As an Endocrinologist, I am always amazed at the large number of medications we now have to treat Type 2 diabetes. Compare this to the time when I started my career, where we only had Metformin, Insulin and Sulfonylureas! The new medicines have revolutionized the way doctors treat diabetes, but no medicine will ever replace the need for eating and exercising correctly.
Which medicine is the best for you? As it depends on a number of factors, it is best to discuss this with your doctor. But the good news is we now have medications which can address different metabolic aspects of Type 2 diabetes. Also, if you don’t get good control with one type of medicine, you probably will achieve it by combining them.
You may be on quite a few medicines initially until your control improves. However, the good news is that most patients can reduce them once their control improves. In fact some of my patients with Type 2 diabetes have managed to control their blood sugars with just Metformin, after having been on numerous different medicines initially including insulin. This can be achieved by losing weight and focusing on the right food and exercise.
Types of Medications
SGLT-2 inhibitors (Invokana, Forxiga)
DPP-4 inhibitors (Sitagliptin, Saxagliptin)
Long-acting insulins (Lantus, Levemir and Tresiba)
Short-acting insulins (Novorapid, Humalog, Apidra)
GLP-1 inhibitors (Victoza, Bydureon, Trulicity)
Getting the right medications
Your doctor can help you start the correct medicines for your diabetes. Some groups like the GLP-1 and SGLT-2 inhibitors can help you lose weight. If you are on insulin, make sure you inject yourself correctly and rotate injection sites. Otherwise you might not absorb insulin correctly and I’ve seen this cause problems for many patients. If the sites you normally inject insulin are bruised or hardened, try new areas such as the upper thighs or the sides of your tummy.