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Finding the right treatment for you

This article provides a topline overview to help people with type 2 diabetes begin discussions with their doctors. It is not a comprehensive document and is not intended to replace the advice of a doctor or other healthcare professionals.

Medication overview

Diabetes medications use a range of approaches to bring your blood glucose (sugar) under control by affecting how the body handles insulin and/or sugar.

All medicines can cause side effects in some people. If you do suffer from any, it’s worth talking to your doctor as there may be ways to manage the side effects, or there may be another medicine that could work better for you. Speak to your doctor to find out more.

People with type 2 diabetes should reassess their medications every 3–6 months. Are you on the right medication for you? Read on to find out more and be sure to discuss it with your doctor!

Step 1 on the medication map

Metformin  (biguanides)  is the first medicine generally prescribed to people with type 2 diabetes who require medication in addition to diet and exercise to maintain their target blood glucose (sugar) level. Metformin is the only medicine in the biguanide class and is taken orally as a tablet. In some cases, other or additional medicines may also be considered depending on factors such as your cardiovascular risk or kidney problems.

Metformin works by reducing the amount of sugar your liver releases into the blood and helps your body respond better to insulin.

Potential benefits of Metformin:

  • Helps to lower blood glucose (sugar) throughout the day
  • Benefits to your cardiovascular health 

Potential risks of Metformin:

  • Common side effects include those of the gut, including diarrhoea and nausea
  • May not be suitable in people with kidney disease

Are you aware of cardiovascular risk?

People with type 2 diabetes are 2-4 times more likely to have a heart attack or stroke compared to someone living without diabetes.

Learn how you can reduce the risk.

Step 2 on the medication map

If you don’t need any extra protection for your heart or kidneys and your blood glucose (sugar) is well-controlled, you may be able to stay on metformin alone. If your diabetes evolves and metformin is not enough to control your blood glucose (sugar) alone, your doctor can recommend another treatment option.

A range of other treatment options is available, with a range of different combinations being possible. The medication map will be there to support you to navigate the treatments landscape!

Alternative medications


Dipeptidyl peptidase-4 inhibitors (DPP-4is) are oral medicines that help increase the amount of insulin produced after eating and reduce the amount of sugar released by the liver when it’s not needed. They also slow down digestion.

Potential benefits of DPP-4is:

  • May help to control appetite

Potential risks of DPP-4is:

  • Common side effects include those of the  gut, including diarrhoea and nausea, and  flu-like symptoms

Thiazolidinediones (TZDs)

Thiazolidinediones are  oral medicines that increase the body’s sensitivity to insulin and increase the amount of ‘good’ cholesterol in the blood.

Potential benefits of TZDs:

  • Reduced blood pressure
  • Increased levels of ’good cholesterol’

Potential risks of TZDs:

  • Weight gain
  • Fluid retention

Sulfonylureas (SUs)

Sulfonylureas can be taken orally around a meal to simulate the production of insulin by the pancreas and increase the effectiveness of insulin in the body.

Potential benefits of SUs:

  • Long history of use and familiar effectiveness and side effect profile to doctors 

Potential risks of SUs:

  • Modest weight gain
  • Low blood glucose (sugar) (hypos)


GLP-1 RAs and SGLT-2is

A diabetes doctor might prescribe glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and sodium-glucose cotransporter-2 inhibitor (SGLT-2is) to a range of different people living with type 2 diabetes for a range of reasons. However, these medicines may be particularly suited to people at risk of cardiovascular disease, heart failure or chronic kidney disease and are discussed in the next section.


GLP-1 RAs can be taken orally or given by a once-daily or once-weekly injection under the skin, depending on the medicine. GLP-1 RA medicines work in several ways: they slow down food leaving your stomach and help reduce the amount of sugar released from your liver. When your blood glucose (sugar) gets high, GLP-1 RAs also increase the amount of insulin released by your pancreas. 

Potential benefits of GLP-1 RAs:

  • Promotes weight loss
  • Cardiovascular risk reduction (particularly recommended for those with cardiovascular disease or at high risk of cardiovascular disease, especially strokes and heart attacks)

Potential risks of GLP-1 RAs:

  • Side effects include those of the gut, including diarrhoea, nausea, and dizziness


SGLT-2is are oral medicines. These medications work to reduce blood sugars by preventing the kidneys from reabsorbing sugar back into the blood and therefore increasing the amount of sugar lost in the urine. 

Potential benefits of SGLT-2is: 

  • Reduce blood pressure and weight loss  
  • Particularly recommended for those with heart failure or chronic kidney disease

Potential risks of SGLT-2is:

  • Increased chance of urinary and genital infections
  • May not be suitable in people with some types of kidney disease

Treating type 2 diabetes through lifestyle

How to manage diabetes through exercise
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How to manage diabetes through exercise

You’ve probably had someone tell you to make exercise part of your life. You’ve probably heard there’s a mountain of evidence that our bodies are meant to be used and move around.

How to manage diabetes with diet
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How to manage diabetes with diet

Eating healthy is important for everyone, but it's even more important for people living with type 2 diabetes.

4 tips for better weight management
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4 tips for better weight management

Being overweight (or carrying excess body weight) can increase your risk of developing type 2 diabetes and cardiovascular disease.

Get familiar with diabetes and how you can manage type 1 or 2 diabetes

Living with diabetes

Living with diabetes

Diabetes is considered a critical illness because, over time, high glucose levels in the blood can cause severe damage to your heart, eyes, kidneys, and other organs. With the correct management, care, and treatment, many people living with diabetes manage to live a close to normal and healthy life. 

About diabetes

About diabetes

Type 2 diabetes is a chronic condition where the pancreas is unable to make sufficient insulin levels, and the body doesn’t correctly use the insulin that is made. Type 2 symptoms can appear gradually over time and can be managed through medication, exercise, and diet.

Treatment for diabetes
1 min. read

Treatment for diabetes

Type 2 diabetes treatment guidelines are considerably different to type 1 treatment guidelines. While type 1 is dependent on insulin injections, type 2 diabetes can be treated initially without medication or tablets.  However, as the disease progresses over time, medication may be needed to keep blood glucose levels under control.

January 2024. IE23DI00239

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