Medications
Understanding Diabetes Medications
Managing diabetes often involves more than lifestyle changes alone. For many people, medications play an essential role in keeping blood glucose levels within a healthy range and reducing the risk of long-term complications. Understanding how different medications work can help you feel more confident and in control of your health.
Please note: This information is general in nature. Always consult your healthcare team before starting, stopping, or changing any medication.
Metformin
Metformin is typically the first medication prescribed for type 2 diabetes. It works by reducing the amount of glucose produced by the liver and improving the body's sensitivity to insulin.
- How it's taken: Oral tablet, usually once or twice daily with meals.
- Benefits: Well-established safety record, supports modest weight loss, low risk of hypoglycaemia when used alone.
- Common side effects: Nausea, diarrhoea, or stomach upset — often reduced by taking with food or using the extended-release form.
GLP-1 Receptor Agonists
GLP-1 (glucagon-like peptide-1) receptor agonists are a newer class of medications that mimic a natural gut hormone to help regulate blood glucose. Examples include semaglutide (Ozempic®, Wegovy®) and dulaglutide (Trulicity®).
- How they work: Stimulate insulin release after meals, reduce glucagon secretion, slow gastric emptying, and reduce appetite.
- How they're taken: Weekly or daily injection (some oral forms are available).
- Benefits: Significant blood glucose lowering, meaningful weight loss, and cardiovascular and kidney protective effects in many people.
- Common side effects: Nausea, vomiting, reduced appetite — usually improve over time.
SGLT-2 Inhibitors
SGLT-2 inhibitors (e.g., empagliflozin/Jardiance®, dapagliflozin/Forxiga®) work by causing the kidneys to remove excess glucose from the body through urine.
- Benefits: Lower blood glucose, support weight loss, reduce blood pressure, and offer significant heart and kidney protective benefits.
- Common side effects: Increased urination, genital thrush, and a small risk of diabetic ketoacidosis (DKA) — particularly in certain situations.
Insulin
Insulin therapy is used when the body no longer produces enough insulin on its own. It is essential for people with type 1 diabetes and is also used in type 2 diabetes when other medications are insufficient.
- Types of insulin: Rapid-acting, short-acting, intermediate-acting, long-acting, and combination (premixed) insulins — each with different onset and duration profiles.
- How it's taken: Injection via pen or syringe, or via an insulin pump.
- Key considerations: Dose timing, carbohydrate intake, physical activity, and illness all affect insulin requirements. Regular blood glucose monitoring is essential.
Other Medications
There are several other medication classes used in diabetes management, including:
- DPP-4 inhibitors (e.g., sitagliptin/Januvia®) — help increase insulin release and reduce glucose production with a low risk of hypoglycaemia.
- Sulfonylureas (e.g., glipizide, gliclazide) — stimulate the pancreas to produce more insulin; older class with a higher risk of hypoglycaemia and weight gain.
- Acarbose — slows carbohydrate absorption in the gut to reduce post-meal glucose spikes.
Working With Your Medications
Getting the most from your diabetes medications involves more than just taking them as prescribed. It also means:
- Understanding when and how to take each medication
- Knowing the signs of hypoglycaemia (low blood glucose) and how to treat it
- Being aware of how food, exercise, illness, and stress interact with your medications
- Keeping your healthcare team informed of any side effects or concerns
- Never stopping or adjusting medications without professional guidance
Ready to Review Your Medications?
As a Credentialled Diabetes Educator, I provide personalised medication education to help you understand your treatment plan, manage side effects, and feel confident in your day-to-day diabetes management.
Medicare rebates
You may be eligible for a Medicare rebate for consultations with a Credentialled Diabetes Educator. Ask your GP about a Chronic Disease Management (CDM) plan or Team Care Arrangement, which can provide rebates for up to five allied health visits per calendar year.
For fee information, please visit the Fees page.