You now have more ways to control your diabetes and boost your overall health than ever before. You and your doctor will create a plan to keep your blood sugar (glucose) in check, get to a healthy weight, and reach other goals.
You may need different types of medicine to keep your sugar levels normal or to make enough insulin, the hormone that helps control your glucose. You'll probably start with one medicine and add others later.
Diabetes Drugs You Take by Mouth
Most people with type 2 diabetes start their treatment with metformin (Glucophage), a pill that helps your liver make less blood sugar.
Metformin also makes your muscles absorb insulin better. This lets your body process glucose better.
You'll probably take the drug twice a day. Swallow your pills with food. That will lower your chance of having diarrhea, a common side effect.
If you can't reach your blood sugar targets with metformin alone, your doctor may raise your dose or add another diabetes pill. Medicines they may suggest include:
Alpha-glucosidase inhibitors: These help lower your blood sugar by blocking your body's breakdown of starchy foods you eat, like potatoes and bread.
- Acarbose (Precose)
- Miglitol (Glyset)
Bile acid sequestrant pills like colesevelam (Welchol): They lower levels of LDL "bad" cholesterol in your body, and they also seem to lower glucose. If you have liver problems and can't take other diabetes pills, you might be able to take this drug safely.
DPP-4 inhibitors: Your doctor may suggest:
- Alogliptin (Nesina)
- Linagliptin (Tradjenta)
- Saxagliptin (Onglyza)
- Sitagliptin (Januvia)
They help control your diabetes by lowering your blood sugar levels.
GLP-1 receptor agonists: These include:
- Dulaglutide (Trulicity)
- Exenatide (Byetta)
- Extended-release exenatide (Bydureon)
- Liraglutide (Victoza)
- Lixisenatide (Adlyxin)
- Semaglutide (Ozempic)
These tell your body it needs to make more insulin and slows down digestion to make you feel full.
Meglitinides: This type of medication includes:
- Nateglinide (Starlix)
- Repaglinide (Prandin)
They help your body make more insulin. You take these drugs before your meals.
SGLT2 inhibitors: Your doctor may prescribe:
- Canagliflozin (Invokana)
- Dapagliflozin (Farxiga)
- Empagliflozin (Jardiance)
They help your kidneys get rid of extra glucose by removing it from your blood and putting it into your urine.
Sulfonylureas: You may need to take medicine like:
- Chlorpropamide (Diabinese)
- Glimepiride (Amaryl)
- Glipizide (Glucotrol)
- Glyburide (Diabeta, Glynase)
They help your pancreas make more insulin.
Thiazolidinediones: These include:
- Pioglitazone (Actos)
- Rosiglitazone (Avandia)
They help insulin work better in your muscles or fat tissues. They also let your liver make less sugar.
- Pramlintide (Symlin)
This helps move blood sugar into your body's cells so you can use it for energy and stay healthy.
If you need to take insulin, don't feel like you've failed to manage your diabetes. Every person's body is different. If you've had type 2 diabetes for a long time, have very high blood sugar, or have other health problems that make it hard for you to control your glucose, you might need to take insulin along with your pills.
Insulin is a hormone. Most people inject it into the fat of their skin. Your doctor will figure out how much you need to take each day to keep your body healthy.
Some types of insulin act quickly. Others last for a long time to keep your blood sugar levels steady. You might give yourself shots of it with a syringe or a prefilled injection pen. Or you might use an insulin pump or infuser. Your doctor puts these devices under your skin to give you insulin when you need it.
Types of insulin include:
- Insulin aspart (NovoLog)
- Insulin degludec (Tresiba)
- Insulin detemir (Levemir)
- Insulin lispro (Humalog)
- Insulin glargine (Basaglar, Lantus, Toujeo)
- Insulin glulisine (Apidra)
- Insulin isophane (Humulin N, Novolin N)
Take Your Meds the Right Way
Follow your doctor's directions. You’ll need to take some drugs with food to help ease side effects.
It's also important to follow your pharmacist's instructions about how to store your medicine. That way, it will stay fresh and effective.
You shouldn't drink alcohol if you take some drugs, including metformin. When you have type 2 diabetes, you might feel the effects of alcoholic drinks more than other people. So use caution if you drink.