This webpage can only give general information. You should always get individual advice about your own health and any treatment and medication you may need from a healthcare professional, such as a GP or pharmacist.
Many people with type 2 diabetes need medication to help them manage their blood sugar. You might need to try different doses and combinations of medication to reach your target blood sugar level. Your doctor should discuss with you the benefits and risks of your medication options, based on your individual circumstances and needs.
Like all medications, diabetes treatments can sometimes cause side effects, though not everyone will get side effects. The patient information leaflet that comes with your medication has a full list of these.
Talk to your GP or pharmacist if you have any questions. They can give advice about how to take your medication and what do about side effects. Do not stop taking your medication without speaking to your GP.
In England, you can ask your pharmacist about the NHS New Medicines Service. This gives you three appointments to offer support with new medication and check on your progress.
Diabetes prescriptions are free of charge. In England, you may need a medical exemption certificate if you're under 60.
How it works
Metformin comes as tablets or as a liquid. It helps to lower your blood sugar levels by reducing the amount of glucose your liver releases into the body. It also helps your body to respond better to the insulin it produces.
It’s usually prescribed as a first-line treatment for all people with type 2 diabetes, unless there’s a reason you cannot take it. It’s recommended it be used alongside SGLT2 inhibitors for most people. But it can also be used on its own or alongside other medications.
Some possible side effects
It can sometimes cause stomach upsets. To help avoid this, it’s usually taken along with food and may be given in a low dose to start with and gradually increased. People starting metformin are usually given a modified-release version which can be easier on the stomach and reduce side effects.
How they work
SGLT2 inhibitors work by increasing the amount of sugar removed from the body through your wee, which helps lower blood sugar. They can also help protect your heart and kidneys and reduce the risk of serious complications such as a stroke or heart attack.
NICE treatment guidelines recommend an SGLT2 inhibitor should be offered to all people with type 2 diabetes as a first-line treatment, including for people with heart failure, cardiovascular disease, chronic kidney disease, or obesity.
You may be offered an SGLT2 inhibitor along with metformin or other diabetes medications, or on its own.
Examples include dapagliflozin, canagliflozin, empagliflozin and ertugliflozin.
Some possible side effects
These may include thrush or weeing more than usual. Diabetic ketoacidosis (DKA) is a rare side effect which can be serious and needs urgent treatment. Signs include dehydration, drowsiness, and feeling or being sick.
How they work
GLP-1 agonists work by increasing the levels of gut hormones called incretins, which help boost insulin production when needed and reduce blood sugar levels. They also slow digestion to keep your blood sugar levels stable after eating.
GLP-1 agonists come as an injection you can give yourself or as tablets. They may be offered alongside other diabetes medications.
Examples include dulaglutide, liraglutide and semaglutide. The semaglutide medications prescribed for diabetes are often referred to by their brand names, Ozempic and Rybelsus.
There is also a medication for type 2 diabetes called tirzepatide, which is a GLP-1/GIP agonist drug often referred to by the brand name Mounjaro.
You may be offered a GLP-1 agonist for type 2 diabetes if you are living with obesity or have cardiovascular disease. GLP-1 agonists can help with weight loss, and semaglutide has been shown to help reduce the risk of stroke and heart attacks in people with cardiovascular disease who are overweight or obese.
GLP-1 agonists may also sometimes be offered to people diagnosed with type 2 diabetes under the age of 40 (early onset diabetes), alongside other medication.
Some possible side effects
These may include feeling or being sick, constipation or diarrhoea. More serious side effects may include a worsening of diabetic retinopathy (an eye condition) or acute pancreatitis.
How they work
This type of drug works by helping your pancreas to produce more insulin. It can be given in a low dose to start with and gradually increased. It might be used with other medications to manage blood sugar.
Examples include glimepiride, gliclazide, tolbutamide and glipizide.
Some possible side effects
These may include hypoglycaemia (low blood sugar), nausea, constipation and weight gain.
How they work
These drugs prevent the breakdown of a naturally occurring hormone called GLP-1 which helps the body produce insulin when blood sugar levels are high and reduce glucose being released by the liver. Gliptins keep levels of GLP-1 higher in the blood to help reduce blood sugar, but without causing low blood sugar (hypoglycaemia). They may be used with other medications.
Examples include alogliptin, linagliptin, sitagliptin, saxagliptin and vildagliptin.
Some possible side effects
These may cause headaches, indigestion and diarrhoea.
Insulin is the main hormone that helps our bodies use glucose. It’s the treatment for people with type 1 diabetes, but it can also be used for type 2 diabetes if other medicines are not suitable or do not help to manage blood glucose. There are different types of insulin treatments available.
Your healthcare team will talk to you about the type of insulin they think is best for you. They will also teach you how to inject it yourself and help you with any concerns you may have.
Less commonly used medications include:
- Acarbose slows down the absorption of carbohydrates from the gut which helps reduce a peak in blood sugar after a meal.
- Meglitinides (nateglinide and repaglinide) give a short-lived boost to insulin levels after eating.
- Pioglitazone is not usually used alone, and cannot be used by people with heart failure.
Driving and diabetes
By law, if you’re taking long-term insulin, or have severe hypoglycaemia (hypos, or low blood sugar) you need to inform the DVLA (DVA in Northern Ireland). The rules are different for car and large vehicle licences, so you need to make sure you know which rules apply to you. Find out more about diabetes and driving from Diabetes UK.
See more information from the DVLA about stroke, diabetes and driving.
