When your doctor tells you that you have Type 2 Diabetes, you've probably already started exercising and controlling your diet. That's a good thing. But sometimes, it can be difficult to control your blood sugar levels with a healthy lifestyle alone. That's when your doctor tells you to start taking medication.
There are two main types of medication for type 2 diabetes: pills and insulin . Both help keep your blood sugar levels close to normal. This is important because if your blood sugar levels are high for a long time, you are more likely to develop serious conditions like nerve damage, vision problems, kidney problems, and heart disease.
So, which pills or insulin are best for you? Before you talk to your doctor about this, let's get into some more detail.
Types of diabetes pills
If you've just been diagnosed with type 2 diabetes, your doctor will likely first prescribe a type of medication. These don't replace the hormone insulin, but they can help your body:
- Produce more insulin.
- Use the insulin produced by the body more efficiently.
- Lower blood sugar levels.
You may be given one of these medications or a combination of several. Let's look at the main types of medications.
Metformin
Simply put, this is the most common first-line medication that doctors prescribe for type 2 diabetes. It comes in pill and liquid form. Metformin works primarily by reducing the amount of sugar your liver makes and by helping your body use insulin better. You may also be given other diabetes medications along with it. This medication may also help you lose some weight.
However, if you have liver disease, kidney problems, or heart conditions, or if you drink alcohol excessively, you may not be able to take Metformin. In such cases, your blood sugar levels may become dangerously low or a dangerous condition called lactic acidosis may occur.
Sulfonylureas
These medications work by helping your body produce more insulin. Glimepiride (Amaryl), Glipizide (Glucotrol), and Glyburide (DiaBeta) are some examples of this type of medication. However, they can cause weight gain and low blood sugar (hypoglycemia).
Meglitinides
These medications also stimulate the pancreas to produce more insulin. However, they work faster than sulfonylureas, but they last longer. Repaglinide (Prandin) and Nateglinide (Starlix) are among these medications. Side effects can include low blood sugar and weight gain.
Thiazolidinediones
These work by making your body's tissues more sensitive to insulin. This means they help your body use insulin more effectively. Rosiglitazone (Avandia) and Pioglitazone (Actos) are medications in this class. But they are usually only given if other treatments have failed because of the risk of serious side effects, such as heart attack and anemia.
Let's summarize these types of medications in an easy-to-understand way.
| Drug Class | How the body works | Common side effects |
|---|---|---|
| DPP-4 Inhibitors (Example: Sitagliptin (Januvia)) | Slightly lowers blood sugar levels. | Joint pain, inflammation of the pancreas (pancreatitis). |
| SGLT2 Inhibitors (eg, Dapagliflozin (Farxiga), Empagliflozin (Jardiance)) | It prevents the kidneys from reabsorbing glucose into the body and excretes it in the urine. | Risk of urinary tract infections, low blood pressure, and diabetic ketoacidosis. |
| GLP-1 Receptor Agonists (Example: Semaglutide (Rybelsus) pill) | Helps the body produce more insulin after eating. | Nausea, vomiting, diarrhea, weight loss, headache. |
When is insulin needed?
If you can't control your blood sugar levels with pills alone, your doctor may start you on insulin. Insulin is something you get as a shot.
Why can't you swallow insulin like a pill? The reason is, even if you swallow it like that, it would be completely destroyed during the digestive process in our stomach. So it wouldn't be of any use. That's why it's given as an injection.
There are also different types of insulin, which vary in how long they work.
- Long-acting insulin: It doesn't enter the bloodstream until a few hours after injection, but it keeps blood sugar levels under control for 24 hours. Doctors often recommend this type of insulin at night for people with type 2 diabetes.
- Intermediate-acting insulin: This also starts working within a few hours and remains active for between 12 and 18 hours.
- Regular or “short-acting” insulin: It enters the bloodstream about half an hour after injection and works for between 3 and 6 hours.
- Rapid-acting insulin: Starts working almost immediately after injection, but works for a short period of time, about 2 to 4 hours.
In the past, doctors prescribed insulin as a last resort. But now, because it can control blood sugar levels quickly, there are times when insulin can be started earlier. The main side effect of all types of insulin is low blood sugar (hypoglycemia) .
Questions to ask your doctor
The best treatment for you is a decision you and your doctor will make together. Whatever medication is recommended, be sure to ask about these things.
- What are the side effects of each medication?
- How are their prices?
- How should I use this medicine?
- How should this medicine be stored?
Also, learn exactly how to recognize when your blood sugar level is too low (hypoglycemia), and what to do if it happens. This is very important.
Take-Home Message
- Type 2 diabetes is a condition that needs to be managed well. Taking medication along with a healthy lifestyle may be essential.
- Doctors often start with a medication like metformin.
- If you cannot control your blood sugar levels with pills alone, you will have to use insulin injections.
- Always talk openly with your doctor about the treatment that is best for you. Ask any questions you have.
- Be aware of the symptoms of low blood sugar (hypoglycemia) and what to do if it happens.
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