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Medicines that can help manage your type 2 diabetes

There are many different types of medicines out there to help you manage your diabetes. You may find yourself wondering where to start. Listen, I know this can get a little confusing, but trust me—this is good info to know, and a good topic to discuss with your care team.

Let’s take a look to see how these medicines work with your body. And, of course, be sure to talk to your doctor if you’ve got any questions.

Doctor talking to patient
Non-insulin medicines icon

Non-insulin medicines for type 2 diabetes

There are several different types of non-insulin medicine—some are taken orally and some are injectable—and it’s important to talk to your doctor about which one is right for you. It’s not uncommon for people with diabetes to take more than one type of treatment to help manage their blood sugar.

Oral antidiabetic drugs (OADs) (medicines you put in your mouth)

There are many types of OADs. They work in different ways to lower blood sugar.

Metformin (biguanide)
Helps lower insulin resistance in the muscles and reduce the production of glucose

Sodium-glucose co-transporter 2 or SGLT2 inhibitors (dapagliflozin, empagliflozin, canagliflozin, ertugliflozin)
Help the kidneys get rid of extra sugar in the body through the urine

DPP-4 inhibitors (sitagliptin, saxagliptin, linagliptin, alogliptin)
Help prevent the breakdown of GLP-1, a hormone produced in the intestines

Thiazolidinediones or TZDs (pioglitazone, rosiglitazone)
Help improve the liver and muscle response to insulin, meaning more sugar leaves the blood and enters the muscles and fat (where it belongs)

Sulfonylureas (glimepiride, glyburide, glipizide)
Help the pancreas release more insulin

Meglitinides (nateglinide, repaglinide)
Help the pancreas release insulin

Alpha-glucosidase inhibitors (acarbose, miglitol)
Slow down the digestion and absorption of carbohydrates

OAD combinations (medicines that work together)

Since the different kinds of OADs help lower blood sugar in different ways, some may be used together. These options allow doctors to come up with treatment plans that meet individual needs.

GLP-1 receptor agonists (medicines that work with your body in multiple ways)

A GLP-1 receptor agonist (GLP-1 RA) is a non-insulin medicine that acts like the GLP-1 made in your body. 

GLP-1, or glucagon-like peptide-1, is a hormone that works in different ways to help keep your blood sugar in balance.

GLP-1 works by:

  • Helping the pancreas release more insulin after you’ve eaten
  • Telling the liver not to make so much sugar (by releasing glucose) at mealtimes 
  • Slowing down movement of food leaving the stomach so after-meal blood sugar levels don’t go as high

Learn more about an injectable option for type 2 diabetes:

Injectable treatment option
Dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 RA (an injectable option)

People with type 2 diabetes have a lower insulin response and resistance to GIP, a main hormone that influences insulin release. GIP and GLP-1 RA action work together to help the pancreas release insulin, stop the liver from making too much sugar, and slow down the movement of food leaving the stomach so after-meal blood sugar levels don't go as high.

Amylin agonists (another injectable option)

Another option your doctor may prescribe is an amylin agonist. This is an injectable drug that acts like a hormone produced by the pancreas. Amylin is a naturally occurring hormone that affects several different organ systems and works by slowing down the movement of food leaving the stomach and prompting an end to eating through the feeling of being full. Amylin also inhibits glucagon secretion.

Insulin medicines icon

Insulin medicines

The insulin that your body makes naturally is a hormone that is important for allowing cells to produce energy from food. Some people with type 2 diabetes may not be able to use their own insulin well. This is called insulin resistance. It may cause blood sugar levels to increase.

As diabetes changes over time, the body makes less insulin and can’t control blood sugar levels. For these people, insulin can be injected under the skin. This helps lower blood sugar levels back to their normal range.

Different insulin medicines work in different ways to replace the insulin you’re missing. They are grouped together based on:

  • When they start to work (onset)
  • When they have the greatest effect on blood sugar (peak)
  • How long they work (duration)
Human insulin (that’s actually made in a lab)

It’s called “human” because the structure is identical to the insulin your body makes.

