Type 2 diabetes care

Question 1

Where are scheduled visits available? Is there a One Medical office near me?

Answer

In-Person Visits are scheduled appointments with the provider of your choice. Video Visits are scheduled, virtual appointments with the provider of your choice and are available in U.S. states where One Medical offices are located.

One Medical currently has primary care doctors' offices in or around the following locations:

Atlanta, GA

Austin, TX

Boston, MA

Chicago, IL

Columbus, OH

Connecticut

Dallas-Ft. Worth, TX

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Houston, TX

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Los Angeles, CA

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Miami-Ft. Lauderdale, FL

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New Jersey

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New York

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Orange County, CA

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Phoenix, AZ

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Portland, OR

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Raleigh-Durham, NC

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San Diego, CA

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Seattle-Tacoma, WA

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San Francisco Bay Area, CA

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Washington D.C. Metro Area (DMV) and Northern Virginia

In-Person and Video Visits are not included in membership and are billed to you/your insurance; copays and deductibles may apply.

Find out more about One Medical locations, including One Medical Seniors offices, on the location page.

Question 2

How can One Medical set me up for success in managing diabetes?

Answer

At One Medical, patients with diabetes can benefit from targeted interventions through our multidisciplinary chronic care management program, Impact by One Medical.* Through the program, patients work with their dedicated care team led by a primary care provider to set health goals and make a personalized plan to meet them. This can include 1:1 behavioral coaching sessions, self-guided educational resources, remote monitoring and data syncing from wearable devices, and coordinated care with specialists at our health systems partners.

Your One Medical provider can share more information about the Impact program and whether it might be a good fit for you.

*Impact by One Medical program is not included in the membership; services that are part of the program are billed to you or your insurance, copays and deductibles may apply. Only available in locations where One Medical has offices.

Question 3

Who should be screened for type 2 diabetes?

Answer

Certain risk factors can increase the likelihood that you'll develop type 2 diabetes. Even if you don't have diabetes symptoms, a healthcare provider may recommend screening for diabetes if you have any of the following risk factors:

• A history of certain health conditions, including high blood pressure, high cholesterol, polycystic ovarian syndrome (PCOS), gestational diabetes, or a skin condition known as acanthosis nigricans

• Higher body weight

• Age over 45

• A parent or sibling with diabetes type 2

• Family history of heart disease

• Tobacco use

• A physically inactive lifestyle

Question 4

How is type 2 diabetes diagnosed?

Answer

Type 2 diabetes is diagnosed through lab testing checking blood sugar (with different thresholds depending on the type of test and if you were fasting beforehand). The lab test may check your blood sugar directly or calculate your hemoglobin A1C, a measure of your average blood sugar level over the past three months. Your healthcare provider will help you understand the diagnosis and if additional testing is needed.

Question 5

What's the difference between type 1 and type 2 diabetes?

Answer

The main difference between type 1 and type 2 diabetes is in what causes them. Type 1 diabetes occurs when the body’s immune system mistakenly attacks and destroys the insulin-producing cells in the pancreas. This leaves the body unable to produce enough insulin. It usually starts in childhood or young adulthood. It is treated with insulin.

Type 2 diabetes occurs when the body becomes resistant to insulin or doesn’t make enough insulin. Over time, blood sugar levels start to rise as the body struggles to keep up. It is treated with medication (pills or injections) or insulin.

In both types, high blood sugar can lead to complications like nerve, kidney, and heart damage if blood sugar levels are not well controlled. While there is no cure yet for diabetes, healthy lifestyle choices and medications can help manage symptoms and reduce complications.

Question 6

What diet is best for type 2 diabetes management?

Answer

A nutritious, balanced diet is a key part of managing diabetes, but it’s important to know that a diagnosis of diabetes doesn’t mean you have to follow one specific eating plan or turn your current food practices upside down. You can work with your primary care provider or nutritionist to create a customized diabetic eating plan that fits your preferences and health goals.

In general, diabetes experts recommend eating regular, balanced meals and snacks that include foods from a variety of food groups, including:

• Vegetables, fruits, whole grains, beans, lentils, nuts and seeds. These foods are high in fiber and nutrients.

