Let's Talk About Diabetes Medication
There’s no cure for the disease, but there are dozens of effective medications that can help you manage it. Learn more about what’s available, so you can make the best choice for you.by Sunny Sea Gold Health Writer
Stable blood sugar plays a crucial role in helping you feel stronger and more energetic every day. It also lowers your risk of dangerous diabetes complications, such as nerve damage and heart disease. Diabetes medications that moderate blood sugar levels are often used in combination with each other—you may find yourself using two or more drugs at some point as you find a plan that gets you back to feeling good. Here’s what you should know about the options available to you.
Our Pro Panel
We went to some of the nation’s top experts in diabetes to bring you the most up-to-date information possible.
Nilem Patel, M.D.
Adventist Health White Memorial Hospital
Los Angeles, CA
Emily Nosova, M.D.
Mount Sinai Hospital
New York, NY
Laura Cason, R.D.
Certified Diabetes Educator and Spokesperson
Illinois Academy of Nutrition and Dietetics
Type 1 diabetes in an incurable autoimmune disease. Type 2 diabetes cannot be cured, but it can be well-controlled! For some people, diet and exercise works so well to keep blood sugar levels stable that their doctors might consider their disease to be in “remission.”
Insulin-dependent diabetes is an old name for type one diabetes. In people with this disease, the pancreas stops producing the hormone insulin, which helps moderate blood sugar levels. People with type 1 diabetes are dependent on insulin medication in order to lower their blood sugar.
Metformin is a commonly prescribed medication for type 2 diabetes. It works by slowing the breakdown of carbohydrates into sugar in the food you eat, and reducing how much glucose your liver produces.
Common, classic symptoms of diabetes are being very thirsty and having to pee a lot. Other symptoms can be increased hunger, tingling and numbness in the extremities, weight loss, and difficulty fighting infections.
What Is Diabetes Again?
A quick refresher: There are three main types of diabetes: type 1, type 2, and gestational diabetes (which occurs during pregnancy). All three types cause people to have higher-than-normal levels of sugar—or, glucose—in their blood.
Here how it gets there:
After you eat, your digestive system goes to work breaking down the food into glucose (among other things).
When the glucose enters the bloodstream, and your pancreas responds by releasing insulin, a hormone that helps glucose enter muscle and fat cells where it is used for energy.
Your brain, heart, muscles, and just about everything else in your body rely on glucose for fuel.
In type 1 diabetes, people don’t make insulin at all so glucose builds up in their blood. In type 2 diabetes and gestational diabetes, the pancreas makes insulin but the body doesn’t use it very well, also resulting in excessive sugar in your bloodstream. Over time, high blood sugar can lead to a host of serious health problems.
Treatment for Diabetes
Whatever your path of treatment, most likely you’ll start by checking your glucose every day, or even several times per day, in order to make decisions about insulin dosages, food, and exercise.
To do this, you’ll likely use a home glucose meter to poke your fingertip with a specialized lancet “pen,” then drop the blood onto a test strip in the meter to determine your blood sugar level. In some cases, your doc might suggest a continuous glucose monitor, where a tiny sensor is inserted under the skin of your abdomen, arm, or thigh to check glucose levels regularly.
Here are a few types of medications your doctor will consider to keep your glucose levels stable, based on your diabetes type:
Insulin for Diabetes
All people with type 1 diabetes need to take insulin daily. Unfortunately, insulin can’t be taken as a pill because it would be broken down and digested before getting into your blood.
There are a couple of different ways insulin can be delivered to the body:
Injection: This is the most common way to take insulin. To inject the drug, you will use a syringe or “pen,” usually in your belly, upper arm, thigh, or butt.
Insulin Pump: People who need multiple injections per day or are high risk of ketoacidosis may prefer an insulin pump, which automatically delivers insulin throughout the day through a tiny catheter that’s worn on your body.
Insulin Inhaler: Some adults use inhaled insulin, a powder you breathe into your lung through an inhaler. It’s meant to be taken before every meal, but people will still need to take an injectable, longer-acting insulin.
