Diabetes medicines aim to keep your blood glucose levels within a healthy range so you feel well and prevent complications.

Insulin

Insulin is a hormone that helps move glucose from your blood into the cells of your body, where it can be used for energy.

People with type 1 diabetes produce little or no insulin, so need lifelong insulin replacement. Some people with type 2 diabetes, and some women with gestational diabetes (diabetes during pregnancy), also need to use insulin.

Medicines for type 2 diabetes

Most people with type 2 diabetes are able at first to manage their condition through healthy eating, regular physical activity and controlling their weight. Over time, things change and most people need medicines to control their blood glucose levels and prevent long term complications.

There are many types of diabetes medicines that work in different ways, and have different benefits and side effects.

Metformin

Most people with type 2 diabetes start treatment with metformin, a drug that reduces the amount of glucose released into your blood, and increases the amount taken up by your cells.

Sulphonylureas

Sulphonylureas stimulate the pancreas to produce more insulin. Sometime a sulfonylurea may be prescribed for people with type 2 diabetes as an alternative to metformin, but it is usually used as well as metformin, if diet, exercise and metformin alone do not control blood glucose levels adequately.

Both metformin and sulphonylureas have been used for many years and are known to successfully reduce the complications of diabetes.

Other medicines

Other, newer medicines for type 2 diabetes include:

• gliptins - increase the amount of insulin in the blood
• glitazones - help the body to use insulin more effectively
• acarbose - prevents the carbohydrate you eat from being broken down into glucose
• GLP-1 analogues (exenatide) - increase the amount if insulin in the blood
• SGLT2 inhibitors - usually used in combination with other diabetes medicines

These medicines are not necessarily better than the other ones. They can effectively reduce blood glucose levels, but it is not yet known if they can prevent long-term complications of diabetes.

Read more about medicines for type 2 diabetes on the NPS Medicinewise website.

Changes to your medicines over time

Over time, your diabetes can change, meaning your medicines may need to change too. For example, you may need to increase the dose, switch medicines, or add more medicines.

Regardless of the type of diabetes you have, it’s important your blood glucose levels continue to be monitored over time, to make sure your diabetes remains well controlled.

The Royal Australian College of General Practitioners recommends that if you have type 2 diabetes and take oral medication only you should talk to your doctor or specialist about the need to test your blood sugar levels at home. For further information, visit the Choosing Wisely Australia website.

Your doctor will recommend the treatment that best suits you.