A plain guide to diabetes treatment: how drugs are chosen, what HbA1c target to aim for, when insulin or a GLP-1 is right, and what remission of early Type 2 really involves. Written by the practice of Dr. Sanjay Sachdev (MBBS, MNAMS), South Delhi.
Fasting glucose, HbA1c and (where needed) an oral glucose tolerance test. Type 1 or slow-onset autoimmune diabetes is considered in lean or younger patients using antibody and C-peptide testing — misclassifying Type 1 as Type 2 is a common and costly error.
Step 2 — the non-drug base
Weight reduction of 7–15% where BMI allows, protein-forward meals with lower refined carbohydrate, 150 minutes of activity weekly plus twice-weekly resistance training, sleep of 7 hours, and alcohol limits. This base decides how few tablets you will eventually need.
Step 3 — choosing medication rationally
Metformin first-line for most. SGLT2 inhibitors where heart failure, kidney disease or albuminuria exist. GLP-1 receptor agonists (semaglutide, tirzepatide) where obesity or cardiovascular risk dominates. DPP-4 inhibitors for the frail elderly. Insulin when HbA1c is very high, during acute illness, or when beta-cell reserve is exhausted. Sulfonylureas only with hypoglycaemia counselling.
Step 4 — monitoring that changes decisions
HbA1c every 3 months until at target, then 6-monthly. Home glucose or CGM data reviewed at each visit for time-in-range, variability and nocturnal lows. Annual: urine albumin-creatinine ratio, kidney function, lipids, retina screening, foot and pulse examination, vitamin B12 for long-term metformin users.
Step 5 — remission of early Type 2
Where diagnosis is recent and beta-cell function preserved, a structured weight-loss programme — with GLP-1 support when indicated — can normalise sugars and allow a staged medication taper. Progress is measured on HbA1c and weight quarterly, and the plan is maintained, not stopped, once remission is reached.
Treatment in South Delhi
Diabetes care at Friends Colony East (C-58) and Maharani Bagh (E-64) — 45–60 minute first consultation, previous reports read in full, and a written plan with drug rationale, red flags, HbA1c target and next review date. Home sample collection available across South Delhi.
Frequently asked
6 answers
What is the treatment for diabetes?+
Type 2 diabetes treatment has four parts: nutrition and weight change, physical activity (especially resistance training), medication chosen for your profile, and structured monitoring. Drugs commonly used are metformin, SGLT2 inhibitors, DPP-4 inhibitors, GLP-1 receptor agonists (semaglutide, tirzepatide), pioglitazone, sulfonylureas and insulin. Type 1 diabetes always requires insulin.
Which is the best medicine for diabetes?+
There is no single best drug. Metformin remains first-line for most people; SGLT2 inhibitors are preferred with heart failure or kidney disease; GLP-1 agonists when weight loss or cardiovascular protection matters most; insulin when HbA1c is very high or beta-cell reserve is low. The right answer depends on your HbA1c, weight, kidney function, heart history and budget — which is why it is a consultation, not a search result.
Can diabetes be cured or reversed permanently?+
Type 2 diabetes cannot be 'cured', but early disease can go into remission — normal sugars without medication — usually with 10–15% weight loss achieved within the first few years of diagnosis. Remission needs maintaining; sugars return if the weight does. Type 1 diabetes cannot be reversed.
What HbA1c should I aim for?+
For most adults, below 7%. Tighter (6.0–6.5%) for young, newly diagnosed patients without heart disease; looser (7.5–8%) for the elderly or those with frequent hypoglycaemia. The target should be written down at your first visit and revisited yearly.
What are the complications of untreated diabetes?+
Retinopathy (vision loss), nephropathy (kidney failure), neuropathy (numbness, foot ulcers), heart attack and stroke, fatty liver, and recurrent infections. Most are preventable with sugar, BP and cholesterol control plus annual screening — retina, urine albumin-creatinine ratio, foot exam and lipids.
Where can I get diabetes treatment in South Delhi?+
Dr. Sanjay Sachdev (MBBS, MNAMS) treats diabetes at Friends Colony East (C-58) and Maharani Bagh Community Centre (E-64), Monday to Saturday, 10:00 AM – 7:00 PM by appointment. WhatsApp or call +91 98110 78388.