For people with mild to moderate type 2 diabetes, medications taken by mouth are effective in controlling blood sugar levels. Some increase the body’s sensitivity to insulin, also described as decreasing insulin resistance. Others enhance the effects of hormones that help control blood sugar levels.
One commonly prescribed medication for type 2 diabetes is metformin, which belongs to a class of medications known as biguanides. This medication is taken daily by mouth.
The medication makes your liver and muscles more sensitive to insulin and reduces glucose production in the liver. This allows the body to use glucose more efficiently.
In rare instances, metformin can cause mild gastrointestinal symptoms, such as stomach upset and diarrhea. These symptoms can be avoided if the medication is started at a low dosage and is slowly increased.
Doctors commonly prescribe sulfonylurea medications, such as glyburide, glipizide, and others, to lower blood sugar levels in people with type 2 diabetes.
These medications increase insulin production in the pancreas. Sulfonylurea medications are often prescribed in combination with metformin.
Side effects can include hypoglycemia, or low blood sugar levels, and increased hunger and weight gain. Your doctor monitors you carefully in order to avoid these.
Medications belonging to a class called thiazolidinediones, or glitazones, reverse insulin resistance by improving insulin sensitivity in muscle, liver, and fat cells. They also help prevent the liver from releasing excess glucose.
Taken once daily, glitazones are often prescribed in combination with other medications for type 2 diabetes. Because they increase insulin sensitivity, they may reduce the amount of medication needed to increase insulin production.
These medications can cause fluid retention, which may exacerbate congestive heart failure in people who have that condition. They may also increase the risk of bladder cancer, as well as fractures in people with osteoporosis. Your doctor weighs your risk of these conditions into account when recommending these medications.
Gliptins, also called DPP4 inhibitors, block the action of an enzyme called DDP4. They enhance the effects of a hormone that stimulates insulin production and prevents the liver from releasing too much glucose. Our doctors may prescribe these medications for people who have difficulty controlling blood sugar levels after meals.
Gliptins, taken daily, are prescribed alone or in combination with metformin. These medications are generally well tolerated but may cause hypoglycemia in people who are using them with other medications for type 2 diabetes.
Meglitinides, also known as glinides, rapidly lower blood sugar levels by stimulating the pancreas to release insulin after meals. These medications are often prescribed for people with moderately high glucose levels. Because meglitinides work rapidly for a short period of time, they’re most effective when taken before meals.
The most common side effect of these medications is hypoglycemia, especially when taken with other medications for type 2 diabetes. Other side effects include headache, nausea, and stomach pain.
Glucosidase inhibitors, sometimes called “starch blockers,” reduce blood sugar levels by blocking an enzyme called glucosidase. This enzyme helps break down carbohydrates in the small intestine, allowing carbohydrates to release sugar into the bloodstream. These medications help slow the intestine’s absorption of carbohydrates.
Taken at the beginning of meals, glucosidase inhibitors can help prevent a sharp increase in blood sugar levels. When taken with other medications to control blood sugar levels, these medications can cause hypoglycemia. Common side effects include bloating, nausea, diarrhea, and gas.
Gliflozins, or SGLT2 inhibitors, are a newer class of medications that prevent the kidneys from reabsorbing glucose. The excess sugar is eliminated in the urine.
Gliflozins can be taken alone or in combination with metformin. Common side effects include vaginal yeast infections and urinary tract infections.