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Here’s the deal. When you get diagnosed with type 2 diabetes, your doctor may prescribe medicine to you as part of your overall treatment plan. It’s important to take control of the disease—but even so, your diabetes may change over time. It’s not your fault—it’s just the way diabetes works. As it changes, your doctor may have to change your medicine or add additional medicine, so it’s important that you understand them all.

Non-insulin medicines

Non-insulin medicines are exactly what they sound like—medicines without insulin. 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.

Non-insulin medicines icon

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

Metformin (biguanide)
Helps lower insulin resistance 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, muscle, and fat cells’ 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

Alpha-glucosidase inhibitors (acarbose, miglitol)
Slow down the digestion of carbohydrates and keep the body from absorbing sugar

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.

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

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

The insulin that your body makes naturally is a hormone that is important for producing 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 causes 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)
Insulin medicines icon

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 insulin, is taken 30 minutes before breakfast, before the evening meal, or at bedtime, and is effective for anywhere from 12 to 18 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 anywhere from 10 to 18 hours.

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 when you sleep. 
  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 anywhere from 16 to 24 hours. 

Anthony Anderson's diabetes story

Diabetes is diabetes, even if you’re a celebrity. Hear how I got real about eating healthy, being active, and taking my medicine as discussed with my doctor.

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