Newer methods of insulin delivery include a high-pressure “jet injector” that sprays insulin into the skin rather than injecting liquid through a needle. Some people also use an injection port: a tube inserted into your skin that you inject insulin into rather than directly into your skin.
Different types of insulin are generally categorized by how long they last, how quickly they kick in, and when they hit peak potency. Many people take more than one type. These are the common options:
Rapid-Acting Insulin: This medication starts to work within about 15 minutes of taking it. You’ll likely take it just before a meal to prevent blood glucose from rising. It works for two to four hours. Examples include Apidra (glulisin), Humalog (lispro) and Novolog (aspart).
Short-Acting Insulin: Also called “regular” insulin, this med takes about 30 minutes to kick in. You’ll take it before a meal to help lower increased levels of blood sugar when you eat. It works for three to six hours. Examples include Humulin R and Novolin R.
Intermediate-Acting Insulin: Often combined with rapid-acting insulin, this med starts working about two to four hours after taking and balances your body’s glucose levels for 12 to 18 hours. Examples include Humulin N and Novolin N (NPH).
Long-Acting Insulin: These meds take several hours to kick in. They work to maintain lower blood sugar levels for up to 24 hours. Examples include Lantus (insulin glargine) and Levemir (insulin detemir).
Ultra-Long-Acting Insulin: These meds can take up to six hours to reach your bloodstream and last about 36 hours. Examples include Toujeo (glargine u-300) and Tresiba (degludec).
Other Diabetes Medications
There are several different pills and liquids that can help people manage their diabetes. They’re often taken in combination with each other, or with insulin, to control blood sugar. Most of these medications are only used in people with type 2 diabetes.
Actos and Avandia (thiazolidinediones): These oral medications help glucose get out of the bloodstream and into your muscles. Possible side effects include fractures, heart problems, and weight gain.
Amaryl, DiaBeta, Glucotrol, Glynase PresTab, and Micronase (sulfonylureas): This class of drugs encourages the pancreas to make more insulin. The increased insulin helps lower blood sugar. Possible side effects include low blood sugar, skin rash, and weight gain.
Bromocriptine and Cyclocet (D-2 dopamine agonist): This drug causes the liver to release less glucose. Possible side effects include fatigue, weakness, and constipation.
Farxiga, Invokana, and Jardiance (sodium-glucose transporter 2 inhibitors): These drugs decrease the reabsorption of glucose from the urine, decreasing the amount of sugar in the blood. Possible side effects include yeast and urinary tract infections.
Glucophage, Glumetza, Fortamet, and Riomet (metformin): These meds slow the breakdown of carbohydrates into sugar and reduce how much glucose your liver produces. Metformin is usually prescribed to people with type 2 diabetes, but it’s sometimes used along with insulin in type 1. Possible side effects include nausea and diarrhea.
Glyset and Orecose (alpha-glucosidase inhibitors): This type of medication slows the digestion and breakdown of starches into glucose and cuts how much glucose is absorbed by the small intestine. Possible side effects include gas, diarrhea, and stomachache.
Januvia and Onglyza (dipeptidyl-peptidase 4 inhibitors): These drugs trigger the pancreas to produce more insulin. Possible side effects include upper respiratory tract infections, headache, and sore throat.
Prandin and Starlix (meglitinide): Like sulfonylureas, these medications trigger the release of additional insulin. Possible side effects include low blood sugar, weight gain, and nausea.
Symlin (pramlintide): This injection, given at mealtimes, slows digestion of food in your stomach, thereby slowing the speed at which glucose enters the blood. It can be prescribed with insulin for people with type 1 diabetes, or with other medications for people with type 2. Possible side effects include low blood sugar, nausea, and vomiting.
Welchol (bile acid sequestrant): This medication lowers blood sugar and cholesterol. Possible side effects include indigestion, constipation, gas.
Other medications: Because diabetes is a risk factor for cardiovascular disease, drugs that treat high cholesterol and high blood pressure are sometimes prescribed for people with diabetes as a way to help lower their heart risk.
