If you’ve been diagnosed with diabetes, there’s a good chance your doctor will prescribe oral medication or insulin to help treat it. In fact, more than 85% of American adults with diabetes use one or both. Whichever medications you take, understanding how they work can help you get the most benefit from them.   

When you have diabetes, your body doesn’t make enough of the hormone insulin. Or your body doesn’t use the insulin it makes properly. As a result, your body doesn’t get the fuel it needs. Taking medicine is an important part of managing diabetes. 

Karen Kemmis, DPT, of the American Association of Diabetes Educators, describes managing diabetes as a triangle: “At the 3 points of that triangle are healthy eating, being physically active, and taking diabetes medications. At the center is checking blood glucose.” Without proper treatment, diabetes can lead to a number of problems, including: 

• Fatigue. 
• Infections. 
• Blindness. 
• Kidney disease. 
• Stroke. 

Your doctor will help you make a treatment plan that works for you, including deciding on the right medications. Here are the main differences between the 2 primary types of medications — oral and injectable. 

(If you have questions about your diabetes medications, log in to Wellframe, your digital health management tool. This free app comes with your health plan, and it can connect you directly with your diabetes care team for help getting the answers you need.)  

Oral medicine for diabetes 

There’s a long list of diabetes medications that are taken by mouth. These are used by people with type 2 diabetes, whose bodies still produce some insulin. (As of now, there are no oral medications for people with type 1 diabetes. But there’s an oral medication being reviewed by the Food and Drug Administration that may get approved at some point.) 

Sometimes oral diabetes medicines are combined and work in different ways to lower your blood sugar level. Depending on your situation, oral diabetes medication may be used with insulin to get the best control of your blood glucose levels. Most of these medications help provide the following benefits: 

• Make your tissues more sensitive to insulin. That helps blood glucose enter the muscles, fat, and liver more easily. 
• Prompt the pancreas to release more insulin so blood glucose is better regulated. 
• Lower the amount of sugar the intestines absorb. 
• Help the kidneys remove excess sugar. 
• Lower the amount of glucose released by the liver.  

If you’re taking oral medication to manage diabetes, remember these tips: 

• Get familiar with your diabetes medicines. Learn their names and when and how much to take. Also learn the side effects and how they might interact with other medicines you take. That can help you stay on track with your medication schedules, which is very important when you have diabetes. 
• Talk with your doctor about your medication habits. Don’t be afraid to say if you’re having trouble following your treatment plan. Your doctor might be able to reduce the number of medications you take to make it easier to stick to your medication schedule. 
• Follow the eating and exercise plan your diabetes care team recommends. Research suggests that diet and exercise help improve blood sugar control. In fact, people who stick to a regular exercise and healthy-eating plan are sometimes able to take less medication or even stop taking it altogether. 

Insulin for diabetes 

Insulin is the primary medicine given by injection to treat type 1 diabetes. People with type 1 diabetes can’t produce insulin on their own. But some people with type 2 diabetes may also be candidates for insulin therapy because their bodies don’t use insulin properly. Insulin therapy is usually recommended for type 2 diabetes when other steps aren’t doing enough to control blood glucose. Those steps can include exercise, oral medications, weight loss, and nutrition changes. 

People who might be candidates for insulin include: 

• People with type 1 diabetes. 
• People with type 2 diabetes who have taken oral diabetes medications that weren’t able to control their blood sugar level or that became less effective over time. 
• Women with gestational diabetes (diabetes during pregnancy). 

If your healthcare provider recommends that you take insulin, ask about the options. There are several different kinds of insulin, including: 

• Rapid-acting insulin: 
  Begins to work: In about 15 minutes. 
  Peaks: 1-2 hours after injection. 
  Lasts: 2-4 hours. 
• Regular or short-acting insulin:  
  Begins to work: Within 30 minutes of injection. 
  Peaks: 2-3 hours after injection. 
  Lasts: 3-6 hours. 
• Intermediate-acting insulin: 
  Begins to work: 2-4 hours after injection. 
  Peaks: 4-12 hours after reaching the bloodstream. 
  Lasts: 12-18 hours. 
• Long-acting insulin: 
  Begins to work: Several hours after injection. 
  Peaks: It does not peak. 
  Lasts: Up to 24 hours. 
• Ultra-long-acting insulin: 
  Begins to work: 6 hours after injection. 
  Peaks: It does not peak. 
  Lasts: 36 hours or longer. 

Your doctor may also suggest a combination of these. Insulin can be delivered by a syringe, pen device, or pump. In addition to injected insulin, there is an inhaled version. 

Injected medicine for diabetes, beyond insulin

Aside from insulin, there are other injected diabetes medicines that help control blood sugar and have other beneficial effects. These include: 

• Amylin analogs: Also called agonists, these are used for both type 1 and type 2 treatments. They are given before meals and help lower blood glucose levels. 
• Incretin mimetics: Used for type 2 diabetes, these injectables are also considered to be agonists. They are often used for people who haven’t been able to control their condition with oral medication. They help lower post-meal blood sugar levels. 

An advantage of these medicines is a decreased appetite, which can help with weight loss. Not everyone with diabetes needs to lose weight. But for those who do, these medications can be another tool for reaching that goal. 

(Suggested CTA: Don’t know what to make of your blood sugar test results? To get help, sync your glucometer with your Wellframe app. You can send real-time blood sugar readings to your diabetes care team for answers and support. To learn more, log in or download the app today.)

Medications for other conditions 

People with type 1 and 2 diabetes are often treated with other medications for conditions that are common among people with diabetes. For example, your doctor may prescribe statins if you have high cholesterol. If you have high blood pressure, ACE inhibitors or beta blockers are common treatments. Diabetes can make high cholesterol, high blood pressure, and other conditions worse. That’s why it’s super important to take all your medicines as directed by your doctor and to get your diabetes under control. 

Being diagnosed with diabetes and learning how to manage it can feel overwhelming at first. But the good news is that medications, along with staying active and eating a healthy diet, can go a long way toward helping you take charge of your diabetes.     

SOURCES:

[1] “Fast Stats: Data and Statistics About Diabetes.” American Diabetes Association, https://professional.diabetes.org/sites/professional.diabetes.org/files/media/Fast_Facts_12-2015a_1.pdf. Accessed July 19, 2021.  

[2] “Diabetes: Adding Lifestyle to Medication Can Deliver a Knockout Punch.” Harvard Health Publishing, https://www.health.harvard.edu/blog/diabetes-adding-lifestyle-changes-medication-can-deliver-knockout-punch-2017092812468. Accessed July 19, 2021. 

[3] “Insulin and Other Injectables: Insulin Basics.” American Diabetes Association, https://www.diabetes.org/healthy-living/medication-treatments/insulin-other-injectables/insulin-basics. Accessed July 19, 2021.  

[4] “Amylin Analogs.” Drugs.com, https://www.drugs.com/drug-class/amylin-analogs.html. Accessed July 19, 2021. 

[5] “Incretin Mimetic Drugs for Type 2 Diabetes.” FDA, https://www.fda.gov/drugs/information-drug-class/incretin-mimetic-drugs-type-2-diabetes. Accessed July 19, 2021. 

[6] “Cholesterol Medications.” American Heart Association, https://www.heart.org/en/health-topics/cholesterol/prevention-and-treatment-of-high-cholesterol-hyperlipidemia/cholesterol-medications/. Accessed July 19, 2021.  

[7] “Types of Blood Pressure Medications.” American Heart Association, https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/types-of-blood-pressure-medications. Accessed July 19, 2021.