Medication for Diabetes

By Editorial Team

4 min read

Reviewed by: HU Medical Review Board | Last reviewed: May 2022 | Last updated: January 2023

Type 2 diabetes is a disease in which the level of glucose (blood sugar) in a person’s bloodstream becomes too high. This can happen because the person’s pancreas does not make enough insulin. Insulin is a hormone that helps to move the glucose consumed in foods and drinks from the bloodstream and into the cells of the body, which require glucose for energy. In other people with type 2 diabetes, the pancreas produces insulin that does not work as well as it should to move the glucose into the cells from the bloodstream.

It is very important for people with type 2 diabetes to control their blood sugar levels, because having high blood sugar can cause serious health problems over time. Some people with type 2 diabetes can control their blood sugar through lifestyle management, which involves maintaining a healthy diet and a regular schedule of physical exercise.

People who cannot control their type 2 diabetes with lifestyle management may also need to take one or more prescription medications to help control their blood sugar levels. There is a wide range of different classes of drugs that can be used to treat type 2 diabetes, and each works in different ways:

Based on your healthcare provider’s advice, you may need to try different types of treatments, or combinations of treatments, to find the ones that are most effective for you. It is very important to take all your medications regularly and on time, in order to control your blood sugar levels and reduce the risk of developing serious health problems that high blood sugar can cause.

What are biguanides?

Biguanides are drugs for type 2 diabetes that usually contain an active ingredient called metformin. These drugs work by reducing the amount of glucose produced by the liver, which has the effect of lowering blood sugar levels. Biguanides are one of the oldest and most commonly prescribed treatments for type 2 diabetes. They may be prescribed alone or in combination treatments with other drugs.

What are sulfonylureas?

Sulfonylureas are a type of medication for type 2 diabetes that works by directly stimulating the pancreas to increase the amount of insulin that it produces.² This additional insulin helps to control blood sugar levels.

What are meglitinide derivatives?

Meglitinide derivatives work in a similar way as sulfonylureas, by directly affecting the pancreas to increase the amount of insulin that is produced to better control blood sugar.²

What are alpha-glucosidase inhibitors?

Alpha-glucosidase inhibitors work by slowing down the way that carbohydrates from food you eat are absorbed and digested by the intestines.² This reduces the increase in blood sugar levels that consuming carbohydrates can cause.

What are thiazolidinediones (TZDs)?

Thiazolidinediones (TZDs) are drugs for type 2 diabetes that have the effect of increasing a person’s sensitivity to insulin, therefore reducing the amount of insulin that is needed to transfer glucose from the bloodstream into the cells.²

What are glucagon-like peptide-1 (GLP-1) agonists?

Glucagon-like peptide-1 (GLP-1) agonists or incretin mimetics are a type of medication that increase the amount of insulin produced by the pancreas. They can also have the effects of slowing down the rate that food moves through your stomach, as well as making you feel full.²

What are dipeptidyl peptidase 4 inhibitors (DPP-4 inhibitors)?

Dipeptidyl peptidase 4 inhibitors (DPP-4 inhibitors) also work by increasing the amount of insulin produced by the pancreas by enhancing the effects of the hormone incretin.² This can help to control blood sugar in people with type 2 diabetes.

What are selective sodium-glucose co-transporter 2 (SGLT2) inhibitors?

Selective sodium-glucose co-transporter 2 (SGLT2) inhibitors are a type of drug for type 2 diabetes that prevents the kidneys from reabsorbing glucose into the body.²

What are amylin analogs?

Amylin analogs are injectable drugs that work by slowing down the rate that food moves through the stomach. This type of drug also has the effect of reducing the appetite.²

What are bile acid sequestrants?

Bile acid sequestrants help to control blood sugar in people with type 2 diabetes by lowering the amount of glucose that is produced by the liver.

What are dopamine agonists?

Dopamine agonists are types of drugs that increase insulin sensitivity by increasing the activity of dopamine receptors in the brain.²

What is insulin treatment?

To effectively control their blood sugar, some people with type 2 diabetes may need to take insulin as well as other types of medications and lifestyle management. Insulin generally has to be injected rather than taken by mouth in a pill or liquid, because it needs to travel more directly into the bloodstream rather than being digested. There are many different types of insulin products available, which start working, reach their peak effect, and continue to work for different amounts of time.

Rapid-acting insulin starts to work within about 15-20 minutes after it is injected, it peaks after about an hour and keeps working for 2-4 hours.

Short-acting or Regular insulin begins to work after about 30 minutes, peaks between 2-3 hours after it is injected, and continues working for between 3-6 hours.

Intermediate-acting insulins start working between 1-2 hours after they are injected, peak after between 4-12 hours, and stay effective for around 12-18 hours.

Long-acting insulin begin to work several hours after being injected and the effects tend to last for an entire day, so it is usually taken once daily.

Ultra long-acting insulins is the longest lasting type. It is injected once per day and its effects last for up to 42 hours.

Premixed insulin products combine two different types of insulin in a single injected dose. Typically, it combines one insulin that is rapid-acting and one insulin that is intermediate-acting.

What are combination treatments?

Combination treatments for type 2 diabetes combine two different oral medications in a single dose. For some people, taking fewer medications makes them less likely to miss a dose.