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Posts Tagged ‘Type II Diabetes’

Manage Diabetes Through Lifestyle Modifications. By Our Student Pharmacist, Isatu Kamara.

As November comes to a close, so does National Diabetes Month. Diabetes, however, is a condition that must be managed year-round. If you or a loved one has diabetes, it is important to understand how the condition is best managed to prevent further progression of the disease.

Type 2 diabetes may be managed with oral medications, but may also require insulin injections. In this post, instead of focusing on the medications used to treat diabetes, I will be discussing what you can do to manage type 2 diabetes through lifestyle modifications like diet and exercise.



One of the easiest ways to create healthy meals is to follow the American Diabetes Association Diabetes Plate Method. By using this method, you can create a balanced meal of vegetables, carbohydrates, and protein without having to do any weighing or calculations. Here’s how to put together your plate:

  1. Find a reasonably sized plate, not too big or too small. A plate that is about 9 inches across is recommended.
  2. Fill half of your plate with non-starchy vegetables. Non-starchy vegetables are high in vitamins, minerals, and fiber and lower in carbohydrates, so they won’t raise blood sugar much.


  • Asparagus
  • Broccoli/Cauliflower
  • Celery
  • Mushrooms
  • Leafy greens like kale or collards
  • Salad greens like lettuce, spinach, or arugula
  1. Fill one quarter of the other half of your plate with lean protein foods. Lean proteins are lower in fat and saturated fat than other sources of protein.


  • Chicken, turkey, or eggs
  • Fish like salmon, tuna, or tilapia
  • Shellfish like shrimp, lobster, or scallops
  • Lean beef or pork cuts
  • Cheese

Plant-based examples:

  • Beans, lentils, or hummus
  • Nuts and nut butters
  • Edamame
  • Tofu
  1. Fill the last quarter of your plate with carbohydrates. Foods high in carbohydrates have the greatest effect on raising blood sugar so limiting these foods to a quarter of a plate can help prevent blood sugar spikes after meals.


  • Whole grains like brown rice, bulgur, oats/oatmeal, or quinoa
  • Starchy vegetables like green peas, plantain, potato or sweet potato
  • Beans and legumes
  • Fruits
  • Dairy products like milk/milk substitutes and yogurt
  1. For your beverage choose water or a low-calorie drink. Water is the best option because it has no calories or carbohydrates, so it won’t affect your blood sugar.

Other options include:

  • Unsweetened tea or coffee
  • Sparkling or flavored water with no sugar
  • Diet soda



Try adding physical activity to your daily routine. Physical activity lowers your blood sugar levels and can help you lose weight. If you aren’t used to physical exercise here is a resource to help you get started safely. Generally, the goal is to incorporate 20-25 minutes of moderate-intensity physical activity every day to total at least 150 minutes a week.

Some examples of moderate-intensity physical activity are:

  • Walking briskly
  • Dancing
  • Swimming
  • Bicycling

You should always talk to your doctor or diabetes educator before starting a new exercise program and let them know if you have any questions or concerns with your routine.

If not properly treated, diabetes can lead to serious problems like, heart attack, stroke, kidney disease, vision problems, nerve pain and amputation. It is important to make healthy lifestyle choices to manage your diabetes and follow up regularly with your health care providers.


  1. Get active! Centers for Disease Control and Prevention. https://www.cdc.gov/diabetes/managing/active.html. Published May 6, 2021. Accessed November 8, 2022.
  1. Managing diabetes with diet and exercise. Commonwealth Care Alliance. https://www.commonwealthcarealliance.org/living-well-at-home/how-to-manage-diabetes-with-diet-and-exercise/. Published October 18, 2021. Accessed November 8, 2022.
  1. Patient education: Patient education: Type 2 diabetes (The Basics). UpToDate. https://www.uptodate.com/contents/type-2-diabetes-the-basics. Published January 21, 2021. Accessed November 8, 2022.
  1. What is the diabetes plate method? Diabetes Food Hub. https://www.diabetesfoodhub.org/articles/what-is-the-diabetes-plate-method.html. Published February 1, 2020. Accessed November 8, 2022.

Novel New Diabetes Treatment: Mounjaro. By Our Student Pharmacist, Austin Cotsmire.

If you are a diabetic patient, there may be a new and exciting treatment option for your care. In May, the Food and Drug Administration (FDA) approved a new medication called Mounjaro (tirzepatide) for the treatment of Type II Diabetes in addition to diet and exercise for patients over the age of 18.

This medication is the first of its kind as it combines two different medication classes in a single injection. One class is known as glucagon-like peptide-1 (GLP-1) which you may be familiar with as medications such as Trulicity and Ozempic fall into this category.

The second component of Mounjaro is known as glucose-dependent insulinotropic polypeptide, or GIP for short. This combination is what makes Mounjaro so special and the first of its kind.

