Medications

How medicine helps manage diabetes

Some people with type 2 diabetes need pills (oral medicines) to help their bodies make insulin, decrease insulin resistance, or slow down how quickly their bodies absorb carbohydrate.

You may take no medicine, one medicine, or a few medicines. Some people need to take medicine for a short time, while others always need to take medicine. How much medicine you need depends on how well you can keep your blood sugar within a target range.

Taking two or more medicines may work better to lower your blood sugar level than taking one medicine alone. Also, taking two or more medicines may mean fewer side effects because you are taking a lower dose of each.

Medicine choices

• Oral medicines that help your body make insulin. These include:
  • Sulfonylureas, such as glipizide (Glucotrol), glyburide (DiaBeta, Glynase, and Micronase), glimepiride (Amaryl), and other medicines that work in combination (Glucovance, Metaglip, and Duetact).
  • Meglitinides, such as repaglinide (Prandin), nateglinide (Starlix), and a combination medicine (Prandimet).
  • DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), and a combination medicine (Janumet).
• Oral medicines that lower insulin resistance.These include:
  • Biguanides, such as metformin (Glucophage), and other medicines that are combined with metformin (Prandimet, Avandamet).
  • Thiazolidinediones, such as rosiglitazone (Avandia), pioglitazone (Actos) and combination medicine such as (Actoplus Met).
• Oral medicines that slow down absorption of carbohydrates.These include:
  • Alpha-glucosidase inhibitors, such as acarbose (Precose) and miglitol (Glyset).
• Medicines that help lower blood sugar.If you are having trouble controlling your blood sugar with pills, your doctor may suggest that you try one of these medicines:
  • Incretin mimetics, such as exenatide (Byetta) and liraglutide (Victoza). You take this medicine as a shot 1 or 2 times a day.
  • Amylinomimetics, such as pramlintide (Symlin). This medicine works with insulin and glucagon to help control blood sugar. It is given as a shot before meals.
• Insulin. Insulin lets sugar (glucose) in the blood enter cells, where it is used for energy. Without insulin, the blood sugar level rises above what is safe for the body. Most of the time, people who take insulin use a combination of short-acting and long-acting insulin. This helps keep blood sugar within the target range. You may also want to learn more about when insulin is needed for type 2 diabetes.

What to Think About

You may also need to take:

• A low-dose aspirin every day. Talk to your doctor about whether you should take low-dose aspirin. Daily low-dose aspirin (81 milligrams) may help prevent heart problems if you are at risk for heart attack or stroke.
• Medicines that control high blood pressure. For more information, see the topic High Blood Pressure (Hypertension).
• Medicines that control high cholesterol, such as statins. For more information, see the topic High Cholesterol.
• An ACE inhibitor or an angiotensin ll receptor blocker (ARB), if you have protein in your urine. Protein in the urine could mean a problem with your kidneys (diabetic nephropathy).