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Diabetes treatment: Medications for type 2 diabetes
By Mayo Clinic staffHealthy lifestyle choices — including diet, exercise and weight control — provide the foundation for managing type 2 diabetes. However, you may need medications to achieve target blood sugar (glucose) levels. Sometimes a single medication is effective. In other cases, a combination of medications works better.
The list of medications for type 2 diabetes is long and potentially confusing. Learning about these drugs — how they're taken, what they do and what side effects they may cause — will help you discuss treatment options with your doctor.
Diabetes treatment: Lowering blood sugar
Several classes of type 2 diabetes medicines exist. Each works in different ways to lower blood sugar. A drug may work by:
- Stimulating the pancreas to produce and release more insulin
- Inhibiting the production and release of glucose from the liver
- Blocking the action of stomach enzymes that break down carbohydrates
- Improving the sensitivity of cells to insulin
Each class of medicine has one or more drugs. Some of these drugs are taken orally, while others must be injected. And some type 2 diabetes pills contain a combination of two classes of drugs.
Compare diabetes medications
Here's an at-a-glance comparison of common diabetes medications. More medications are available depending on your needs and situation. Ask your doctor about your options and the pros and cons of each.
| Oral medications | |||
|---|---|---|---|
| Medications | Action | Advantages | Possible side effects |
Meglitinides
|
Stimulate the release of insulin | Work quickly | Severely low blood sugar (hypoglycemia); weight gain; nausea; back pain; headache |
Sulfonylureas
|
Stimulate the release of insulin | Work quickly | Hypoglycemia; weight gain; nausea; skin rash |
Dipeptidy peptidase-4 (DPP-4) inhibitors
|
Stimulate the release of insulin; inhibit the release of glucose from the liver | Don't cause weight gain | Upper respiratory tract infection; sore throat; headache; inflammation of the pancreas (sitagliptin) |
Biguanides
|
Inhibit the release of glucose from the liver; improve sensitivity to insulin | May promote modest weight loss and modest decline in low-density lipoprotein (LDL), or "bad," cholesterol | Nausea; diarrhea; rarely, the harmful buildup of lactic acid (lactic acidosis) |
Thiazolidinediones
|
Improve sensitivity to insulin; inhibit the release of glucose from the liver | May slightly increase high-density lipoprotein (HDL), or "good," cholesterol | Heart failure; heart attack; stroke; liver disease |
Alpha-glucosidase inhibitors
|
Slow the breakdown of starches and some sugars | Don't cause weight gain | Stomach pain; gas; diarrhea |
| Injectable medications | |||
|---|---|---|---|
| Medications | Action | Advantages | Possible side effects |
Amylin mimetics
|
Stimulate the release of insulin; used with insulin injections | May suppress hunger; may promote modest weight loss | Hypoglycemia; nausea or vomiting; headache; redness and irritation at injection site |
Incretin mimetics
|
Stimulate the release of insulin; used with metformin and sulfonylurea | May suppress hunger; may promote modest weight loss | Nausea or vomiting; headache; dizziness; kidney damage or failure |
How to choose your diabetes medication
No single diabetes treatment is best for everyone, and what works for one person may not work for another. Your doctor can determine how a specific medication or multiple medications may fit into your overall diabetes treatment plan and help you understand the advantages and disadvantages of specific diabetes drugs.
- Oral medications: What are my options? American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/oral-medications/what-are-my-options.html. Accessed Aug. 1, 2011.
- DPP-4 inhibitor: Dipeptidyl peptidase-4 (DPP-4) inhibitor. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/medicines_ez/insert_G.aspx. Accessed Aug. 11, 2011.
- Information for Healthcare Professionals - Acute pancreatitis and sitagliptin (marketed as Januvia and Janumet). U.S. Food and Drug Administration. http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/DrugSafetyInformationforHeathcareProfessionals/ucm183764.htm. Accessed Aug. 4, 2011.
- Ripsin CM, et al. Management of blood glucose in type 2 diabetes mellitus. American Family Physician 2009;79:29.
- Meglitinide. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/medicines_ez/insert_H.aspx. Accessed Aug. 1, 2011.
- Nathan DM, et al. Medical management of hyperglycemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy. Diabetes Care. 2009;32:193.
- Sulfonylurea. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/medicines_ez/insert_I.aspx. Accessed Aug. 1, 2011.
- Biguanide. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/medicines_ez/insert_E.aspx. Accessed Aug.1, 2011.
- Bolen S, et al. Systematic review: Comparative effectiveness and safety of oral medications for type 2 diabetes mellitus. Annals of Internal Medicine. 2007;147:386.
- Thiazolidinedione. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/medicines_ez/insert_J.aspx. Accessed Aug. 1, 2011.
- Alpha-glucosidase inhibitor. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/medicines_ez/insert_D.aspx. Accessed Aug. 1, 2011.
- What I need to know about diabetes medicines. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.aspx#types. Accessed Aug. 1, 2011.
- Other injectionable medications. American Diabetes Association. http://www.diabetes.org/living-with-diabetes/treatment-and-care/medication/other-injectable-medication.html. Accessed Aug. 1, 2011.
- Amylin mimetic. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/medicines_ez/insert_L.aspx. Accessed Aug. 1, 2011.
- Incretin mimetic. National Institute of Diabetes and Digestive and Kidney Diseases. http://diabetes.niddk.nih.gov/dm/pubs/medicines_ez/insert_M.aspx. Accessed Aug. 1, 2011.
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