Read aloud

Medications for type 2 diabetes fact sheet

PDF coverThis fact sheet is available in two formats.

You can download and print out the PDF version.

Or you can read it as a website page below.

Many people with type 2 diabetes need medications to help manage their blood glucose levels.

When you are first diagnosed with type 2 diabetes, you may not need medication. However, over a period of time, most people need medications to help lower their blood glucose levels.

Your doctor may prescribe medication to help manage your diabetes. Ask about how these medications work and if there are any side effects you need to know about. Remember that the type—and dose—of the medication you need is likely to change over time.

Diabetes medications

There are several different types of medication that can be used to help manage type 2 diabetes. They are grouped together based on how they work in your body. Each type of medication works differently to help keep your blood glucose levels in your target range.

While most of these medications are available as a tablet, some are taken as an injection. Many medications can be taken in combination. Your doctor will prescribe the medications most suitable for you.

Starting a new diabetes medication

If you are starting a new medication, it’s important to talk to your doctor about:

  • what time to take it
  • how much to take, or dosage levels
  • when to take it—before, with or after food
  • how to take it—can tablets be crushed, split or swallowed whole
  • what to do if you forget to take it
  • the common side effects
  • what to do on sick days
  • how to store the medication
  • whether the medication can cause low blood glucose levels (hypoglycaemia or hypo)
  • whether it’s suitable to take with other medications you have either been prescribed or supplements/over the counter medicines you are using.

You can also talk to your pharmacist about any new medications when you fill your prescription. When starting a new medication, your doctor may ask you to start monitoring your glucose levels at home if you are not doing this already.

Types of diabetes medications
Class name How it works Common side effects Additional information
Oral medications

Biguanides
(metformin)

  • blocks glucose release from the liver
  • improves insulin sensitivity
  • increases peripheral utilisation of glucose.
  • nausea
  • vomiting
  • anorexia
  • diarrhoea.
  • take with or directly after food
  • avoid if you have severe kidney or liver damage
  • tell your doctor immediately if you have a loss of appetite, nausea, vomiting, abdominal pain, cramps, fatigue, diarrhoea, or weight loss.

Sulphonylureas
(glibenclamide, gliclazide, glimepiride, glipizide)

  • stimulates the pancreas to release more insulin
  • may decrease insulin resistance.
  • hypoglycaemia
  • weight gain.
  • take with food to minimise risk of hypoglycaemia
  • avoid skipping meals
  • avoid if you have severe liver impairment.

DPP-4 inhibitors
(alogliptin, linagliptin, saxagliptin, sitagliptin, vildagliptin)

  • blocks the action of DPP-4 enzyme
  • stimulates the release of insulin
  • blocks the release of glucose from the liver.
  • respiratory tract infections
  • common cold symptoms
    (sore throat, runny nose, cough)
  • hypoglycaemia (when used with insulin or a sulphonylurea)
  • headaches
  • musculoskeletal pain.
  • take with or without food
  • seek medical advice if you develop a rash or hives, or swelling of the face, lips, mouth or tongue.

SGLT2 inhibitors
(dapagliflozin, empagliflozin, ertugliflozin)

  • blocks glucose from being re-absorbed by the kidneys.
  • urinary tract infections
  • yeast infections
  • dehydration
  • constipation
  • nausea
  • increased thirst
  • hypoglycaemia (when used with insulin or a sulphonylurea)
  • increased urination or pain on urination.
  • can be taken with or without food
  • drink plenty of water to avoid dehydration
  • speak to your doctor about having regular kidney checks
  • check for ketones and signs of diabetic ketoacidosis (severe vomiting and abdominal pain) if you are unwell—even if your blood glucose levels are in the normal range—and seek urgent medical help.

Thiazolidinediones
(pioglitazone)

  • improves the sensitivity of cells to insulin
  • decreases glucose release from the liver.
  • weight gain
  • fluid accumulation
  • headache
  • dizziness
  • joint or muscle pain.
  • avoid if you have severe liver or heart damage
  • seek medical advice if you develop shortness of breath during daily activities, swollen ankles or fatigue.

Alpha glucosidase inhibitors
(acarbose)

  • slows down the digestion of carbohydrate from food.
  • flatulence (wind)
  • bloating
  • diarrhoea
  • abdominal pain.
  • avoid if you have severe kidney damage
  • take just before food
  • if you experience hypoglycaemia, treat with glucose only, e.g., glucose tablets or gel.
Injectables

GLP-1 agonists
(dulaglutide, exenatide, liraglutide, semaglutide)

  • blocks glucose release from the liver
  • slows glucose release from the gut
  • stimulates the release of insulin
  • decreases appetite.
  • nausea
  • vomiting
  • diarrhoea
  • constipation
  • reflux
  • abdominal pain
  • fatigue
  • injection site reaction
  • hypoglycaemia (when used with insulin or a sulphonylurea).
  • tell your doctor if you experience rapid weight loss or develop unexplained severe abdominal pain.
Insulin
  • allows glucose to move from the bloodstream to the body cells
  • hypoglycaemia
  • injection site reaction
  • weight gain
  • there are different classes of insulin and these vary according to how long they take to start working and how long they last
  • avoid skipping meals.

The table above provides general information about the different groups of medications to treat type 2 diabetes.  Many of these medications come in different brands, formulations and in combination with each other, for more information or for a copy of the Consumer Medicines Information leaflet speak to your treating doctor, credentialled diabetes educator or pharmacist.

Once you have started on or changed to a new diabetes medication, your doctor will discuss the scheduling of your next appointment for a review. They may wish to see you more often after you start a new medication.

Your doctor will want to check your blood glucose levels, ask about any side effects or problems you might be having, and decide whether your dose needs to be changed. Your doctor may also discuss adding or starting another type of diabetes medication.

The approach to managing diabetes, and the use of medications, is different for everyone, so let your diabetes health professionals help you work out what treatment is best for you.

Your pharmacist can also assist you with information and advice about the medication you have been prescribed.

Even if you take medication to help manage your diabetes, healthy eating and regular physical activity are essential to help manage your diabetes.

Complementary or alternative medicines

Taking complementary, alternative or over-the-counter medicines may affect the diabetes medications you are taking. Always talk to your doctor, pharmacist or credentialled diabetes educator first before starting any of these. They should NEVER REPLACE your prescribed medication.

Review your medications every year as part of your diabetes annual cycle of care. This is a series of health checks your GP can do to help you manage your diabetes.

Tips for taking diabetes medication

  • Take the correct dose at the right time, as prescribed by your doctor. Taking your medication incorrectly can cause your blood glucose levels to rise or fall at the wrong time. It can also increase some side effects from that medication.
  • Read the information leaflet that comes in the medication box, or ask your pharmacist for information.
  • Don’t split or crush your tablets without checking with your pharmacist first, as it may change the effectiveness of your medication.
  • If you drink alcohol, make sure your doctor knows, as it may affect your medication. Some medications can also cause alcohol-related hypos—ask your doctor if you are at risk.
  • If you need help remembering to take your medication, ask your pharmacist about using a dosette box or Webster-pak®.

The NDSS and you

A wide range of services and support is available through the NDSS to help you manage your diabetes. This includes information on diabetes management through the NDSS Helpline and website. The products, services and education programs available can help you stay on top of your diabetes.

This information is intended as a guide only. It should not replace individual medical advice. If you have any concerns about your health, or further questions, you should contact your health professional.

Version 4 August 2020. First published June 2016.