What Medications Treat Diabetes

Health & Fitness

Many different types of medications are available to help lower blood sugar levels in people with T2D. Each medication works in a different way. Combining two or more medications commonly gets better outcomes.

  • Sulfonylureas: These stimulate the pancreas to release more insulin. Sometimes, the pancreas lacks enough stored insulin to respond adequately to sulfonylurea.
  • Biguanides: These decrease the amount of glucose produced by the liver by improving its sensitivity to insulin.
  • Alpha-glucosidase inhibitors: These slow absorption of starch as a person eats, which slows down the rise of blood glucose level during and after meals.
  • Thiazolidinediones: These increase tissue sensitivity to insulin but are restricted in the U.S. market.
  • Meglitinides: These stimulate the pancreas to release more insulin.
  • D-phenylalanine derivatives: These stimulate the pancreas to release more insulin more quickly.
  • Sodium-glucose co-transporter 1 (SGLT2) inhibitors: These block reabsorption of glucose by the kidney, leading to increased glucose excretion and reduction of blood sugar levels. Urinary tract infections are more common with SGLT2 inhibitors due to higher sugar levels in the urine.
  • Amylin synthetic derivatives: Amylin is a naturally occurring hormone secreted by the pancreas along with insulin. Amylin derivatives, such as pramlintide (Symlin), help lower blood sugar levels after meals when insulin alone does not. Pramlintide is injected subcutaneously along with insulin.
  • Incretin mimetics: These promote insulin release by the pancreas. They mimic other natural actions that lower blood sugar level. Exenatide (Byetta) was the first incretin mimetic agent approved in the U.S. It is indicated for T2D in addition to metformin (Glucophage) or a sulfonylurea, when these agents alone cannot control the sugar level.
  • Insulins: Only synthetic types of human insulin are available in the U.S., since they are less likely to cause allergic reactions than the animal-derived insulin used in the past. Different formulations of insulin are categorized according to action onset and duration. Commercial mixtures of insulin sometimes provide constant (basal) control and immediate control.
    • Rapid-acting insulin formulations:
      • Regular insulin (Humulin R, Novolin R)
      • Insulin lispro (Humalog)
      • Insulin aspart (Novolog or Fiasp)
      • Insulin glulisine (Apidra)
      • Prompt insulin zinc (Semilente, slightly slower acting)
    • Intermediate-acting insulin formulations:
      • Isophane insulin, neutral protamine Hagedorn (NPH) (Humulin N, Novolin N)
      • Insulin zinc (Lente)
    • Long-acting insulin formulations:
      • Extended insulin zinc insulin (Ultralente)
      • Insulin glargine (Lantus or Basaglar)
      • Insulin detemir (Levemir)

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