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Medications for type 2 diabetes fact sheet

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You can download and print out the PDF version.

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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

Hand holding a glass of water and a tabletIf 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 nameHow it worksCommon side effectsAdditional information

Biguanides

Common brands:
Metformin® (MR) Diabex®(XR), Diaformin®, Metex®, Formet®

  • Blocks glucose release from the liver
  • Slows glucose release from the gut
  • Improves insulin sensitivity
  • Nausea
  • Diarrhoea
  • Metallic taste in the mouth
  • Cramps and bloating
  • Indigestion

Take with or directly after food

Avoid if you have severe kidney or liver damage

Sulphonylureas

Common brands:
Diamicron® (MR), Glyade®, Amaryl®, Glimel®

  • Stimulates the pancreas to release more insulin
  • Hypoglycaemia
  • Weight gain
  • Rash

Take just before a meal

Avoid skipping meals

DPP-4 inhibitors

Common brands:
Januvia®, Galvus®, Trajenta®, Onglyza®, Nesina®

  • 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)
  • Headaches
  • Musculoskeletal pain
Take with or without food

SGLT2 inhibitors

Common brands:
Forxiga®, Jardiance®, Invokana®

  • Blocks glucose from being re-absorbed by the kidneys
  • Urinary tract infections
  • Yeast infections
  • Dehydration
  • Constipation
  • Increased urination

Can be taken with or without food

Have with a full glass of water

Thiazolidinediones

Common brands:
Avandia®, Actos®

  • Improves the sensitivity of cells to insulin
  • Decreases glucose release from the liver
  • Weight gain
  • Fluid accumulation
Avoid if you have severe liver or heart damage

Alpha glucosidase inhibitors

Common brands:
Glucobay®

  • Slows down the digestion of carbohydrate from food
  • Flatulence (wind)
  • Bloating
  • Diarrhoea

Take just before food

If you are taking this with a medication that can cause hypos, treat hypos with glucose only, e.g., glucose tablets or gel

GLP-1 agonists

Common brands:
Byetta®, Victoza®

  • Blocks glucose release from the liver
  • Slows glucose release from the gut
  • Stimulates the release of insulin
  • Induces feeling of fullness
  • Nausea
  • Vomiting
  • Diarrhoea
  • Constipation
  • Reflux
  • Injection site reaction

This medication is injected

Tell your doctor if you experience rapid weight loss

Insulin
  • Allows glucose to move from the bloodstream to the body cells
  • Hypoglycaemia
  • Injection site reaction
  • Weight gain

This medication is injected

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

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 fact sheet is intended as a guide only. It should not replace individual medical advice and if you have any concerns about your health or further questions, you should contact your health professional.

Version 2 November 2018. First published June 2016.