Key takeaways
Medications for type 1 diabetes primarily focus on replacing insulin, as the body cannot produce it on its own. They include short-acting, rapid-acting, intermediate-acting, long-acting, and combination insulins, as well as amylinomimetic injectables.
Type 2 diabetes medications aim to help the body use insulin more effectively or eliminate excess glucose from the blood, and include both oral drugs and injectable drugs.
People with diabetes, whether type 1 or type 2, may need additional medications to address related health conditions like high cholesterol and high blood pressure.
Recall of extended-release metforminIn May 2020, the
Food and Drug Administration (FDA)
recommended that some makers of extended-release metformin remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets. If you currently take this drug, call a healthcare professional. They will advise whether you should continue to take your medication or if you need a new prescription.
is a condition that leads to high levels of blood
(sugar) in the body.
This reaction happens when your body can’t make or use the hormone insulin like it’s supposed to. Produced by the pancreas, insulin helps your body use the sugar from the food you eat.
There are two major types of diabetes:
and
. People with either type need medications to help manage their blood sugar levels.
The types of medications you take depend on the type of diabetes you have. Learn more about the available treatment options.
If you have type 1 diabetes, your body can’t make its own
. The goal of treatment is to replace the insulin that your pancreas can’t make.
Insulin
Insulin is the most common type of medication used in type 1 diabetes treatment. There are more than
sold in the United States under many names, both brand and generic.
Insulin is given as an infusion under the skin (with the help of an
) or as an
.
There are multiple types of insulin. They vary based on how quickly they start working, how long they work, and whether they have a peak level of action.
The type of insulin you need depends on your body’s sensitivity to insulin and the severity of your insulin deficiency. These include the following:
Short-acting insulin
Regular or “short-acting” insulin may reach the bloodstream 30 minutes after injection and peak 2–3 hours afterward. These injections also work
.
Types of regular insulin include:
Novolin R FlexPen
Novolin R ReliOn
Novolin R FlexPen ReliOn
Rapid-acting insulin
As the name suggests, rapid-acting insulin works within
. The peak time is 1–2 hours after use, and the medication lasts between 2 and 4 hours.
The available types of rapid-acting insulin include:
inhaled insulin (
)
insulin aspart, sold under brand names including:
Fiasp FlexTouch
Fiasp PenFill
NovoLog FlexPen
NovoLog FlexTouch
NovoLog PenFill
ReliOn NovoLog
ReliOn NovoLog FlexPen
insulin glulisine (Apidra, Apidra SoloStar), which is only available as a brand-name drug
insulin lispro, sold under brand names including:
Admelog SoloStar
Humalog KwikPen
Humalog Junior KwikPen
insulin lispro-aabc (
, Lyumjev KwikPen)
Intermediate-acting insulin
Intermediate-acting insulin works about
after use, with an average peak time of 4–12 hours. You can expect this type of insulin to last between 12 and 18 hours.
Examples include:
insulin isophane, sold under brand names including:
Humulin N KwikPen
Novolin N
Novolin N FlexPen
Novolin N ReliOn
Novolin N FlexPen ReliOn
Long-acting insulin
Long lasting insulin helps lower your blood glucose levels for up to
or longer. It stabilizes your bloodstream longer without a peak.
The types of available long-acting insulin include:
insulin degludec (
, Tresiba FlexTouch)
insulin glargine, sold under brand names including:
KwikPen
Lantus SoloStar
Toujeo Max SoloStar
insulin glargine-yfgn (Semglee-yfgn)
concentrated regular insulin (Humulin R U-500, Humulin R U-500 KwikPen)
Combination (premixed) insulins
Combination insulins typically contain a rapid or immediate acting insulin with a regular or short acting insulin to provide coverage both immediately and shortly after.
insulin aspart protamine/insulin aspart 70/30 (NovoLog Mix 70/30, NovoLog Mix 70/30 FlexPen)
insulin isophane/regular insulin 70/30, sold under brand names including: Humulin 70/30
Humulin 70/30 KwikPen
Novolin 70/30
Novolin 70/30 FlexPen
Novolin 70/30 FlexPen ReliOn
insulin lispro protamine/insulin lispro 50/50 (Humalog Mix 50/50, Humalog Mix 50/50 KwikPen)
insulin lispro protamine/insulin lispro 75/25 (Humalog Mix 75/25, Humalog Mix 75/25 KwikPen)
Amylinomimetic injectables
Pramlintide (SymlinPen) is an amylinomimetic. It’s an injectable medication that’s used before meals.
It works by delaying the time your stomach takes to empty itself. It also reduces the secretion of the hormone glucagon after meals. These actions lower your blood sugar.
Pramlintide reduces appetite, too.
The goal of type 2 diabetes treatment is to help your body use insulin better or to get rid of extra glucose in your blood.
for type 2 diabetes are oral drugs. However, insulin or injectables may also be used. Some of these medications are combinations of more than one diabetes drug.
Insulin
Some people with type 2 diabetes may also need to take insulin. The same types of insulin used to treat type 1 diabetes
type 2 diabetes.
A doctor may recommend the aforementioned types of insulin used in type 1 diabetes treatment for type 2 diabetes. As with type 1 diabetes, this depends on the type of insulin needed and the severity of your insulin deficiency. See the above types of insulin to discuss with a doctor.