• Lean protein sources like fish, poultry, Greek yogurt and tofu

• Low-fat dairy and healthy fats

They also recommend:

• Limiting processed foods, sweets, sugary beverages and refined carbs like white bread which can spike blood sugar

• Paying attention to portion sizes and carbohydrate counts

• Eating small, frequent meals every 3-4 hours to keep blood sugar stable

Question 7

Can exercise help with type 2 diabetes management?

Answer

Regular physical activity is an important part of living with diabetes and helps to lower blood sugar. Physical activity has other benefits, too - it can help lower blood pressure, improve cholesterol levels, improve sleep, and improve memory and mood. The goal is simply to get exercise as many days per week as possible, in whatever way best fits with your interests and lifestyle right now. If you haven’t been active in a while, start slow and talk with your provider about the best way to safely increase your physical activity.

Question 8

Will I need to take insulin if I have type 2 diabetes?

Answer

Insulin is sometimes prescribed for type 2 diabetes, but it isn’t a go-to treatment in most cases. There are many types of medication available to treat type 2 diabetes, including options that are easier to use and cause fewer side effects than insulin. Your provider may recommend starting insulin if your blood sugar is very high when you’re diagnosed or if other medications and lifestyle changes aren’t controlling your blood sugar well enough.

Question 9

If I have to take medication for type 2 diabetes, will I need to take it forever?

Answer

It depends. Blood glucose self-monitoring (BGSM), including continuous glucose monitoring (CGM), can be helpful in understanding how your diet, lifestyle, and medications affect your blood sugar levels day-to-day, but whether and how to use BGSM as part of your diabetes treatment plan should be a shared decision between you and your provider. Factors like your medications, how motivated you feel to monitor your blood sugar at home, how well you already understand the ways diet and lifestyle affect your blood sugar, and cost may all come into play when making decisions about BGSM.

Question 10

Will I need to check my blood sugar at home if I have type 2 diabetes?

Answer

A nutritious, balanced diet is a key part of managing diabetes, but it’s important to know that a diagnosis of diabetes doesn’t mean you have to follow one specific eating plan or turn your current food practices upside down. Eat regular, balanced meals and snacks that include foods from a variety of food groups, including: lean proteins, legumes, vegetables, fruits, whole grains, low-fat dairy, and healthy fats. Reducing added sugars and processed foods in your diet will also help to keep blood sugar levels in a healthy range.

Maintaining a healthy diet that works with your lifestyle and preferences can sometimes be challenging, and your provider can refer you to a dietitian or diabetes educator for additional support if you need it.

Question 11

What are the possible complications of diabetes?

Answer

Over time, high blood sugar levels can cause damage to the body’s blood vessels, leading to a variety of problems. Damage to large blood vessels can cause emergencies like heart attack and stroke. Damage to smaller blood vessels can cause gradual injury to the eye (retinopathy), kidneys (nephropathy), and nerves (neuropathy). If untreated, these problems can progress to blindness, kidney failure, and severe nerve damage.

It’s important to note that these complications can be managed or prevented through lifestyle changes and medication. People with diabetes should work closely with their healthcare providers to work out a treatment plan that’s best for them.

Question 12

What is a diabetic coma?

Answer

A diabetic coma, also called diabetic ketoacidosis (DKA), is a very serious complication of diabetes that can lead to unconsciousness and even death if left untreated. It happens when the body starts breaking down fat at a dangerous rate, causing a build-up of acids called ketones in the blood.

Some of the main symptoms of diabetic coma or DKA include:

• Very high blood sugar levels

• Excessive thirst and frequent urination

• Nausea, vomiting, and abdominal pain

• Shortness of breath and fruity-scented breath

• Confusion and drowsiness

DKA requires emergency medical treatment. It is usually prevented by taking insulin as prescribed and monitoring blood sugar levels closely. If you experience any of these diabetic coma symptoms, seek medical help immediately.

Question 13

What is gestational diabetes?

