Non-insulin diabetes medicines
Since most people with type 2 diabetes usually make some insulin, non-insulin diabetes medicines can help their bodies work better to lower blood sugar levels. People with type 1 diabetes make no insulin so they must take insulin to manage their blood sugar.
Diabetes pills (OADs)
There are many types of non-insulin diabetes medicines you can take by mouth. These pills are also called oral antidiabetic drugs, or OADs for short. Diabetes pills work best when you also follow a meal plan and get regular physical activity. They work in different ways to lower blood sugar levels. Each of these medicines works in one or more of the following ways:
- Some medicines help the body release more insulin. These medicines help the beta cells in the pancreas release insulin to process high blood sugar levels, such as from a meal. This helps keep blood sugar levels in the target range. One of these medicines (meglitinides) leaves the bloodstream quickly so insulin levels return to baseline between meals and during the night. They can be taken one or two times per day before a meal. Other medicines (sulfonylureas) are also taken once or twice a day and work for up to 24 hours. If you take these types of pills, be sure to eat regularly. Your blood sugar can get too low if you wait too long to eat.
- Some medicines lower the amount of sugar the liver makes. These medicines (biguanides) can also help to improve the body’s ability to use insulin. They are usually taken two times a day with food.
- Some medicines help insulin work better in muscle and fat. Insulin resistance can be a problem for many people with type 2 diabetes. Insulin resistance is what happens when the cells and tissues in the body can’t use insulin properly. Some medicines (thiazolidinediones, or TZDs for short) help the cells and tissues in the body use insulin. These medicines help insulin work better in muscle and fat. They make the body respond to the insulin that it already makes. This means that more sugar leaves the blood. The sugar enters the muscles and fat cells, where it belongs. This helps lower blood sugar levels. These medicines are taken once or twice a day.
- Some medicines slow the breakdown of food into sugar. These medicines (alpha-glucosidase inhibitors) help keep blood sugar from rising too high after a meal. They are taken at the start of each meal.
Depending on your treatment needs, you may need to take more than one of these medicines to control your diabetes as your diabetes progresses. The action of the different types of medicines can complement each other and help to lower blood sugar levels. For many people with type 2 diabetes, these medicines may not help to prevent the loss of beta cells.
Be sure you know when to take your medicine.
Diabetes medicines that are taken by mouth do not work for everyone. Sometimes they do not bring blood sugar levels down low enough. Or they sometimes stop working after a few months or years. This may happen because of the loss of beta cells over time for people with type 2 diabetes. This does not mean you have failed to control your diabetes. It simply means that your body has changed and needs a different type of treatment.
Non-insulin injectable medicines
In addition to the diabetes medicines taken by mouth, there is a non-insulin medicine that is taken by using a special prefilled pen. This medicine acts like natural GLP-1, a hormone in the body that helps control blood sugar levels. When blood sugar levels go too high, this medicine helps beta cells release more insulin. The increased insulin lowers the blood sugar levels. In addition, it slows the movement of food through the stomach and decreases appetite, assisting with weight loss.
A second medicine is a man-made form of the hormone amylin. Amylin, like insulin, is made by the pancreas. One way it works in the body is also to slow down the movement of food through the stomach. This affects how fast sugar enters the blood after eating. This medicine is for people with type 1 and type 2 diabetes who take insulin to help lower blood sugar after meals. Although it is injected like insulin, it cannot be mixed with insulin in a syringe. Different syringes must be used for each product. It is taken before each meal.
Talk with your diabetes care team
As with all medicines, tell your diabetes care team if you notice any unusual problems that you think the medicine may be causing.
Be sure you know when to take your medicine. Don't stop taking your medicine because you feel better. The medicine only works if you take it the way your doctor has recommended. Use a pill organizer or other tools to help you remember to take your medicine as directed.
