Diabetes Treatment: Type 2 Diabetes Medications (2023)

Lifestyle choices, including healthy eating, exercise, and maintaining a healthy weight, are key to managing type 2 diabetes. However, you may also need to take medication to keep your blood sugar (also called glucose) at healthy levels. Sometimes one drug is enough. In other cases, taking more than one drug works better.

The list of medications for type 2 diabetes is long and can be confusing. Take the time to learn more about these medicines - how to take them, what they do, and the side effects they may cause. This can help you prepare to talk to your doctor about the right diabetes treatment options for you.

Diabetes Treatment: Lowering Blood Sugar

There are different classes of medicines used to treat type 2 diabetes. Each class of drugs lowers blood sugar in a different way. Medicines can work in the following ways:

• This causes the pancreas to produce and release more insulin.
• Limits the liver's ability to make and release sugar.
• Blocks the action of enzymes in the gut that break down carbohydrates and slows cellular absorption of carbohydrates.
• Improves the sensitivity of cells to insulin.
• The ability of the kidneys to absorb sugar is reduced, resulting in more sugar being excreted from the body in the urine.
• Slows down the rate at which food moves through the stomach.

Each drug class has one or more drugs. Some of these medicines are taken orally, while others are given by injection.

Compare Diabetes Drugs

Below is a list of common diabetes medications. Other medicines may also be used. Ask your doctor about your options and the pros and cons of each.

medicines you take by mouth

Mika Rena

drug

• Reina Mizuki
• Nagarina

action

• triggers the pancreas to release insulin

advantage

• work fast

possible side effects

• Blood sugar levels drop too low - a condition called hypoglycemia
• weight gain

Sulfonyl Hahnstorff

drug

• Glipizide (Glucotrol XL)
• Glimepiride (Amaryl)
• Glibenclamide (DiaBeta, Glycinase)

action

• triggers the pancreas to release insulin

advantage

• low cost
• Effectively lower blood sugar

possible side effects

• Blood sugar levels drop too much
• weight gain
• rash
• Nausea or vomiting when drinking alcohol

Dipeptidyl peptidase 4 (DPP-4)-inhibitor

drug

• Saxagliptin (Onlyza)
• sitagliptin (Januvia)
• Linagliptin (Tradjenta)
• Alogliptin (Nesina)

action

• Causes insulin to be released when blood sugar levels rise
• Limits the ability of the liver to release glucose

advantage

• don't cause weight gain
• Do not let blood sugar levels drop too low when used alone or with metformin

possible side effects

• upper respiratory infection
• sore throat
• Headache

biguanide

drug

• Metformin (Fortamet, Glumetza, and others)

action

• Limit the ability of the liver to release sugar
• Increases the sensitivity of cells to insulin

advantage

• very effective
• May cause slight weight loss
• low cost

possible side effects

• nausea
• stomachache
• diarrhea
• Rarely, people with kidney or liver failure can develop a harmful buildup of lactic acid, a condition called lactic acidosis

Thiazolidinedione

drug

• Rosiglitazone (Avandia)
• Pioglitazone (Acts)

action

• Increases the sensitivity of cells to insulin
• Limits the liver's ability to make and release sugar

advantage

• May slightly increase high-density lipoprotein (HDL) cholesterol (“good” cholesterol)

possible side effects

• weight gain
• fluid retention
• increased fracture risk
• Increased risk of heart problems, including heart failure
• Pioglitazone May Increase Bladder Cancer Risk

People with liver problems or a history of heart failure should not take this type of diabetes medicine.

α-Glucosidase-Hemmer

drug

• Acarbose
• Miglitol (glitol)

action

• Slows the body's ability to break down starches and some sugars

advantage

• don't cause weight gain
• Do not let blood sugar levels get too low unless you are taking it with insulin or sulfonylureas

possible side effects

• gas
• stomachache
• diarrhea

Sodium glucose transporter 2 (SGLT2) inhibitors.

drug

• Canagliflozin (Invokana)
• Dapagliflozin (Farxiga)
• Empagliflozin (Jardiance)
• Aitugliflozin (Steglatro)

action

• Limiting the ability of the kidneys to absorb sugar, thereby increasing the amount of sugar excreted from the body in the urine

advantage

• May cause weight loss
• can lower blood pressure

possible side effects

• urinary tract infection
• yeast infection

bile acid sequestrant

drug

• Collevelen (Vercors)

action

• May lower cholesterol and do less to lower blood sugar when used with other diabetes medications

advantage

• Possibly Safe for People with Liver Problems

possible side effects

• gas
• constipate
• indigestion
• Increased blood fats (triglycerides)

medicines you take by injection

Amylin mimetics

drug

• Pramlintide (Symlin)

action

• help regulate blood sugar
• food moves slowly in the stomach
• For use with insulin syringes

advantage

• May reduce hunger
• May cause slight weight loss

possible side effects

• Blood sugar levels drop too much
• nausea
• stomachache

Incretin Mimetics (GLP-1 Receptor Agonists)

drug

• dulaglutide (Trulicity)
• Exenatide (Byetta, Bydureon Bcise)
• Liraglutide (Saxenda, Victoza)
• Adlyxin
• Semaglutide (Ozempic, Rybelsus, Wegovy)

action

• Causes insulin to be released when blood sugar levels rise
• Can be used with metformin, basal insulin, or sulfonylureas

advantage

• May reduce hunger
• May cause weight loss

possible side effects

• nausea
• Vomit
• diarrhea
• stomachache
• increased risk of inflammation of the pancreas -- a condition called pancreatitis

How to Choose the Right Diabetes Medication for You

No one diabetes treatment is right for everyone. What works for one person may not work for another. Your doctor can explain how one or more medicines might fit into your diabetes treatment plan. Sometimes, drug combinations can increase how well each drug lowers blood sugar. Discuss the risks and benefits of certain diabetes medications with your doctor.

October 29, 2022

Please see details for more information