Keeping your blood sugar (glucose) well controlled is key to reducing your risk of long-term complications such as heart, kidney or eye problems. Regardless of whether you need medication or which medication you are taking, diet and lifestyle play a key part in preventing long-term complications. You can find out more about how you can improve your diabetes control with diet from our separate leaflet called Type 2 diabetes diet. The initial stages in type 2 diabetes treatment are usually to follow a healthy diet, lose weight if you are overweight, and do regular physical activity. If lifestyle advice does not control your blood glucose levels then medicines are used to help lower these levels. One medicine (usually metformin) is used first but two or even three medicines may be needed. In addition to controlling your blood glucose, keeping raised blood pressure, cholesterol and other risk factors under control are also important.
You can read more about controlling other risk factors in our separate leaflet called Type 2 diabetes. The rest of this leaflet is about medications to control blood glucose. Most of the type 2 diabetes medicines are given in tablet form. However, some people with type 2 diabetes need insulin injections to help control blood sugar (glucose) levels. Some people gain a great deal of benefit from insulin injections. Insulin injections can be used in combination with other medicines to further improve glucose control. Medication is used in addition to, and not instead of, the above lifestyle measures. Is one medication better than another for type 2 diabetes treatment? According to international guidelines, patients should take metformin as their first-line type 2 diabetes treatment unless there is a medical reason that it should not be prescribed. However, in recent years, many new medicines have been developed for MedicGLP Official type 2 diabetes treatment.
It has now been shown that some of them offer benefits in addition to glucose-lowering. For instance, SGLT-2 inhibitors in particular may protect the heart and kidneys. Therefore, they may be offered in addition to metformin as first-line treatment for MedicGLP Official people with certain health conditions or risk factors. You can find out more about who might be offered them under the section below on SGLT-2 inhibitors. For other people with type 2 diabetes, various factors should be taken into account when choosing a 'second-line' medication to add to metformin. You can find out more about the individual medicines later in this leaflet. If it is important to avoid low blood glucose (hypoglycaemia) - DPP-4 inhibitor, SGLT-2 inhibitor, pioglitazone or GLP-1 mimetic. For people with a history of (or at high risk of) heart attack, stroke, etc - SGLT-2 inhibitor or GLP-1 mimetic with proven heart benefit. For people with a history of heart failure or chronic kidney disease - SGLT-2 inhibitor or, if not suitable, GLP-1 mimetic.
For people where weight loss or avoiding weight gain is important - SGLT-2 inhibitor or GLP-1 mimetic (or DPP-4 inhibitor if neither of these is suitable). Some medications commonly prescribed to people with diabetes can cause complications if you are otherwise unwell, particularly if you are dehydrated. ACE inhibitors (used to reduce blood pressure and protect the kidneys). ARBs, which may be used as an alternative to ACE inhibitors. Non-steroidal anti-inflammatory drugs or NSAIDs, used for pain. If you are taking any of these medicines and become unwell, particularly with diarrhoea and/or vomiting, contact your doctor or nurse. They may recommend that you stop taking some of your medication temporarily. Our leaflet on diabetes and illness gives more advice on what you should do if you are unwell. Metformin is a biguanide medicine. It lowers blood glucose mainly by decreasing the amount of glucose that your liver releases into the bloodstream. It also increases the sensitivity of your body's cells to insulin.
