Conventional Treatment Options

There is currently no cure for osteoarthritis. The primary goal of treatment is to manage symptoms and maintain joint function.

Conventional treatment approaches include:

• Lifestyle changes: Weight management and low-impact exercise
• Physical therapy: Improves flexibility and muscle strength around the joint
• Medications: Pain relievers, anti-inflammatory drugs, and corticosteroid injections
• Assistive devices: Braces, orthotics, or walking aids
• Surgical options: Joint replacement or realignment surgery in severe cases

While these methods may offer symptom relief, they do not reverse or regenerate damaged cartilage.

Symptoms

T2DM may develop gradually and often goes undiagnosed for years. Common symptoms include:

• Frequent urination (polyuria)
• Excessive thirst (polydipsia)
• Increased hunger (polyphagia)
• Fatigue
• Blurred vision
• Slow-healing wounds
• Numbness or tingling in hands or feet
• Recurrent infections (e.g., urinary tract or skin infections)

Diagnosis

Diagnosis is based on one or more of the following criteria:

• Fasting blood glucose ≥126 mg/dL
• HbA1c ≥6.5%
• 2-hour plasma glucose ≥200 mg/dL after oral glucose tolerance test
• Random plasma glucose ≥200 mg/dL with symptoms

Conventional Treatment

Treatment aims to achieve and maintain optimal blood glucose levels, reduce risk factors, and prevent complications.

Lifestyle modification:

• Healthy diet (low glycemic index foods, high fiber)
• Regular physical activity (150 minutes/week)
• Weight loss (5–10% can significantly improve glycemic control)

Oral medications:

• Metformin: First-line therapy that reduces hepatic glucose production.
• Sulfonylureas: Increase insulin secretion.
• DPP-4 inhibitors: Enhance incretin activity.
• SGLT2 inhibitors: Increase urinary glucose excretion.
• Thiazolidinediones: Improve insulin sensitivity.

Injectables:

• GLP-1 receptor agonists: Promote insulin secretion and weight loss.
• Insulin therapy: Required in advanced or poorly controlled cases.

Monitoring:

• Regular blood glucose checks
• Quarterly HbA1c tests
• Monitoring blood pressure and cholesterol

Complications

Poorly controlled T2DM can lead to a wide range of complications:

Microvascular:

• Diabetic retinopathy (vision loss)
• Nephropathy (kidney failure)
• Neuropathy (nerve damage)

Macrovascular:

• Cardiovascular disease
•  Stroke
• Peripheral artery disease

Other complications:

• Diabetic foot ulcers
• Erectile dysfunction
• Cognitive impairment

Supportive and Holistic Management

Effective diabetes management extends beyond medication:

• Nutrition counseling: Tailored meal plans by dietitians
• Exercise programs: Structured physical activity
• Mental health care: Stress, anxiety, and depression can affect diabetes control
• Education programs: Empower patients through self-management education (DSME)

Stem Cell Therapy in Type 2 Diabetes

Stem cell therapy offers promise as a regenerative treatment for T2DM by improving insulin sensitivity and potentially regenerating beta-cell function.

Types of stem cells:

• Mesenchymal stem cells (MSCs)
• Pancreatic progenitor cells

Mechanism of action:

• Modulation of immune and inflammatory responses
• Promotion of beta-cell regeneration
• Improvement in insulin sensitivity and glucose metabolism

Clinical evidence:

• Research suggest improved glycemic control and reduced insulin requirements
• MSCs may reduce systemic inflammation and support metabolic homeostasis

Hyperbaric Oxygen Therapy (HBOT) for Type 2 Diabetes

HBOT is primarily used in T2DM to treat chronic wounds such as diabetic foot ulcers. Its potential systemic benefits are also under investigation.

Mechanism:

• Enhances oxygen delivery to hypoxic tissues
• Promotes angiogenesis and collagen synthesis
• Reduces inflammation and oxidative stress
• Stimulates insulin sensitivity and cellular repair

Applications:

• Healing of non-healing diabetic foot ulcers
• Potential role in improving beta-cell function

Clinical evidence:

• Approved by FDA for diabetic wound care
• Some studies show improved insulin sensitivity and reduced HbA1c in selected patients

Prevention and Remission

T2DM is often preventable and, in some cases, reversible, especially in the early stages.

Prevention strategies:

• Maintain a healthy weight
• Adopt a balanced diet
• Exercise regularly
• Avoid tobacco and limit alcohol

Diabetes remission:

• Achievable through significant lifestyle changes or bariatric surgery
• Marked by normal blood sugar levels without medications

Technology and Innovation

• Continuous glucose monitoring (CGM)
• Smart insulin pens and apps
• Digital health platforms for lifestyle tracking and telemedicine support

These tools help patients monitor their condition in real-time and make informed decisions.

Prognosis

With effective management, individuals with T2DM can lead healthy, active lives. Early intervention, comprehensive care, and regular follow-up are key to preventing complications and improving long-term outcomes.

Conclusion