Answer

Gestational diabetes is a type of diabetes that can develop during pregnancy in women who did not have diabetes before getting pregnant. It occurs when the body cannot make enough insulin to handle the extra blood sugar levels that occur during pregnancy. Many women with gestational diabetes have no symptoms. If left untreated, gestational diabetes can cause health issues for both the mother and baby. This is why your doctor will test for gestational diabetes around the 24th to 28th week of pregnancy.

The good news is that through proper diet, exercise, medication if needed, and careful blood sugar monitoring, it can be managed. Speak to your doctor about getting tested for gestational diabetes if you are pregnant and have any of those symptoms. They can help come up with a treatment plan involving meal planning, physical activity recommendations, and possibly medications to keep your blood sugar levels in check.

Question 14

What is pre-diabetes?

Answer

Pre-diabetes refers to when blood sugar levels are higher than normal, but not high enough yet to be diagnosed as type 2 diabetes. Specifically, prediabetes is defined as 5.7% to 6.4% A1C.

Some key things to know about pre-diabetes:

• Insulin resistance syndrome means the body doesn't respond properly to normal amounts of insulin. The body then makes more insulin to get the same results. This problem is sometimes called prediabetes.

• Over time, prediabetes can cause health problems and lead to type 2 diabetes if not managed.

• Lifestyle changes like eating healthy, exercising, and losing weight can help prevent prediabetes from turning into diabetes.

Question 15

What other care or treatments might I need if I have type 2 diabetes?

Answer

Comprehensive diabetes care involves more than managing blood sugar levels. Because diabetes increases your risk of heart disease and stroke, your provider will work with you to manage any other conditions you have that also increase your risk, like high cholesterol or high blood pressure. Because diabetes can weaken the immune system, your provider will also help you stay up-to-date with vaccinations. Your provider will help you stay on track with dental care, eye exams, foot exams, and more. If living with diabetes is affecting your mental health, your provider can help you explore options for supporting your mental health, too.

Question 16

How can diabetes be prevented?

Answer

Diabetes can often be prevented or delayed by making healthy lifestyle choices. Some tips to help prevent diabetes include:

• Maintaining a healthy weight by eating a balanced, nutritious diet and exercising regularly

• Limiting intake of foods high in sugar, refined carbohydrates, and unhealthy fats

• Quitting smoking and limiting alcohol intake

• Getting enough sleep and managing stress levels

• Having regular checkups to monitor blood sugar, blood pressure, and cholesterol levels

Making small, sustainable lifestyle changes can go a long way in reducing your risk of developing type 2 diabetes. People with prediabetes can also benefit greatly from lifestyle changes to prevent progression to full-blown diabetes.

Question 17

Can exercise help with type 2 diabetes?

Answer

Regular physical activity is an important part of living with diabetes and helps to lower blood sugar. Physical activity has other benefits, too - it can help lower blood pressure, improve cholesterol levels, improve sleep, and improve memory and mood. The goal is simply to get exercise as many days per week as possible, in whatever way best fits with your interests and lifestyle right now. If you haven’t been active in a while, start slow and talk with your provider about the best way to safely increase your physical activity.

Question 18

Clinical sources

Answer

1. Basu, S., Zhang, T., Gilmore, A., Datta, E., & Kim, E. Y. (2020). Utilization and Cost of an Employer-Sponsored Comprehensive Primary Care Delivery Model. JAMA network open, 3(4), e203803.

2. Drucker D. J. (2024). Efficacy and Safety of GLP-1 Medicines for Type 2 Diabetes and Obesity. Diabetes care, 47(11), 1873–1888.

3. Lesser, L. I., & Behal, R. (2021). Change in Glycemic Control for Patients Enrolled in a Membership-Based Primary Care Program: Longitudinal Observational Study. JMIR diabetes, 6(2), e27453.

4. Stratton, I. M., Adler, A. I., Neil, H. A., Matthews, D. R., Manley, S. E., Cull, C. A., Hadden, D., Turner, R. C., & Holman, R. R. (2000). Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ (Clinical research ed.), 321(7258), 405–412.

Type 2 diabetes care

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