There are 3 types of human insulin:

  1. Short-acting. This insulin, also called regular insulin, is usually taken 30 minutes before a meal and lasts 3 to 6 hours.
  2. Intermediate-acting. This type of human insulin, also called NPH, starts to work 2 to 4 hours after injection and lasts 10 to 16 hours.
  3. Premixed. This type of human insulin includes both a regular insulin and an intermediate-acting insulin. It is taken 30 minutes before breakfast and/or the evening meal and works for up to 10 to 16 hours.
Insulin analogs (insulin modified to work faster or longer)

Insulin analogs are human insulin with small changes made to the hormone so that it is absorbed faster or lasts longer in the body.

The 3 main types of insulin analogs are:

  1. Long-acting. Also called basal insulin, this type is not taken with food. It works slowly and lasts longer to control blood sugar between meals and can work up to 42 hours.
  2. Fast-acting. Also called bolus insulin. Depending on the medicine, this type of insulin may be taken just before a meal, at mealtime, or shortly after starting a meal.
  3. Premixed. This type is a mixture of fast-acting and intermediate-acting insulins. It works to control blood sugar at mealtime and works for up to 10 to 16 hours.

"If you’ve got questions about any of these treatment options, you know what to do—talk with your health care team. They’re there to support you."

How Anthony got real about diabetes

Here's how Anthony got real about eating healthy, being active, and listening to his doctor.

Check out his story

Anthony Anderson is a paid spokesperson for Novo Nordisk, Inc.
NovoCare® is a registered trademark and Get Real About Diabetes™ is a trademark of Novo Nordisk A/S.
Novo Nordisk is a registered trademark of Novo Nordisk A/S.

© 2024 Novo Nordisk    All rights reserved.    US23DI00427    April 2024

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Have you been diagnosed with type 2 diabetes?

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Having type 2 diabetes means an up to 4 times greater risk of heart attack, stroke, or cardiovascular death compared to people without diabetes.

Why? Because if it’s not managed over time, complications from high blood sugar can damage the blood vessels and nerves that control your heart. And people with type 2 diabetes are more likely to have other conditions that raise their risk, too.

Talk to your doctor about ways to manage your cardiovascular risk.

Having type 2 diabetes means an up to 4 times greater risk of heart attack, stroke, or cardiovascular death compared to people without diabetes.

But cardiovascular disease is still the leading cause of death in the US, even for those without diabetes. There’s never a bad time to talk to your doctor about ways to manage your cardiovascular risk.

Have you had a cardiovascular event in the past—for instance, a heart attack or a stroke?

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The unfortunate fact is that once someone has had a heart attack or stroke, they’re at increased risk for another cardiovascular event. That applies to people with and without type 2 diabetes.

But there are ways you can help lower your risk of having another event or keep it from getting worse. Talk to your doctor about understanding your cardiovascular risk and ways to manage it.

I bet this will make you want to keep it that way: Once someone has had a heart attack or stroke, they’re at increased risk for another cardiovascular event. That applies to people with and without type 2 diabetes. 

Talk to your doctor about understanding your cardiovascular risk and ways to manage it.

Do you have high blood pressure?

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High blood pressure is a big risk factor for cardiovascular disease and events, such as heart attack, stroke, or even cardiovascular death. 

If you aren’t already taking steps to keep your blood pressure under control, now’s a great time to start. 

Talk to your doctor about understanding your cardiovascular risk and ways to manage it.

Hey, you’re nailing it!

High blood pressure is a big risk factor for cardiovascular disease and events, such as heart attack, stroke, or even cardiovascular death. So keep doing what you’re doing to maintain your blood pressure. And keep your doctor in the loop, too.

High blood pressure is a big risk factor for cardiovascular disease and events, such as heart attack, stroke, or even cardiovascular death. 

So if you don’t know your blood pressure, talk to your doctor about your numbers. Knowing where you stand is the first step toward taking action.

Do you have high cholesterol?

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High cholesterol is a strong cardiovascular risk factor. 

And there’s more than one kind of cholesterol, too. Talk to your doctor about “good” and “bad” cholesterol, and what you can do to keep it under control.