Alpha-glucosidase inhibitors
These medications help your body break down starchy foods and table sugar. This effect lowers your blood sugar levels.
These medications may cause
(low blood sugar). Your risk of hypoglycemia
if you take them with other types of diabetes medications. Therefore, it’s important to take them only as prescribed.
For best results, take alpha-glucosidase inhibitors before meals. These medications include:
miglitol (Glyset)
Biguanides
Biguanides decrease how much glucose your liver makes. They also decrease how much glucose your intestines absorb, help your muscles absorb glucose, and make your body more sensitive to insulin.
The most common biguanide is
(Glumetza).
Metformin is considered the
prescribed oral medication for type 2 diabetes. It can also be combined with other type 2 diabetes medications. It’s an ingredient in the following medications:
metformin-alogliptin (Kazano)
metformin/canagliflozin (Invokamet)
metformin/dapagliflozin (Xigduo XR)
metformin/empagliflozin (Synjardy)
metformin/ertugliflozin (Segluromet)
metformin/glipizide
metformin/glyburide (Glucovance)
metformin/linagliptin (Jentadueto, Jentadueto XR)
metformin/pioglitazone (Actoplus Met, Actoplus Met XR)
metformin/repaglinide
metformin/saxagliptin
metformin/sitagliptin (Janumet, Janumet XR)
Dopamine-2 agonist
It’s unknown exactly how this drug treats type 2 diabetes. It may affect rhythms in your body and prevent
.
Dipeptidyl peptidase-4 (DPP-4) inhibitors
DPP-4 inhibitors are used to help reduce blood sugar without causing hypoglycemia.
DPP-4 inhibitors
the DPP-4 enzyme. This enzyme destroys a hormone called incretin, which normally helps your body produce insulin when it’s needed. Incretins also decrease glucose output from the liver when your body doesn’t need it.
These drugs can also help the
make more insulin.
Examples of DPP-4 inhibitors include:
alogliptin (Nesina)
alogliptin/metformin (Kazano)
linagliptin (Tradjenta)
linagliptin/empagliflozin (Glyxambi)
linagliptin/metformin (Jentadueto, Jentadueto XR)
saxagliptin (Onglyza)
saxagliptin/metformin
sitagliptin (Januvia)
sitagliptin/metformin (Janumet and Janumet XR)
sitagliptin/simvastatin
Glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists)
GLP-1 receptor agonists are similar to incretin. A doctor may prescribe them in addition to a diet and exercise plan
better glycemic control.
GLP-1 receptor agonists increase how much insulin your body uses and the growth of pancreatic beta cells. They decrease your appetite and how much glucagon your body uses.
GLP-1 receptor agonists also slow stomach emptying, which may maximize nutrient absorption from the foods you eat while
you maintain or lose weight.
These are all important actions for people with diabetes.
These drugs include:
dulaglutide (Trulicity)
exenatide (Byetta)
exenatide extended-release (
BCise)
liraglutide (Saxenda, Victoza)
lixisenatide
semaglutide (
)
tirzepatide (Mounjaro)
Meglitinides
These medications help your body release insulin. However, they’re not for everyone. In some cases, they may lower your blood sugar too much,
if you have advanced
.
These drugs include:
nateglinide (Starlix)
repaglinide (Prandin)
Sodium-glucose transport protein 2 (SGLT2) inhibitors
SGLT2 inhibitors work by preventing the kidneys from holding on to glucose. Instead, your body gets rid of the glucose through your urine.
Again, in cases where atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease predominate, the ADA recommends SGLT2 inhibitors as a possible treatment option. Examples
:
canagliflozin (Invokana)
canagliflozin/metformin (Invokamet, Invokamet XR)
dapagliflozin (Farxiga)
dapagliflozin/metformin (Xigduo XR)
dapagliflozin/saxagliptin (Qtern)
empagliflozin (Jardiance)
empagliflozin/linagliptin (Glyxambi)
empaglifozin/linagliptin-metformin (Trijardy XR)
empagliflozin/metformin (Synjardy, Synjardy XR)
ertugliflozin (Steglatro)
Sulfonylureas
These are
diabetes drugs still used today. They work by stimulating the pancreas with the help of beta cells. This causes your body to make more insulin.
These drugs include:
glimepiride (Amaryl)
glimepiride/pioglitazone (Duetact)
gliclazide
glipizide
glipizide ER (Glipizide XL, Glucotrol XL)
glipizide/metformin
glyburide (Glynase)
glyburide/metformin
Thiazolidinediones
Thiazolidinediones work by decreasing glucose in your liver. They also help your fat cells use insulin better
insulin resistance.
These drugs come with an increased risk of
. If your doctor prescribes one of these drugs, they will monitor your heart function during treatment.
Options include:
pioglitazone/alogliptin (Oseni)
pioglitazone/glimepiride (Duetact)
pioglitazone/metformin (Actoplus Met, Actoplus Met XR)
rosiglitazone
Many medications are available to treat type 1 and type 2 diabetes. They each work in different ways to help control your blood sugar.
Ask a doctor which diabetes drug may be the best fit for you. They can make recommendations based on the type of diabetes you have, your health, and other factors.
It’s also important to know that new medications for diabetes are constantly being investigated for approval.