Medication For Type 2 Diabetes

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What medication is used for type 2 diabetes?

Type 2 diabetes medication can help you reduce your blood glucose levels, effectively manage your diabetes and protect your health.

Many people can control their type 2 diabetes by changing their diet and increasing their daily activity. However, you may need diabetes medication to keep your blood sugar levels down, maintain your health, and prevent diabetes complications.

There are many diabetes medications available that can be taken as tablets or injected. Innovative treatments are continually being developed to improve diabetic control and support healthy weight loss.

Steps to take to help your type 2 diabetes treatment

Type 2 diabetes often responds well to changes to your lifestyle and diet. Weight loss can help return your blood sugar levels to the normal range. This is known as remission and can allow you to stop taking medication and safeguard your future health:

  • Increase your exercise: Try and live an active life, remembering that exercise doesn’t have to be in the gym. Walking instead of driving, taking the stairs and dancing can all help you stay healthy and improve your diabetes control
  • Change your diet: Aim for a healthy balanced diet rich in fresh fruit and vegetables. Choose healthy fats from nuts, seeds, fish and avocado, and low GI foods instead of sugar and processed carbohydrates
  • Aim for a healthy BMI
  • Drink plenty of water and cut out alcohol which can predispose to hypos
  • Monitor your blood glucose regularly: Careful glucose monitoring is key to controlling your blood sugar levels, maintaining health, and reducing the complications of diabetes. Your diabetes team will give you a target HbA1c and work with you to achieve that goal

For more information about maintaining a healthy lifestyle when you have type 2 diabetes, as well as the latest diet plans, visit our weight management page and start your weight loss journey today.

Diabetes tablets

Diabetes tablets are usually the first line of treatment for type 2 diabetes that isn’t controlled by lifestyle changes. A range of oral medications is available, many of which can be combined to achieve optimum results.

  • Metformin is usually the first diabetes medication offered when you are diagnosed with type 2 diabetes. Metformin is an insulin sensitiser that helps your body respond to the insulin it produces; it also reduces the amount of glucose produced by your liver and decreases glucose absorption in the gut
  • Sulfonylureas include Glibenclamide, Gliclazide, Glipizide and Tolbutamide. They stimulate insulin release helping to reduce blood glucose levels
  • Alpha-glucosidase inhibitor: Acarbose is a starch blocker, a tablet that slows down the absorption of starchy foods from your diet. Your glucose levels will rise more gradually after a meal or snack
  • Prandial glucose regulators: Repaglinide and Nateglinide stimulate the pancreas to produce more insulin. They act quickly, and for a shorter time than sulfonylureas, so they are usually prescribed to be taken thirty minutes before a meal
  • Thiazolidinediones or glitazones: Pioglitazone allows insulin to work more effectively by reducing your body’s resistance to the action of insulin. It can also lower blood pressure and improve the balance of good to bad fats in your blood
  • DPP-4 inhibitors or gliptins: Sitagliptin, Vildagliptin, and Saxagliptin block the enzyme DPP-4. DPP-4 breaks down the hormone incretin. Gliptins increase incretin levels so that the body produces more insulin and less glucose
  • SGLT2 Inhibitors: SGLT2 or sodium glucose-like co-transporter 2 inhibitors include Dapagliflozin, Empagliflozin, and Canagliflozin. The drugs work in the kidneys to stop them from reabsorbing glucose that’s been filtered out of the blood. More glucose is passed out in the urine so that glucose levels in the blood are lower

Diabetes medication side effects

All medications have side effects; you can check the complete list of side effects in the patient information leaflet provided with your medication. Your doctor should talk you through the pros and cons of diabetes treatment. You may be able to gradually increase your dosage to minimise side effects; you can also combine medications to optimise your results.

Side effects include:

  • Metformin side effects: Gastrointestinal disturbances, including nausea, pain, bloating, and diarrhoea, are the most common side effects. You may also lose your appetite and have a metallic taste in your mouth.
  • Sulfonylurea side effects: Sulfonylureas are better suited to people that are not overweight or obese because they can lead to weight gain. They can also cause hypos, where your blood glucose falls too low, especially if you skip a meal.
  • Acarbose side effects: Wind and diarrhoea are common problems for people taking acarbose. However, this usually settles over time as you get used to the medication.
  • Prandial glucose regulator side effects: You may notice hypoglycemia, rashes, GI disturbance including nausea, diarrhoea and constipation, and liver problems.
  • Pioglitazone side effects: You may experience water retention, weight gain, eyesight problems, a reduced sense of touch, or a rash. Rarely has it been linked to anaemia, liver, eye, and heart problems, and fractures.
  • Gliptin side effects: You may experience gastrointestinal problems such as nausea, diarrhoea and stomach pain. Flu-like symptoms can develop, and you may notice a rash. Rarely you can develop inflammation in the pancreas that needs urgent medical care.
  • SGLT2 inhibitor side effects: You may experience gastrointestinal problems such as nausea, diarrhoea and stomach pain. Flu-like symptoms can develop, and you may notice a rash. Rarely you can develop inflammation in the pancreas that needs urgent medical care.


Untreated type 2 diabetes

If you do not treat type 2 diabetes by maintaining a healthier lifestyle and taking the right medication, it can start to get progressively worse. Having high blood sugar can impact various cells and organs throughout the body. Complications of this can include:

  • Kidney damage, often leading to dialysis
  • Eye damage, which can lead to blindness
  • Increase risk of heart disease or stroke
  • Low limb amputation

Insulin injections for type 2 diabetes

You may need to inject insulin to provide the best level of insulin control. There are different formulations, including fast, medium, slow-acting, and mixed insulins. There are also pen-like injection devices and insulin pumps to make managing your diabetes as comfortable and straightforward as possible.

Incretin mimetics

Not all injected diabetes medication is insulin. GLP1 therapies or incretin mimetics are innovative medications that are injected daily or weekly. An example is Liraglutide or Saxenda. The drugs act to stimulate insulin release, reduce the release of glucagon and slow down stomach emptying. They can reduce glucose levels after a meal and make you feel less hungry. Saxenda is licensed for the treatment of obesity and the treatment of type 2 diabetes.

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Carol Willis

Carol Willis - Diabetes Clinic Facilitator

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