Lifestyle choices, including eating a healthy diet, exercising and staying at a healthy weight, are key to managing type 2 diabetes. But you also might need to take medication to keep your blood sugar, also called glucose, at a healthy level. Sometimes one medication is enough. In other cases, taking several medications works better.
The list of medications for type 2 diabetes is long and can be confusing. Take time to learn about these medicines — how they’re taken, what they do and what side effects they may cause. That can help you get ready to talk to your health care provider about diabetes treatment choices that are right for you.
Diabetes treatment: Lowering blood sugar
Several classes of type 2 diabetes medicines exist. Each class of medicine works in a different way to lower blood sugar. A medication may work by:
Causing the pancreas to make and release more insulin.
Limiting the liver’s ability to make and release sugar.
Blocking the action of enzymes in the intestines that break down carbohydrates, slowing how quickly cells take in carbohydrates.
Improving cells’ sensitivity to insulin.
Limiting the kidneys’ ability to take in sugar, which increases the amount of sugar that leaves the body in urine.
Slowing how quickly food moves through the stomach.
Each class of medicine has one or more medications. Some of these medications are taken by mouth, while others must be taken as a shot.
Compare diabetes medications
Below is a list of common diabetes medications. Other medications are available too. Ask your health care provider about your choices and the pros and cons of each.
Medications you take by mouth
Meglitinides
Medications
Repaglinide
Nateglinide
Action
Trigger the release of insulin from the pancreas
Advantages
Work quickly
Possible side effects
Blood sugar levels drop too low — a condition called hypoglycemia
Weight gain
Sulfonylureas
Medications
Glipizide (Glucotrol XL)
Glimepiride (Amaryl)
Glyburide (DiaBeta, Glynase)
Action
Trigger the release of insulin from the pancreas
Advantages
Low cost
Effective in lowering blood sugar
Possible side effects
Blood sugar levels drop too low
Weight gain
Skin rash
Nausea or vomiting if you drink alcohol
Dipeptidyl-peptidase 4 (DPP-4) inhibitors
Medications
Saxagliptin (Onglyza)
Sitagliptin (Januvia)
Linagliptin (Tradjenta)
Alogliptin (Nesina)
Action
Cause the release of insulin when blood sugar is rising
Limit the liver’s ability to release glucose
Advantages
Don’t cause weight gain
Don’t cause blood sugar levels to drop too low when used alone or with metformin
Possible side effects
Upper respiratory tract infection
Sore throat
Headache
Biguanides
Medications
Metformin (Fortamet, Glumetza, others)
Action
Limit the liver’s ability to release sugar
Improve cells’ sensitivity to insulin
Advantages
Very effective
May lead to minor weight loss
Low cost
Possible side effects
Nausea
Stomach pain
Diarrhea
Very rarely, the harmful buildup of lactic acid — a condition called lactic acidosis —in people with kidney failure or liver failure
Thiazolidinediones
Medications
Rosiglitazone (Avandia)
Pioglitazone (Actos)
Action
Improve cells’ sensitivity to insulin
Limit the liver’s ability to make and release sugar
Advantages
May slightly increase high-density lipoprotein (HDL) cholesterol, the “good” cholesterol
Possible side effects
Weight gain
Fluid retention
Increased risk of broken bones
Increased risk of heart problems, including heart failure
Possible increased risk of bladder cancer with pioglitazone
People with liver problems or a history of heart failure shouldn’t take this kind of diabetes medicine.
Alpha-glucosidase inhibitors
Medications
Acarbose
Miglitol (Glyset)
Action
Slow the body’s ability to breakdown starches and some sugars
Advantages
Don’t cause weight gain
Don’t cause blood sugar levels to drop too low unless you take them with insulin or a sulfonylurea
Possible side effects
Gas
Stomach pain
Diarrhea
Sodium-glucose transporter 2 (SGLT2) inhibitors
Medications
Canagliflozin (Invokana)
Dapagliflozin (Farxiga)
Empagliflozin (Jardiance)
Ertugliflozin (Steglatro)
Action
Limit the kidneys’ ability to take in sugar, which increases the amount of sugar that leaves the body in urine
Advantages
May lead to weight loss
May lower blood pressure
Possible side effects
Urinary tract infections
Yeast infections
Bile acid sequestrants
Medications
Colesevelam (Welchol)
Action
Lower cholesterol and have a small effect in lowering blood sugar when used with other diabetes medications
Advantages
Likely safe for people with liver problems
Possible side effects
Gas
Constipation
Indigestion
Rise in blood fats called triglycerides
Medications you take as a shot
Amylin mimetics
Medications
Pramlintide (Symlin)
Action
Help regulate blood sugar
Slow food moving through the stomach
Used with insulin shots
Advantages
May decrease hunger
May lead to minor weight loss
Possible side effects
Blood sugar levels drop too low
Nausea
Abdominal pain
Incretin mimetic (GLP-1 receptor agonists)
Medications
Dulaglutide (Trulicity)
Exenatide (Byetta, Bydureon Bcise)
Liraglutide (Saxenda, Victoza)
Lixisenatide (Adlyxin)
Semaglutide (Ozempic, Rybelsus, Wegovy)
Action
Cause the release of insulin as blood sugar levels are rising
May be used with metformin, basal insulin or a sulfonylurea
Advantages
May decrease hunger
May lead to weight loss
Possible side effects
Nausea
Vomiting
Diarrhea
Abdominal pain
Increased risk of inflamed pancreas — a condition called pancreatitis
How to choose your diabetes medication
No one diabetes treatment is best for everyone. What works for one person may not work for another. Your health care provider can explain how one medication or multiple medications may fit into your diabetes treatment plan. Sometimes combining medicines may increase the effectiveness of each individual medicine to lower blood sugar. Talk to your provider about the pros and cons of specific diabetes medications for you.
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June 14, 2024
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