What You Can Do

By Alice Park

DIET AND EXERCISE

Start by planning your meals and increasing your physical activity; 30 minutes daily is the goal. Eating several small meals (breakfast, lunch and dinner plus two snacks) at the same time each day, and choosing high-fiber and low-fat foods, such as raw fruits and vegetables, beans and unrefined whole grains, help stabilize blood-sugar levels.

DRUGS

If changing your diet and getting more active are not enough to keep glucose under control, there are several medications that can help:

--SULFONYLUREAS These drugs activate the pancreas to release more insulin.

--MEGLITINIDES Like sulfonylureas, these trigger the pancreas to churn out insulin.

--BIGUANIDES This class of drugs signals the liver to produce less glucose and sensitizes muscle tissue to absorb more glucose from the blood.

--THIAZOLIDINEDIONES The most recent additions to the diabetic medicine chest, these pills improve insulin's ability to push glucose into muscle and fat tissue.

--ALPHA-GLUCOSIDASE INHIBITORS Acting in the intestine, these drugs block conversion of starches in bread and pastas into glucose.

INSULIN

Depending on how long blood-sugar levels remain high and other health factors, some Type 2 diabetics may need insulin. While there are different types of insulin that can be delivered in various ways, for Type 2 diabetics, injections--either with a needle and a syringe or an insulin pen, which contains a needle and a cartridge of variable doses of insulin--are the most convenient. Many benefit from a combination of oral drugs and insulin to control glucose levels.

TESTS

Once you've been diagnosed with diabetes, it's important to keep track of your blood-glucose levels. This can be done in several ways:

--A1C Also known as the glycated hemoglobin test, A1C is a blood test that provides a record of your glucose levels over two to three months. Glucose in the blood attaches to hemoglobin, a protein in red blood cells that ferries oxygen, forming glycated hemoglobin. Because red blood cells circulate in the body for several months, levels of glycated hemoglobin are a good marker for average blood-glucose levels over time.

--URINE When the body cannot make enough insulin and blood-sugar levels get too high, it begins to break down fat, forming ketones. These compounds spill out into the urine, signaling too little insulin at work.

--FINGER STICK The most common way to keep track of blood-sugar levels--pricking the finger for blood before meals and bed--has become more convenient and less painful than it used to be. Automatic lances make the drawing of blood easier, and computerized devices can record readings automatically.

--NONINVASIVE Only one device approved by the Food and Drug Administration provides glucose measurements without puncturing the skin. Worn on the wrist, it uses tiny electric currents to gently draw body fluid from the skin up to six times an hour for as long as 13 hours. The needle-phobic still won't be able to avoid finger pricks, however. The "watch" needs to be used in conjunction with conventional blood-sample monitoring. --By Alice Park