But good general advice to follow is to keep your carbs consistent -- eat the same amount at breakfast, lunch, and dinner to keep blood sugar from spiking or dipping too low. Weisenberger recommends 45 grams as a target for the three main meals of the day. "If you go lower than 30 grams at a meal, it's going to be really hard to get all the nutrients you need, such as fiber and phytochemicals," the health-boosting nutrients in fruits and vegetables.
Often, people with type 2 diabetes start using insulin with one long-acting shot at night, such as insulin glargine (Lantus) or insulin detemir (Levemir). Discuss the pros and cons of different drugs with your doctor. Together you can decide which medication is best for you after considering many factors, including costs and other aspects of your health.
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Another non-insulin injection for people with diabetes is exenatide (Byetta). This medication, originally derived from a compound found in the saliva of the Gila monster, triggers insulin release from the pancreas when blood glucose levels rise. Exenatide is meant to be used along with oral diabetes drugs. It is dosed twice daily and should be injected within an hour of the morning and evening meals. Recently, the FDA warned that exenatide may increase the risk of severe even fatal pancreatitis (inflammation of the pancreas) and that the drug should be discontinued and not restarted if signs and symptoms of pancreatitis develop (severe abdominal pain, for example). It is not for use in people with type 1 diabetes.