Below is a list of the ways that each of these medication classes work in your body to help lower blood sugar and A1c:

Works in the brain to decrease food intake

Works in the brain to promote the feeling of fullness

Increases insulin production in the pancreas

Reduces glucagon production in the pancreas

Glucagon increases glucose (or sugar) levels in the body

Slows emptying of stomach contents

Works in the brain to decrease food intake

Increases insulin sensitivity

Increases insulin production by the pancreas

Increases glucagon produced by the liver

Beneficial to help prevent low blood sugar episodes

Mounjaro Effects in the Body

Mounjaro is a once weekly injection just like most other GLP-1’s and is available in doses of 2.5 mg, 5 mg, 7.5 mg, 10 mg, 12.5 mg, and 15 mg weekly. The medication is supplied in a box containing four prefilled, auto-injecting pens (shown below). The pens are single use and should be disposed of after use.

Since the injections are once weekly, one box of four pens is a 28 day or one month supply. Like both Trulicity and Ozempic, patients must start on the lowest dose and may increase to the next dose after at least four weeks of treatment if needed. The 2.5 mg dose of Mounjaro is intended to get your body used to the medication in order to prevent side effects before moving up to the 5 mg dose where you will begin to see benefits in your blood sugar and A1c readings.

 Mounjaro Pens

In clinical trials, Mounjaro was shown to provide superior diabetic control over Ozempic and other traditional therapies, such as insulin, across all doses. In these studies, patients’ A1c was measured over a course of 40 weeks of treatment. On average, patient’s being treated with Ozempic 1 mg weekly saw an A1c reduction of 1.9 while patients being treated with Mounjaro 5 mg, 10 mg, or 15 mg weekly saw reductions of 2.0, 2.2, and 2.3 respectively.

While this may not seem like a huge difference, the percentage of participants reaching their A1c goal of below 7% exemplifies how important these minor differences are. Over the 40 weeks, 79% of Ozempic patients reached this A1c goal while 82% of patients on Mounjaro 5 mg weekly and 86% of patients on 10 mg and 15 mg weekly both, reached this goal. Furthermore, only 64% of patients on Ozempic reached an A1c of less than 6.5% while 69% of patients on 5 mg, 77% on 10 mg, and 80% on 15 mg of Mounjaro reached this level.

While Mounjaro is only FDA approved for the treatment of Type II Diabetes in adults, patients enrolled in the clinical trials saw huge benefits in weight loss as well. Below are two graphs depicting the weight loss benefits of the different doses of Mounjaro at the end of the 40 weeks trial. As you can see, the 15 mg dose is extremely beneficial. As a result, some doctors may prescribe this drug for off label use in weight loss although insurance would be unlikely to cover it for that use until there is an FDA approval.

Mounjaro Weight Loss

Like all medications, Mounjaro comes with a lengthy list of side effects. The side effects are rare, and most are manageable, however there is one black box warning. This warning is for an increased risk of thyroid c-cell tumors so patients should keep an eye out for symptoms such as a swelling in their neck and have their thyroid function checked regularly. This side effect was only seen in rats and there have been no cases in humans.

For years, first line treatment for diabetes has remained the same with the use of metformin. However, with new and novel drugs like Mounjaro coming to the market, we are beginning to see a shift in recommendations. Depending on compelling conditions that are common in patients with diabetes, such as cardiovascular disease, GLP-1s, and now Mounjaro, are being recommended as first line treatment. If you think you may benefit from this medication, talk to your doctor or pharmacist today!


A1C and Weight Change Results | MounjaroTM (tirzepatide). Accessed August 19, 2022. https://www.mounjaro.com/hcp/a1c-weight

FDA Approves Mounjaro (Tirzepatide) for Diabetes Treatment. diaTribe. Published May 13, 2022. Accessed August 19, 2022. https://diatribe.org/fda-approves-mounjaro-tirzepatide-diabetes-treatment

Getting Started, Dosing & Prescribing | MounjaroTM (tirzepatide). Accessed August 19, 2022. https://www.mounjaro.com/hcp/getting-patients-started

How Mounjaro Works | MounjaroTM (tirzepatide). Accessed August 19, 2022. https://www.mounjaro.com/hcp/how-mounjaro-works

Lexicomp. Accessed August 19, 2022. https://online-lexi-com.proxy.lib.ohio-state.edu/lco/action/doc/retrieve/docid/patch_f/7224042?cesid=3danyJdgnJK&searchUrl=%2Flco%2Faction%2Fsearch%3Fq%3Dmounjaro%26t%3Dname%26acs%3Dfalse%26acq%3Dmounjaro

What are GIP & GLP-1 Incretin Hormones | MounjaroTM (tirzepatide). Accessed August 19, 2022. https://www.mounjaro.com/hcp/what-is-gip