversial” because focusing on the type of fat is more important than the total amount of fat.

The ADA reports that a Mediterranean diet rich in monounsaturated fats can help control blood glucose.

See our guide to the Mediterranean diet here.


Getting enough exercise is one of the most important part of diabetes self-management. ADA has the following recommendations for physical activity:

  • Children with type 2 diabetes և adolescents should have at least 60 minutes of moderate-intensity or vigorous aerobic activity per day, plus vigorous strengthening activities at least 3 days a week.
  • Most adults with type 2 diabetes They should do at least 2-3 resistance exercises – at least 150 minutes a week of moderate to vigorous activity, while younger, physically fit people should do at least 75 minutes of vigorous activity or interval training per week.
  • All adults with type 2 diabetes They should spend less time on sedentary activities; “interrupt sitting for a long time every 30 minutes” with some activity.
  • Elderly people with type 2 diabetes should participate in flexibility and balance training 2-3 times a week.

Learn more about the benefits of exercise for type 2 diabetes here.

Insulin is a hormone produced by the pancreas. Its role is to help the body use or store glucose in the blood. A person with type 2 diabetes produces insulin but does not respond well to it.

Metformin is a prescription drug that can help lower high blood glucose levels in type 2 diabetes. For the combined effect, your doctor may recommend that you take metformin in a synthetic form of insulin.

According to the ADA, “Metformin should be continued as long as it is tolerated and is not contraindicated. Other agents, including insulin, should be added to metformin. ”

The ADA goes on to explain that a physician should consider using it when the human blood glucose level is at least 300 milligrams per deciliter (mg / dL) or the A1C level is more than 10%. Doctors should also consider prescribing it to people who have lost weight or have symptoms of high blood sugar, such as frequent urination or excessive thirst.


They describe several different types of insulin, including:

  • Basal insulin. One can take this with metformin.
  • Prandial insulin. People usually take it before eating.
  • Concentrated insulins. These usually work faster.
  • Inhalation insulin. These also act quickly.


How long does the effect of insulin last? When the level rises in the body, it can vary depending on the type of insulin. Some examples include:


The person can use a pre-filled syringe for injection, or the solution must be mixed first. A person can inject the drug in several areas, including:

  • in the abdomen
  • at the top of the arm
  • in the back
  • in the thigh

Rotate the injection sites and keep those areas clean. Be careful not to inject insulin into the subcutaneous tissue, not the muscle tissue.

Learn about the best places to inject insulin here.

ADA recommends the use of metformin with insulin, noting: “After starting metformin, it should be continued as long as it is tolerated, it is not contraindicated. Other agents, including insulin, should be added to metformin. ”

That is, the doctor should prescribe insulin in parallel with the original treatment, not instead. They recommend prescribing insulin early if:

However, the ADA notes that “a peptide 1 receptor agonist like glucagon is preferable to insulin when possible.” In other words, insulin is usually not even a secondary treatment if a peptide 1 receptor agonist like glucagon is an option for a person.

Learn how to mix insulin here.

People with type 2 diabetes can benefit from surgery. According to the American Society for Metabolism and Bariatric Surgery, people with this type of diabetes who undergo metabolic or bariatric surgery can see their diabetes symptoms improve within a few days, with almost 78% finding that their symptoms are in remission. so no one else needs diabetes medicine after that.

A common example of bariatric surgery is gastric bypass.

Learn more about bariatric surgery: type 2 diabetes here.

Medical treatment can be started with metformin combined with lifestyle changes. Over time, it can become more difficult for a person to manage their blood sugar levels, and if this happens, the ADA recommends combination therapy. This applies to any combination of drugs.

The ADA recommends that in many cases, people with the following health problems should take a combination of metformin նման a peptide 1 receptor agonist such as glucagon or a sodium-glucose transporter 2 inhibitor.

Learn more about Combined Therapy for Type 2 Diabetes here.

According to ADA guidelines, a person should start taking metformin from the time of diagnosis of diabetes, unless there are medical reasons why it is not suitable. For most people, the first line of treatment is metformin, plus lifestyle changes.

Second therapy

The ADA goes on to say that if metformin is suitable, the doctor may use a second therapy. However, “early combination therapy may be considered in some patients at the beginning of treatment to prolong treatment failure time.”

In other words, your doctor may consider prescribing additional medication immediately after diagnosis to help prevent a single treatment failure.

Additional therapy

Over time, the ADA recommends adding treatments based on a person’s risk factors. They note that a “sodium-glucose-transporter-2 inhibitor or a glucagon-like peptide-1 receptor agonist is recommended for cardiovascular disease” or to control glucose levels in people at risk for kidney or heart disease or one of these diseases.

The ADA also advises doctors to follow up regularly to monitor the progress of treatment.

Individual treatment plans

Finally, the ADA says: “The patient-based approach should be used to select pharmacological agents. “Observations include effects on cardiovascular disease, efficacy, risk of hypoglycemia, weight, value, risk of side effects, patient preferences.”

In other words, treatment should be based on the individual’s needs and desires, not on mandatory guidelines.

This encourages people to offer adjustments to their treatment plans and doctors to make adjustments that are likely to be beneficial.

ADA is constantly updating its recommendations for the treatment and management of type 2 diabetes. These recommendations include different combinations of lifestyle changes and medical interventions.

However, ADA recommends that each person work with their doctor to tailor and customize their treatment plan.