Type 2 diabetes medication: Key types and how they work

There are several types of medication used to help manage type 2 diabetes, and each works in a different way.

Some help your body use insulin more effectively, while others manage how your body produces or absorbs glucose, slow digestion or replace insulin. Here's a guide to the key types of type 2 diabetes medication and how they work.

Biguanides (metformin)¹

The most common medication prescribed to help manage type 2 diabetes in Australia is biguanides or metformin. An oral medication works to lower blood glucose (sugar) by decreasing the amount of glucose your liver produces and releases into your blood. It also helps your skeletal muscle tissue absorb glucose for energy, reducing insulin resistance.

Sodium-glucose co-transporter 2 (SGLT2) inhibitors²

Removing excess sugar from the body through the urine, this oral medication helps to manage blood sugar. It can also help manage kidney and heart health for people with chronic conditions.

Glucagon-like peptide-1 (GLP-1) receptor agonists³

Used to treat type 2 diabetes and obesity, this medication is most commonly a liquid injectable used once every week. The medication mimics a natural hormone in the body that triggers insulin release from the pancreas, blocks glucose from going into the blood, slows digestion and makes you feel full after eating.

Dipeptidyl peptidase-4 (DPP-4) inhibitors⁴

This oral medication improves how your body uses insulin, helping to lower blood sugar. It's sometimes prescribed with other type 2 diabetes medications, such as insulin and metformin.

Sulfonylureas⁵

An oral medication that helps the pancreas make insulin and lowers blood sugar levels.

Thiazolidinediones (TZDs)⁶

An oral medication typically taken daily, TZDs improve insulin sensitivity, which helps to lower blood glucose levels and help reduce fat stored in the liver.

Alpha-glucosidase inhibitors⁷

Typically taken with the first bite of each meal, this oral medication slows the rate at which sugar enters your bloodstream and helps prevent blood sugar spikes after eating.

Insulin

Used when other lifestyle measures and treatments aren’t enough to control blood glucose levels, insulin is prescribed to around 50% of people with type 2 diabetes within 6-10 years of diagnosis.8 Insulin is injected at points throughout the day as advised by your doctor.

All medications can cause side effects, but many people will not experience any. If you have side effects, it’s important to talk to your GP before making any changes, says Bupa GP Dr Janice Tan.

“Don't stop a medicine on your own if something bothers you,” says Dr Tan. “There are plenty of alternatives, so tell your GP and they can adjust the dose or switch you to something that suits you better.”