What you should know about diabetes medications

When you have diabetes, your body doesn’t make enough of the hormone insulin. Or your body doesn’t properly use the insulin it does make. As a result, your body doesn’t get the fuel it needs, which is why taking medication is an important part of managing diabetes.

Without proper treatment, diabetes can lead to other health problems, including:  

• Blindness
• Fatigue
• Infections
• Kidney disease
• Stroke

Your doctor will help you create a treatment plan that works for you, including deciding on the right medications. Here are the main differences between the two primary types of diabetes medications: oral and injectable.

Oral medicine for diabetes 

There’s a long list of diabetes medications that are taken by mouth. These are used by people with type 2 diabetes, whose bodies still produce some insulin but can’t use it properly. (In type 1 diabetes, the body typically doesn’t produce insulin at all, so as of now, there are no oral medications for it.)

Sometimes, oral diabetes medicines are combined and work in different ways to lower your blood sugar level. Depending on your situation, oral diabetes medication may be used with insulin to achieve the best control of your blood glucose levels. Most of these medications help provide the following benefits:

• Make your organs and tissues more sensitive to insulin. This helps blood glucose enter the muscles, fat, and liver more easily.
• Prompt the pancreas to release more insulin so blood glucose is better regulated.
• Lower the amount of sugar the intestines absorb.
• Help the kidneys remove excess sugar.
• Lower the amount of glucose released by the liver.

If you’re taking oral medication to manage diabetes, remember these tips:

• Get familiar with your diabetes medicines. Learn their names, when and how much to take, the side effects, and how they might interact with other medicines you take. This information can help you stay on track with your medication schedules, which is hugely important when you have diabetes.
   
• Talk with your doctor about your medication habits. Don’t be afraid to say something if you’re having trouble following your treatment plan. Your doctor might be able to help make it easier to stick to your medication schedule.
   
• Follow the eating and exercise plan your diabetes care team recommends. Research suggests that diet and exercise help improve blood sugar control. In fact, people who stick to a regular exercise schedule and a healthy eating plan are sometimes able to take less medication or even stop taking it altogether.

Insulin for diabetes

Insulin is the primary medicine given by injection to treat type 1 diabetes. People with type 1 diabetes can’t produce insulin on their own. Some people with type 2 diabetes may also be candidates for insulin therapy because their bodies don’t use insulin properly. However, insulin therapy is usually only recommended for type 2 diabetes when other steps aren’t doing enough to control blood glucose. Those steps can include exercise, oral medications, weight loss, and nutrition changes.

People who might be candidates for insulin include:

• Those with type 1 diabetes
• Those with type 2 diabetes who have taken oral diabetes medications and weren’t able to control their blood sugar level, or those whose medication has become less effective over time
• Women with gestational diabetes (diabetes during pregnancy)

If your health care provider recommends that you take insulin, ask about the options.

There are several different kinds of insulin, including:

• Rapid-acting insulin: 
  Begins to work: In about 15 minutes 
  Peaks: 1 to 2 hours after injection 
  Lasts: 2 to 4 hours
   
• Regular or short-acting insulin:  
  Begins to work: Within 30 minutes of injection 
  Peaks: 2 to 3 hours after injection 
  Lasts: 3 to 6 hours
   
• Intermediate-acting insulin: 
  Begins to work: 2 to 4 hours after injection 
  Peaks: 4 to 12 hours after reaching the bloodstream 
  Lasts: 12 to 18 hours
   
• Long-acting insulin: 
  Begins to work: Several hours after injection 
  Peaks: It does not peak 
  Lasts: Up to 24 hours
   
• Ultra-long-acting insulin: 
  Begins to work: 6 hours after injection 
  Peaks: It does not peak 
  Lasts: 36 hours or longer

Your doctor may also suggest a combination of these. Insulin can be delivered by a syringe, pen device, or pump. In addition to injected insulin, there is also an inhaled version.

Injected medicine for diabetes beyond insulin 

Aside from insulin, there are other injected diabetes medicines that help control blood sugar and have other beneficial effects. These include:

• Amylin analogs. Also called agonists, these are used for both type 1 and type 2 treatments. They are given before meals and help lower blood glucose levels.
   
• Incretin mimetics. Used for type 2 diabetes, these injectables are also considered to be agonists. They are often used for people who haven’t been able to control their condition with oral medication. They help lower post-meal blood sugar levels.

Medications for other conditions 

People with type 1 or type 2 diabetes are often treated with other medications for conditions that are common among people with diabetes. For example, your doctor may prescribe statins if you have high cholesterol. If you have high blood pressure, ACE inhibitors or beta-blockers are common treatments. Diabetes can make these and other conditions worse. That’s why it’s super important to take all your medicines as directed by your doctor and get your diabetes under control.

Being diagnosed with diabetes and learning how to manage it can feel overwhelming at first. But the good news is that medications, along with staying active and eating a healthy diet, can go a long way toward helping you take charge of your diabetes.