Diet, Exercise, and Diabetes
You might not think of them as medication in the traditional sense, but along with pharmaceutical prescriptions, diet and exercise are nature-made remedies to help lower your risk for, and symptoms of, type 2 diabetes by keeping blood sugar stable.
What to Eat
There is no single best diet for diabetes, but plant-based meals and the Mediterranean diet (with a focus on fruits, vegetables, fish, and healthy fats) are both recommended to help control blood sugar levels.
Some people with diabetes may also need to count the grams of carbohydrate in their meals in snacks to help make sure blood sugar doesn’t spike after meals, or to figure out the proper dose of mealtime insulin.
Talk with your endocrinologist, registered dietitian, or a certified diabetes educator to create personalized eating guidelines that work for your life.
How to Exercise
Moving your body is a key part of managing blood sugar levels, especially in type 2 diabetes and gestational diabetes. That’s because physical activity helps your body use insulin better, reduces insulin resistance, and lowers blood sugar levels. The national health guidelines for exercise (whether you have diabetes or not) call for 150 minutes of moderate exercise per week.
That’s the equivalent of 30 minutes, five days a week. You don’t have to be an athletic superstar to exercise. We’re talking about taking a brisk walk around the block a time or two before you head to work, or after dinner in the evening.
Are There Supplements for Diabetes?
Researchers have looked into dozens of different dietary supplements, from cinnamon to apple cider vinegar to chromium, to see if they help treat or prevent diabetes. So far there is some weak scientific evidence suggesting that chromium may help keep blood sugar levels stable. Other preliminary research indicates that an antioxidant called alpha-lipoic acid might help with diabetes-related nerve issues.
But there isn’t enough evidence yet to show that most supplements move the needle when it comes to treating diabetes, according to the National Center for Complementary and Integrative Health.
Your best bet: Eat smart, exercise regularly, and talk with your doctor about the growing number of medications available to help treat the disease so you can get back to living your life.
Diabetes Definition: Merck Manual. (2019). “Diabetes Mellitus.” merckmanuals.com/home/hormonal-and-metabolic-disorders/diabetes-mellitus-dm-and-disorders-of-blood-sugar-metabolism/diabetes-mellitus-dm
Checking Blood Sugar: National Institute of Diabetes and Digestive and Kidney Diseases. (2019). “Managing Diabetes.” niddk.nih.gov/health-information/diabetes/overview/managing-diabetes
Types of Insulin: American Diabetes Association. (2020). “Insulin Basics.” diabetes.org/diabetes/medication-management/insulin-other-injectables/insulin-basics
Ways to Take Insulin: National Institute of Diabetes and Digestive and Kidney Diseases. (2019). “Insulin, Medicines, and Other Diabetes Treatments” niddk.nih.gov/health-information/diabetes/overview/insulin-medicines-treatments#typesofinsulin
Oral Medications: Cleveland Clinic. (n.d.) “Oral Diabetes Medication.” my.clevelandclinic.org/health/articles/12070-oral-diabetes-medications
Symlin: Food and Drug Administration. (2007). “Medication Guide: Symlin.” fda.gov/media/73053/download
Diabetes Medication and Side Effects: Mayo Clinic. (2019). “Diabetes Treatment: Medications for Type 2 Diabetes.” mayoclinic.org/diseases-conditions/type-2-diabetes/in-depth/diabetes-treatment/art-20051004
D-2 Dopamine Agonist: Diabetes Care. (2011). “Bromocriptine: A Sympatholytic, D2-dopamine Agonist for the Treatment of Type 2 Diabetes.” medscape.com/viewarticle/740378_1
Diet and Exercise: National Institute of Diabetes and Digestive and Kidney Diseases. (2020). “Diabetes Diet, Eating, & Physical Activity.” niddk.nih.gov/health-information/diabetes/overview/diet-eating-physical-activity
Diabetes and Natural Remedies: National Center for Complementary and Integrative Health. (2020). “Diabetes and Dietary Supplements.” nccih.nih.gov/health/diabetes/supplements