Metformin also helps lower blood glucose levels by making muscle tissue more sensitive to insulin so blood glucose can be used for energy. It is usually taken two times a day.

A side effect of metformin may be diarrhea, but this is improved when the drug is taken with food. DPP-4 inhibitors help improve A1C a measure of average blood glucose levels over two to three months without causing hypoglycemia low blood glucose. They work by preventing the breakdown of naturally occurring hormones in the body, GLP-1 and GIP.

These hormones reduce blood glucose levels in the body, but they are broken down very quickly so it does not work well when injected as a drug itself. By interfering in the process that breaks down GLP-1 and GIP, DPP-4 inhibitors allow these hormones to remain active in the body longer, lowering blood glucose levels only when they are elevated.

DPP-4 inhibitors do not cause weight gain and are usually very well tolerated. As noted in the description for DPP-4 inhibitors, GLP-1 and GIP are natural hormones in the body that help maintain glucose levels. These medications have similar effects to the GLP-1 and GIP produced in the body but are resistant to being broken down by the DPP-4 enzyme.

These medications can result in large benefits on lowering blood glucose and body weight. Some agents in this class have also been shown to prevent heart disease.

Most of these medications are injected, with the exception of one that is taken by mouth once daily, called semaglutide Rybelsus. How often you need to inject these medications varies from twice daily to once weekly, depending on the medication.

The most common side effect with these medications is nausea and vomiting, which is more common when starting or increasing the dose.

Glucose in the bloodstream passes through the kidneys where it can either be excreted in the urine or reabsorbed back into the blood. Sodium-glucose cotransporter 2 SGLT2 works in the kidney to reabsorb glucose.

A new class of medication, SGLT2 inhibitors, block this action, causing excess glucose to be eliminated in the urine. By increasing the amount of glucose excreted in the urine, people can see improved blood glucose, some weight loss, and small decreases in blood pressure.

Bexagliflozin Brenzavvy , canagliflozin Invokana , dapagliflozin Farxiga , and empagliflozin Jardiance are SGLT2 inhibitors that have been approved by the Food and Drug Administration FDA to treat type 2 diabetes. SGLT2 inhibitors are also known to help improve outcomes in people with heart disease, kidney disease, and heart failure.

For this reason, these medications are often used in people with type 2 diabetes who also have heart or kidney problems. Because they increase glucose levels in the urine, the most common side effects include genital yeast infections. Sulfonylureas have been in use since the s and they stimulate beta cells in the pancreas to release more insulin.

There are three main sulfonylurea drugs used today, glimepiride Amaryl , glipizide Glucotrol and Glucotrol XL , and glyburide Micronase, Glynase, and Diabeta. These drugs are generally taken one to two times a day before meals.

All sulfonylurea drugs have similar effects on blood glucose levels, but they differ in side effects, how often they are taken, and interactions with other drugs. The most common side effects with sulfonylureas are low blood glucose and weight gain. Rosiglitazone Avandia and pioglitazone Actos are in a group of drugs called thiazolidinediones.

These drugs help insulin work better in the muscle and fat and reduce glucose production in the liver. A benefit of TZDs is that they lower blood glucose without having a high risk for causing low blood glucose. Both drugs in this class can increase the risk for heart failure in some individuals and can also cause fluid retention edema in the legs and feet.

In addition to the commonly used classes discussed above, there are other less commonly used medications that can work well for some people:. Acarbose Precose and miglitol Glyset are alpha-glucosidase inhibitors. These drugs help the body lower blood glucose levels by blocking the breakdown of starches, such as bread, potatoes, and pasta in the intestine.

By slowing the breakdown of these foods, this slows the rise in blood glucose levels after a meal. These medications should be taken with the first bite of each meal, so they need to be taken multiple times daily. When this happens adjustments to your medication or combination therapy can help, which may include adding insulin to your treatment plan.

This doesn't mean you're doing something wrong. Even if diabetes other medications do bring your blood glucose levels near the normal range, you may need to take insulin if you have a severe infection or need surgery. Other medications may not be able to keep your blood glucose levels in your target range during these stressful times that affect your blood glucose.

Also, if you're not taking insulin but plan to or become pregnant, you may need insulin to manage your diabetes. In general, diabetes medications are safe and work well. But like any other medication, they must be used with care. Diabetes medications can interact with other medications.

Do not replace your prescribed diabetes medicines with alternative medicines. Type 2 diabetes is a serious disease, and following your diabetes treatment plan takes commitment.

To effectively manage diabetes, you may need a good support network. Anxiety and depression are common in people living with diabetes. Talking to a counselor or therapist may help you cope with the lifestyle changes and stress that come with a type 2 diabetes diagnosis.

