Type 2 diabetes - Understanding medicine (2024)

Most people need medicine to control their type 2 diabetes.

This helps keep your blood sugar level as normal as possible to prevent health problems.

You may have to take it for the rest of your life, although your medicine or dose may need to change over time.

Adjusting your diet and being active is usually also necessary to keep your blood sugar level down.

Medicines for type 2 diabetes

There are many types of medicine for type 2 diabetes. It can take time to find a medicine and dose that's right for you.

You'll usually be offered a medicine called metformin first.

You may need to take extra medicines, or a different medicine such as insulin, if:

  • metformin is not suitable for you
  • treatment is not keeping your blood sugar levels below your target
  • you have other health problems, such as heart problems or kidney problems

Your GP or diabetes nurse will recommend the medicines most suitable for you.

Your medicine might not make you feel any different, but this does not mean it's not working. It's important to keep taking it to help prevent future health problems.

Metformin

Metformin is the most common medicine used for type 2 diabetes. It can help keep your blood sugar at a healthy level.

It comes as tablets.

Common side effects of metformin include feeling sick and diarrhoea. If this happens to you, your doctor may suggest trying a different type called slow-release metformin.

Find out more about metformin

Other diabetes medicines

If metformin does not work well enough on its own, you cannot take it or you have other health problems, you may need to take other medicines alongside or instead of metformin.

These include:

  • other tablets that help lower your blood sugar, such as gliclazide, glimepiride, alogliptin, sitagliptin or pioglitazone
  • tablets that lower your blood sugar and help your heart pump blood around your body, such as dapagliflozin, empagliflozin, ertugliflozin or canagliflozin
  • injections or tablets that lower your blood sugar and help you lose weight, such as semaglutide, dulaglutide or tirzepatide

Insulin

You'll need insulin if other medicines no longer work well enough to keep your blood sugar below your target.

Sometimes you may need insulin for a short time, such as if you're pregnant, if you're ill, or to bring your blood sugar level down when you're first diagnosed.

You inject insulin using an insulin pen. This is a device that helps you inject safely and take the right dose.

Using an insulin pen does not usually hurt. The needles are very small, as you only inject a small amount just under your skin. Your diabetes nurse will show you where to inject and how to use your pen.

Your GP or diabetes specialist will recommend the type of insulin treatment that's best for you.

Find out more about insulin

Side effects

Your diabetes medicine may cause side effects.

The side effects you may get depend on which medicines you're taking.

Do not stop taking your medicine if you get side effects. Talk to your doctor, who may suggest trying a different medicine.

Low blood sugar (hypos)

Some diabetes medicines can cause low blood sugar, known as hypoglycaemia or a hypo. These medicines include insulin and medicines such as gliclazide.

If you take medicine that can cause hypos, your doctor might recommend that you check your blood sugar regularly. You'll be given a testing kit and shown how to do a finger-prick test.

If you take insulin at least twice a day and have frequent or severe hypos, you might also be offered a continuous glucose monitor (CGM) or flash monitor.

This is a small sensor you wear on your skin that lets you check your blood sugar level at any time.

Learn more about checking your blood sugar levels from Diabetes UK

You'll need to check the DVLA rules about driving if you take medicine that can cause hypos.

Learn more about diabetes and your driving licence from Diabetes UK

How to get free prescriptions for diabetes medicine

If you take diabetes medicine, you're entitled to free prescriptions for all your medicines, including medicines for other conditions.

To claim your free prescriptions, you'll need to apply for an exemption certificate.

To apply for an exemption certificate:

  • fill in an FP92A form at your GP surgery
  • you should get the certificate in the post about a week later – it'll last for 5 years
  • take it to your pharmacy with your prescriptions

If you have to pay for diabetes medicine before you receive your exemption certificate, save your receipts and ask the pharmacist to give you an FP57 receipt and refund claim form. You can use this to claim the money back after you receive your certificate.

Travelling with diabetes medicines

If you're going on holiday:

  • pack extra medicine – speak to your diabetes nurse about how much to take
  • carry your medicine in your hand luggage just in case checked-in bags go missing or get damaged
  • get a letter from your GP that says you need medicine and to carry medical supplies to treat diabetes if you're going abroad (you may need to pay for the letter)

Page last reviewed: 22 December 2023
Next review due: 22 December 2026

Type 2 diabetes - Understanding medicine (2024)

FAQs

What is the number one medication for type 2 diabetes? ›

The most common biguanide is metformin (Glumetza, Riomet, Riomet ER). Metformin is considered the most commonly prescribed oral medication for type 2 diabetes.