That’s good to hear, because high cholesterol is a strong cardiovascular risk factor.

And there’s “good” and “bad” cholesterol, too. If yours is under control, talk to your doctor about what you can do to keep it there.

High cholesterol is a strong cardiovascular risk factor. And there’s “good” and “bad” cholesterol, too.

That’s why it’s so important to know your numbers. You can start by scheduling a screening with your health care provider.

Has your doctor ever told you that you may be overweight?

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Maintaining a healthy weight is an important part of managing your cardiovascular risk. Your doctor can help you understand what that means and set some goals for you to stay on track.

Maintaining a healthy weight is an important part of managing your cardiovascular risk. Whether you’re on the right track or not, it can’t hurt to check in about weight next time you see your doctor, right?

Maintaining a healthy weight is an important part of managing your cardiovascular risk. So if you’re not sure about your own weight, your doctor can help you understand what that means and set some goals for you to stay on track.

Are you a smoker?

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Smoking cigarettes means increased cardiovascular risk. 

Remember, if you have type 2 diabetes, your risk for events like heart attack or stroke is already up to 4 times greater than someone without type 2 diabetes.

Why pile risk on risk? NOW is a great time to talk to your doctor about quitting.

Now, that’s the best thing you could’ve said.

Remember, if you have type 2 diabetes, your risk for events like heart attack or stroke is already up to 4 times greater than someone without type 2 diabetes. And smoking cigarettes also increases a person’s cardiovascular risk. 

Why pile risk on risk, am I right?

That’s a great answer. Your cardiovascular risk starts decreasing soon after you quit—and for many people, it keeps decreasing over time.

Sounds like a win to me.

Are you a member of an ethnic or minority group such as Black, Hispanic/Latino, American Indian, Asian American, or Pacific Islander?

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According to the American Heart Association, Black Americans have higher rates of type 2 diabetes and may develop cardiovascular disease at an earlier age than other racial groups.

And some racial groups are more likely than others to experience risk factors for heart disease, like high blood pressure.

Talk to your doctor about what you can do to manage your cardiovascular risk.

Minority populations living with type 2 diabetes have an even higher risk of cardiovascular disease than other populations.

But nobody’s off the hook. Everyone living with type 2 diabetes has an increased risk. 

Talk to your doctor about what you can do to manage your cardiovascular risk.

How old are you?

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Even basic factors like age can affect your risk of cardiovascular disease.

In men, risk for heart disease starts increasing around age 45. For women, risk goes up around 55. 

And people 65+ are more likely than younger people to develop heart disease. 

You know what I’m going to say: Talk to your doctor about ways to manage your risk as you age. 

Even basic factors like age can affect your risk of cardiovascular disease.

In men, risk for heart disease starts increasing around age 45. For women, risk goes up around 55. 

And people 65+ are more likely than younger people to develop heart disease. 

You know what I’m going to say: Talk to your doctor about ways to manage your risk as you age. 

Even basic factors like age can affect your risk of cardiovascular disease.

In men, risk for heart disease starts increasing around age 45. For women, risk goes up around 55. 

And people 65+ are more likely than younger people to develop heart disease. 

You know what I’m going to say: Talk to your doctor about ways to manage your risk as you age. 

Even basic factors like age can affect your risk of cardiovascular disease.

In men, risk for heart disease starts increasing around age 45. For women, risk goes up around 55. 

And people 65+ are more likely than younger people to develop heart disease. 

You know what I’m going to say: Talk to your doctor about ways to manage your risk as you age. 

Even basic factors like age can affect your risk of cardiovascular disease.

In men, risk for heart disease starts increasing around age 45. For women, risk goes up around 55. 

And people 65+ are more likely than younger people to develop heart disease. 

You know what I’m going to say: Talk to your doctor about ways to manage your risk as you age. 

Congrats on taking the first step!

If you have type 2 diabetes, the thing to remember is that the more of these risk factors you have, the higher your cardiovascular risk may be. And the next step is talking to your doctor about what you can do.

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