Support groups can be good sources of diabetes education, emotional support and helpful information, such as how to find local resources or where to find carbohydrate counts for a favorite restaurant. If you're interested, your health care provider may be able to recommend a group in your area.

You can visit the American Diabetes Association website to check out local activities and support groups for people living with type 2 diabetes. The American Diabetes Association also offers online information and online forums where you can chat with others who are living with diabetes.

You also can call the organization at DIABETES At your annual wellness visit, your health care provider can screen for diabetes and monitor and treat conditions that increase your risk of diabetes, such as high blood pressure, high cholesterol or a high BMI.

If you are seeing your health care provider because of symptoms that may be related to diabetes, you can prepare for your appointment by being ready to answer the following questions:. If you are diagnosed with diabetes, your health care provider may begin a treatment plan.

Or you may be referred to a doctor who specializes in hormonal disorders, called an endocrinologist. Your care team also may include the following specialists:. Talk to your health care provider about referrals to other specialists who may be providing care.

Before any appointment with a member of your treatment team, make sure you know whether there are any restrictions, such as not eating or drinking before taking a test. Questions that you should regularly talk about with your health care provider or other members of the team include:.

Your health care provider is likely to ask you questions at your appointments. Those questions may include:. Mayo Clinic does not endorse companies or products.

Advertising revenue supports our not-for-profit mission. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. This content does not have an English version. This content does not have an Arabic version. Diagnosis Type 2 diabetes is usually diagnosed using the glycated hemoglobin A1C test.

Results are interpreted as follows: Below 5. More Information A1C test Glucose tolerance test. More Information Medications for type 2 diabetes GLP-1 agonists: Diabetes drugs and weight loss Bariatric surgery Endoscopic sleeve gastroplasty Gastric bypass Roux-en-Y Show more related information.

Request an appointment. Thank you for subscribing! Sorry something went wrong with your subscription Please, try again in a couple of minutes Retry. More Information Caffeine: Does it affect blood sugar? By Mayo Clinic Staff.

Show references Professional Practice Committee: Standards of Medical Care in Diabetes — Diabetes Care. Diabetes mellitus. Merck Manual Professional Version.

Accessed Dec. Melmed S, et al. Williams Textbook of Endocrinology. Elsevier; Diabetes overview. National Institute of Diabetes and Digestive and Kidney Diseases. Type 2 diabetes. Mayo Clinic; Feldman M, et al. Surgical and endoscopic treatment of obesity. In: Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management.

Accessed Oct. Hypersmolar hyperglycemic state HHS. Diabetic ketoacidosis DKA. National Center for Complementary and Integrative Health. Type 2 diabetes and dietary supplements: What the science says.

Preventing diabetes problems. Schillie S, et al. Prevention of hepatitis B virus infection in the United States: Recommendations of the Advisory Committee on Immunization Practices.

MMWR Recommendations and Reports. Related Caffeine: Does it affect blood sugar? Diabetes prevention: 5 tips for taking control GLP-1 agonists: Diabetes drugs and weight loss Hyperinsulinemia: Is it diabetes? Medications for type 2 diabetes Show more related content. Associated Procedures A1C test Bariatric surgery Endoscopic sleeve gastroplasty Gastric bypass Roux-en-Y Glucose tolerance test Show more associated procedures.

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Show the heart some love! Give Today. Help us advance cardiovascular medicine. Find a doctor. Even if diabetes other medications do bring your blood glucose levels near the normal range, you may need to take insulin if you have a severe infection or need surgery.

Other medications may not be able to keep your blood glucose levels in your target range during these stressful times that affect your blood glucose. Also, if you're not taking insulin but plan to or become pregnant, you may need insulin to manage your diabetes. In general, diabetes medications are safe and work well.

But like any other medication, they must be used with care. Patients who have ever had medullary thyroid carcinoma MTC or who have a family member who has ever had MTC are advised not to use Rybelsus. Additionally, patients who have ever had an endocrine system condition called multiple endocrine neoplasia syndrome type 2 MEN 2 are advised not to use Rybelsus.

Rybelsus is not for use in patients with type 1 diabetes and people with diabetic ketoacidosis. It is not known whether Rybelsus can be used by patients who have had pancreatitis.

The risk of hypoglycemia increased when Rybelsus was used in combination with sulfonylureas or insulin. Rybelsus should be taken at least 30 minutes before the first food, beverage or other oral medication of the day, with no more than 4 ounces of plain water.

Rybelsus slows digestion, so patients should discuss other medications they are taking with their health care provider before starting Rybelsus.

The most common side effects are nausea, diarrhea, vomiting, decreased appetite, indigestion and constipation.