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Last Updated on June 22, 2022


Diabetes is a chronic condition that manifests as high blood sugar levels in the body. Broadly speaking, diabetes can be divided into two types: Type 1 and Type 2. People with either type of diabetes need to diligently take their medications to maintain normal blood sugar levels. The medicines you take are determine by the kind of diabetes you have. We strongly urge everyone, including Diabetics, to take diabetes medications prescribed by your doctor or local healthcare professional.

Diabetes: What, Why & How? 


Type 1 diabetes occurs when the insulin-producing cells in the pancreas are destroy by the immune system (autoimmune) by mistake. Type 2 diabetes is most common in people who are overweight or have a genetic predisposition.  


Insulin is a hormone in the body made by the pancreas which helps our body make use of sugar (glucose). Patients with type 2 diabetes are insulin resistant, i.e., their pancreas makes insulin, but their cells, tissues & organs (liver, muscles, etc.) do not respond to it. 


This “resistance” requires their body to produce more insulin to control blood glucose levels. Over time, the amount of insulin left in the pancreas is depleted and then blood glucose may become more difficult to control. Often several medicines, and, insulin injections are needed to keep blood sugar under control, especially after meals. A robust workout routine and modifications in diet can help prevent this condition.

Doctor’s Recommendations 

Your doctor will recommend a treatment plan keeping in mind the severity and stage of diabetes, to keep you healthy and reduce the risk of diabetes-related complications. A balanced with a lower intake of high fat or high carbs food is recommended. Type 2 diabetes medications work through various mechanisms to curb the underlying problems. 

Diabetes Medications

Metformin (Biguanides):

Metformin is one of the most popular drugs that work on the liver that helps lower blood sugar levels. It may induce weight reduction in some people, but it may also cause stomach distress in others. Therefore, your doctor may start metformin once daily (usually after supper) & gradually increase the dose if necessary. It should be avoid if your renal function is impair, and it should be avoid for 48 hours following surgery or a CT scan.

SGLT-2 Inhibitors:

This group of diabetes medications (e.g. Invokana®, Farxiga®, Jardiance®, Steglatro®) work by excreting some sugar through urine. They aid in lowering the blood pressure and reducing weight without lowering the blood sugar levels to the extremes. They are also known to improve heart and kidney functions. Local yeast infections (in the genital area) may occur and rare cases of DKA (diabetic ketoacidosis) have been report. If your oral intake is lower than usual since you are not eating, you will need to stop the medicine temporarily.

GLP-1 analogs (Bydureon®/Victoza®/Trulicity®/Ozempi®c/Rybelsus®):

These agents slow the absorption of carbs and reduce appetite. During the first few days, patients may complain of abrupt weight loss and nausea. Rarely, serious complications like pancreatitis can be report. Furthermore, GLP-1 analogs are known to reduce the risk of heart-related problems in diabetics. They are given as injections (via disposable pens – just under the skin via prefilled pen-like devices), usually once a week.

Actos® (Pioglitazone):

This drug is known to improve insulin resistance and help many Diabetics lower their blood fat levels. If it is use before time, it may help to slow down the decline of the insulin-producing capability of the pancreas. It can cause weight gain, and fluid retention and should not be use if a patient has congestive heart failure. Usually, people consume it with breakfast once a day.


They help to release insulin from the pancreas. Therefore, they should be taken once or twice a day before a meal. Because they may deplete existing insulin stores in the pancreas, they should be avoid if blood sugars are not too high. weight gain and occasional hypoglycemia may be observe in some cases. Examples include Glimepiride, Glyburide, and Glipizide.


They also stimulate the release of insulin from the pancreas, but it is for shorter periods. They should be taken once to three times a day (before a meal). Examples include Prandin® (repaglinide) or Starlix ® (nateglinide). If you do not eat a meal, do not take it (in general).

DPP-4 Inhibitors (Januvia®/Onglyza®/Tradjenta®/Alogliptin):

This class of drugs is often use with other medicines and has fewer side effects. They are more effective in lowering blood glucose levels, especially after meals. This diabetes medications are taken once daily and may be taken in the morning or evening (and before or after a meal). Side effects are uncommon but acute pancreatitis may occur rarely.


Insulin is one of the most effective agents to lower blood glucose & if blood glucose levels are high, or diabetes has been present for >6-8 years, insulin production from your pancreas may be too low. Therefore medicines alone may not be able to keep your blood glucose under control (particularly after meals) and you would have to add insulin to your regimen. Depending on the severity of your diabetes, your doctor will prescribe the ideal combination.

The Takeaway 

Diabetes is a chronic disease that can affect one’s quality of life. By taking responsibility for your health, you may be able to control Diabetes and many of its complications. Both type 1 and type 2 diabetes can be treat with a variety of medicines. They all help you regulate your blood sugar in different ways.

Ask your doctor which diabetes medications is right for you. Based on the type of diabetes you have, your health, and other considerations, your doctor will suggest the best course of action in your treatment plan.

The American Diabetes Association ( has many publications and tools that may be able help one control their diabetes. Good luck! This information is for general knowledge & is not a substitute for medical advice your doctor recommends.

Dr. Wasim Haque M.D., F.A.C.E.

Dr. Wasim A. Haque graduated from the Aga Khan University Medical College with a medical degree. In Flower Mound, Texas, he works as an Endocrinology, Internal Medicine, Diabetes, and Metabolism Specialist. He has been in practice for more than 30 years.