What drink lowers blood sugar? ›

Drinking water is an excellent way to stay hydrated without consuming sugar. Green tea, cow's milk, and fermented milk (kefir) could also help you manage your blood sugar responses. Coffee also contains compounds that may help regulate blood sugar, but confirming this requires more research.

Why do doctors no longer recommend metformin? ›

However, the toll it takes on the digestive system may prevent many people with diabetes from taking it for more than a week or two. “Metformin commonly causes gastrointestinal symptoms such as diarrhea and flatulence,” explained a recent study published in the journal Diabetes, Obesity and Metabolism.

What is the best type 2 diabetes medication with the least side effects? ›

Most experts consider metformin to be the safest medicine for type 2 diabetes because it has been used for many decades, is effective, affordable, and safe. Metformin is recommended as a first-line treatment for type 2 diabetes by the American Diabetes Association (ADA).

What is the new drug replacing metformin? ›

Mounjaro (tirzepatide) is one of the newest metformin alternatives. It's a once-weekly injection that comes in six different doses. It's also the first medication of its type. Mounjaro is a dual glucose-dependent insulinotropic polypeptide (GIP) and GLP-1 agonist.

What is the best medicine to lower A1C? ›

FARXIGA can help with your first priority—lowering your A1C

FARXIGA is a once-daily pill proven to help lower A1C, along with diet and exercise. *Average reduction with 5mg + metformin XR when starting at 9.2% A1C. Metformin XR alone lowered A1C by 1.4% when starting at 9.1% A1C. Individual results may vary.

What brings sugar down immediately? ›

The quickest way to lower your blood sugar is to take fast-acting insulin. Exercising is another fast, effective way. However, in severe cases, you should go to the hospital. High blood sugar levels are known as hyperglycemia or high blood glucose.

What should diabetics drink first thing in the morning? ›

Water is the best all-round drink. If your family likes flavoured waters, make your own by adding a squeeze of lemon or lime, or strawberries.

What organ is metformin hard on? ›

Your kidneys remove metformin from your body. If your kidneys are not working as they should, you'll have higher metformin levels in your system. This raises your risk of lactic acidosis. If you have mild or moderate kidney problems, a doctor may start you on a lower metformin dosage.

Why is metformin banned in America? ›

Concerns over higher-than-acceptable levels of the probable cancer-causing contaminant N-nitrosodimethylamine (NDMA) prompted the recall.

Is cinnamon as good as metformin? ›

As a result, cinnamon seems to be as effective as metformin in increasing the Insulin sensitivity. In line with this study, Maleki et al. showed that HDL and insulin sensitivity were increased by the cinnamon supplementation while LDL, TG, and blood glucose were decreased in patients with PCOS (17).

Why can't diabetics take ibuprofen? ›

Patients of diabetes should be very cautious while consuming over-the-counter pain medications like Advil as these drugs are associated with a high risk of a coronary event. The increased risk for a heart disease in diabetics is further worsened if the patient consumes medications like Ibuprofen.

What is the weekly shot for diabetics? ›

Once-weekly prescription Ozempic®, along with diet and exercise, lowers blood sugar in adults with type 2 diabetes. Scroll below to “What is Ozempic®?” for Limitations of Use. GLP-1 RA=glucagon-like peptide-1 receptor agonist.

What is the first drug of choice for type 2 diabetes? ›

Metformin (Fortamet, Glumetza, others) is generally the first medicine prescribed for type 2 diabetes. It works mainly by lowering glucose production in the liver and improving the body's sensitivity to insulin so it uses insulin more effectively.

Is there a better drug for type 2 diabetes than metformin? ›

Insulin remains the most effective therapy to lower glucose, particularly in comparison to most oral medicines for type 2 (including metformin).

What is the most successful diabetes medication? ›

Metformin is considered the first-line oral agent for patients with diabetes and can be used to treat pre-diabetes. It works by decreasing glucose production in the liver, increasing insulin sensitivity, and lowering intestinal sugar absorption.

What is the new pill for type 2 diabetes? ›

Once-daily RYBELSUS® (semaglutide) tablets is a prescription medicine used along with diet and exercise to improve blood sugar in adults with type 2 diabetes. Scroll below to "What is RYBELSUS®?"

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