Most medications for diabetes type 2 are oral, but some are injections. The first line treatment for type 2 diabetics is generally metformin. In more serious cases, additional drugs will be prescribed. For example, long-term, untreated diabetes can require insulin injections.
The most common medications are:
Biguanides (ex. Glucophage, Metformin Hydrochloride ER, Glumetza, Riomet, Fortamet)
Biguanides help regulate how much sugar your intestines absorb, increase insulin sensitivity, help your muscles absorb more glucose, and decrease the liver’s glucose production. Metformin is a biguanide.
Side effects: the risk of weight gain or hypoglycemia is low but increases if the drug is taken with insulin.
Alpha-glucosidase inhibitors (ex. Precose, Glyset)
These slow down the digestion of carbohydrates by blocking certain enzymes in the small intestine and causing glucose to enter the bloodstream more slowly. This reduces blood sugar spikes.
Side effects: diarrhoea and gas.
DPP-4 inhibitors (ex. Nesina, Kasano, Oseni, Januvia, Janumet)
Incretins are hormones that stimulate insulin production when your body needs it, and reduces the production of glucagon when your body doesn’t need it. Incretins also slow digestion and decrease appetite. So Incretins are good. However, an enzyme called DPP-4 likes to destroy incretins. DPP-4 inhibitors help block this enzyme. By protecting incretins from damage, DPP-4 inhibitors help control blood glucose levels.
Side effects: skin reactions, flu-like symptoms and gastrointestinal problems.
Glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists) (ex. Tanzeum, Trulicity, Byetta, Victoza)
These drugs mimic the function of the hormone incretin, which increases the cells in your pancreas responsible for insulin production (beta cells). It also increases the amount of insulin and decreases the amount of glucagon you body uses. Incretin also decreases your appetite by slowing the speed at which your stomach empties. GLP-1 Receptor drugs mimic these actions.
Meglitinides (ex. Starlix, Prandin, Prandimet)
These medications force the pancreas to produce more insulin.
Side effects: hypoglycemia, constipation, nausea, diarrhoea, abdominal pain, liver problems and skin reactions.
Sodium-glucose transporter (SGLT) 2 inhibitors (ex. Farxiga, Invokana, Jardiance, Steglatro)
Usually the kidneys filter glucose out of the blood, but the glucose is reabsorbed into your body afterwards (through sodium-glucose transport proteins). SGLT inhibitors suppress these proteins so that you can get rid of the glucose through urine without reabsorbing it.
Side effects: genital and urinary tract infections
Sulfonylureas (ex. Amaryl, Duetact, Avandaryl, Glucotrol, Metaglip, Tolinase)
Sulfonylureas help your body make more insulin by stimulating the beta-cells in your pancreas. This tires out the pancreas which can eventually worsen the severity of your diabetes, and in severe cases, even cause type 1 diabetes. Sulfonylureas also commonly cause hypoglycemia. Many doctors try not to prescribe this class of drug for these reasons.
Side effects: pancreas failure, hypoglycemia, skin reactions and weight gain
Thiazolidinediones (ex. Avandia, Actos, Oseni, Amaryl M)
Thiazolidinediones boost insulin sensitivity by targeting a specific receptor in our cells that affect how the body metabolises glucose and stores fat.
Side effects: water retention, eyesight issues, skin reactions, weight gain.