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Health is wealth Diabetes treatment: Lowering blood sugar Several classes of type 2 diabetes medicines exist. Each class of medicine works in a different way to lower blood sugar. A medication may work by: Causing the pancreas to make and release more insulin. Limiting the liver's ability to make and release sugar. Blocking the action of enzymes in the intestines that break down carbohydrates, slowing how quickly cells take in carbohydrates. Improving cells' sensitivity to insulin. Limiting the kidneys' ability to take in sugar, which increases the amount of sugar that leaves the body in urine. Slowing how quickly food moves through the stomach. Each class of medicine has one or more medications. Some of these medications are taken by mouth, while others must be taken as a shot. Compare diabetes medications Below is a list of common diabetes medications. Other medications are available too. Ask your health care provider about your choices and the pros and cons of each. Medications you take by mouth Meglitinides Medications Repaglinide Nateglinide Action Trigger the release of insulin from the pancreas Advantages Work quickly Possible side effects Blood sugar levels drop too low — a condition called hypoglycemia Weight gain Sulfonylureas Medications Glipizide (Glucotrol XL) Glimepiride (Amaryl) Glyburide (DiaBeta, Glynase) Action Trigger the release of insulin from the pancreas Advantages Low cost Effective in lowering blood sugar Possible side effects Blood sugar levels drop too low Weight gain Skin rash Nausea or vomiting if you drink alcohol Dipeptidyl-peptidase 4 (DPP-4) inhibitors Medications Saxagliptin (Onglyza) Sitagliptin (Januvia) Linagliptin (Tradjenta) Alogliptin (Nesina) Action Cause the release of insulin when blood sugar is rising Limit the liver's ability to release glucose Advantages Don't cause weight gain Don't cause blood sugar levels to drop too low when used alone or with metformin Possible side effects Upper respiratory tract infection Sore throat Headache Biguanides Medications Metformin (Fortamet, Glumetza, others) Action Limit the liver's ability to release sugar Improve cells' sensitivity to insulin Advantages Very effective May lead to minor weight loss Low cost Possible side effects Nausea Stomach pain Diarrhea Very rarely, the harmful buildup of lactic acid — a condition called lactic acidosis —in people with kidney failure or liver failure Thiazolidinediones Medications Rosiglitazone (Avandia) Pioglitazone (Actos) Action Improve cells' sensitivity to insulin Limit the liver's ability to make and release sugar Advantages May slightly increase high-density lipoprotein (HDL) cholesterol, the "good" cholesterol Possible side effects Weight gain Fluid retention Increased risk of broken bones Increased risk of heart problems, including heart failure Possible increased risk of bladder cancer with pioglitazone People with liver problems or a history of heart failure shouldn't take this kind of diabetes medicine. Alpha-glucosidase inhibitors Medications Acarbose Miglitol (Glyset) Action Slow the body's ability to breakdown starches and some sugars Advantages Don't cause weight gain Don't cause blood sugar levels to drop too low unless you take them with insulin or a sulfonylurea Possible side effects Gas Stomach pain Diarrhea Sodium-glucose transporter 2 (SGLT2) inhibitors Medications Canagliflozin (Invokana) Dapagliflozin (Farxiga) Empagliflozin (Jardiance) Ertugliflozin (Steglatro) Action Limit the kidneys' ability to take in sugar, which increases the amount of sugar that leaves the body in urine Advantages May lead to weight loss May lower blood pressure Possible side effects Urinary tract infections Yeast infections Bile acid sequestrants Medications Colesevelam (Welchol) Action Lower cholesterol and have a small effect in lowering blood sugar when used with other diabetes medications Advantages Likely safe for people with liver problems Possible side effects Gas Constipation Indigestion Rise in blood fats called triglycerides Medications you take as a shot Amylin mimetics Medications Pramlintide (Symlin) Action Help regulate blood sugar Slow food moving through the stomach Used with insulin shots Advantages May decrease hunger May lead to minor weight loss Possible side effects Blood sugar levels drop too low Nausea Abdominal pain Incretin mimetic (GLP-1 receptor agonists) Medications Dulaglutide (Trulicity) Exenatide (Byetta, Bydureon Bcise) Liraglutide (Saxenda, Victoza) Lixisenatide (Adlyxin) Semaglutide (Ozempic, Rybelsus, Wegovy) Action Cause the release of insulin as blood sugar levels are rising May be used with metformin, basal insulin or a sulfonylurea Advantages May decrease hunger May lead to weight loss Possible side effects Nausea Vomiting Diarrhea Abdominal pain Increased risk of inflamed pancreas — a condition called pancreatitis How to choose your diabetes medication No one diabetes treatment is best for

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