The aims of treatment for type 2 diabetes are to achieve good blood glucose control and to reduce the risk of developing complications through regular monitoring and careful management of cardiovascular risk factors. 

Non-pharmacological treatments, such as lifestyle adjustments, are the first-line treatments for type 2 diabetes. The following areas need to be addressed to ensure the individual is adopting a healthy lifestyle:

• Diet: establishing a healthy balanced diet that is low in saturated fats and includes fibre, low glycaemic index sources of carbohydrates, such as fruit, vegetables, whole grains and pulses, low fat dairy and oily fish. This aims not only to establish good blood glucose control but also maintain blood pressure in the normal range and maintain a lipid and lipoprotein profile that reduces cardiovascular risk
• Weight reduction: a reduction in body weight would be beneficial if overweight. A dietitian would aim for weight loss of five to 10 per cent as an initial target
• Regular physical activity: regular exercise may be seen to lower blood glucose levels due to increased amounts of glucose being used by the muscles for energy
• Smoking cessation (if applicable): support should be offered to stop smoking where necessary, as smoking is a risk factor for developing cardiovascular disease.

If lifestyle adjustments alone are not sufficient to establish good blood glucose control, treatment with antidiabetic medicines will be required. So let’s now consider the medicines available before looking at how they are used.