Managing Diabetes: A Look at Medications
[Originally published: Sept. 8, 2022. Updated: Oct. 30, 2023.]
For some people with diabetes, dietary, exercise, or other lifestyle changes aren’t enough to control blood sugar.
If that’s the case, you may need medication. Treatment for diabetes is focused on keeping blood sugar (glucose) levels at a normal range. In people with Type 1 diabetes, the body makes little to no insulin, which means taking insulin (usually by injection) is necessary. For those with Type 2 diabetes, in which the body is unable to properly use insulin, too much glucose is often produced, so the first line of treatment might be an oral medication such as metformin, which lowers blood glucose levels.
Metformin, explains Yetunde Asiedu, MD, a Yale Medicine primary care physician, also helps the body respond better to its own insulin. “It’s a popular medication because it's effective at treating diabetes and the cost is low,” she says. “That is usually our first go-to, but if you’ve had a heart attack or you have congestive heart failure, there are specific types of diabetes medications that may be even better for you.”
There are even medications for diabetes that can help with weight loss. A class of drugs called GLP-1 (glucagon-like peptide-1) restores the signal to your brain that you are full after you eat, a signal that is believed to be less sensitive in people with diabetes, explains Edgar Albuja, a Yale clinical pharmacist. The medication also slows down digestion so that sugar isn’t absorbed as fast in the bloodstream, helping the body to produce its own insulin.
“These medications are injectable, but they're not insulin. And most of them require injections just once a week. It's a little bit easier to take than, let's say, once-daily insulin injections,” says Kasia Lipska, MD, MHS, a Yale Medicine endocrinologist.
So, what’s the right medication for you? That, she says, will be the one you will take regularly, gives you the least side effects, and works best at reducing your blood sugar levels and risk of complications.
Taking your diabetes medications is of the utmost importance. If there are any problems that make this difficult for you, talk to your pharmacist, Albuja says. “They can help you figure out how to manage your medications—the important thing is to take your medication.”
In this video, Yale experts provide details about how medication can help you manage your diabetes.
