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So Many Medicines—
What Do I Need to Know?

So Many Medicines—
What Do I Need to Know?

Let’s take a closer look at insulin and non‑insulin treatments for type 2 diabetes including GLP‑1 receptor agonists.

Many people with type 2 diabetes will need to combine healthy eating and physical activity (such as walking) with 1 or more medications. There are 2 classes of diabetes medication that we talk about: non-insulin and insulin. Both are taken to help keep blood sugarBlood sugarOr blood glucose. The main sugar (glucose) found in the blood, and the body’s main source of energy. within the target range. Some diabetes medications are taken orally (pills), some are by injection.

Your doctor will let you know if you need to add medicine to your diabetes care plan. This is called “treatment intensification.” He or she will also let you know if and when it’s time to change your medicine if your diabetes has changed.

Non-insulin diabetes medicines

Oral antidiabetic drugs (OADs)

There are many types of OADs. They work in different ways to lower blood sugar.

  • Metformin (biguanide)
    Helps lower insulin resistance and reduce the production of glucose
  • Sodium-glucose co-transporter 2 or SGLT2 inhibitors (dapagliflozin, empagliflozin, canagliflozin, ertugliflozin)
    Help the kidneys to get rid of extra sugar in the body through the urine
  • DPP-4 inhibitors (sitagliptin, saxagliptin, linagliptin, alogliptin)
    Help prevent the breakdown of GLP-1, a hormone produced in the intestines
  • Thiazolidinediones or TZDs (pioglitazone, rosiglitazone)
    Help improve the liver, muscle, and fat cells’ response to insulin, meaning more sugar leaves the blood and enters the muscles and fat (where it belongs)
  • Sulfonylureas (glimepiride, glyburide, glipizide)
    Help the pancreas to release more insulin
  • Alpha-glucosidase inhibitors (acarbose, miglitol)
    Slow down the digestion of carbohydratesCarbohydrateCarbohydrates are the main kinds of food that raise blood sugar levels. Your digestive system changes carbohydrates into glucose (sugar), and then uses this sugar as a source of energy for your cells.

    There are 3 main types of carbohydrates in food: starches (complex carbohydrates), sugars (simple carbohydrates), and fiber. Fiber is the part of plant foods, including fruits, vegetables, and nuts, that you can’t digest.
    and keep the body from absorbing sugar

OAD combinations

Since the different kinds of OADs help lower blood sugar in different ways, some may be used together. These options allow doctors to come up with treatment plans that meet individual needs.

GLP-1 receptor agonists

Your doctor may also prescribe a GLP-1 receptor agonist (GLP‑1 RA) as part of your therapy.

GLP-1 is short for glucagon-like peptide-1. It's a naturally occurring hormone released from cells in your body that helps it release insulin to help keep blood sugar in balance. If you have type 2 diabetes, your body may not be responding to GLP-1 properly. When your insulin isn't released at the right time or in the right amount, your blood sugar can get too high.

A GLP-1 RA is a non-insulin medicine that acts like the GLP-1 in your body. These medicines work by: 

  • Telling the liver not to make so much sugar (by releasing glucose) at mealtimes
  • Helping the pancreas release more insulin after you've eaten
  • Slowing down digestion of food so after-meal blood sugar levels don't go as high

You can learn more about daily GLP-1 RA medicines and a weekly GLP‑1 RA medicine also from Novo Nordisk.

Amylin agonists

Another option your doctor may prescribe is an amylin agonist. This is an injectable drug that acts like a hormone produced by the pancreas.

Insulin medicines

The insulinInsulinA hormone made by the beta cells in the pancreas that helps sugar move from the blood into the cells. Insulin is also an injectable medicine that is used to treat diabetes by controlling the level of sugar in the blood. that your body makes naturally is a hormone that is important for producing energy from food. Some people with type 2 diabetes may not be able to use their own insulin well. This is called insulin resistance. It causes blood sugar levels to increase.

As diabetes changes over time, the body makes less insulin and can’t control blood sugar levels. For these people, insulin can be injected under the skin. This helps lower blood sugar levels back to their normal range.

Different insulin medicines work in different ways to replace the insulin you’re missing. They are grouped together based on:

insulin medicines
  • When they start to work (onset)
  • When they have the greatest effect on blood sugar (peak) 
  • How long they work (duration)

Ways to describe insulin medicine

Human insulin

Human insulin is actually made in a lab. It’s called “human” because the structure is identical to the insulin your body makes.

There are 3 types of human insulin:

  1. Short-acting. This insulin, also called regular insulin, is usually taken 30 minutes before a meal and lasts 3 to 6 hours.
  2. Intermediate-acting. This type of human insulin, also called NPH insulin, is taken 30 minutes before breakfast, before the evening meal, or at bedtime, and is effective for anywhere from 12 to 18 hours.
  3. Premixed. This type of human insulin includes both a regular insulin and an intermediate-acting insulin. It is taken 30 minutes before breakfast and/or the evening meal and works for anywhere from 10 to 18 hours.

Insulin analogs

Insulin analogs are human insulin with small changes made to the hormone so that it is absorbed faster or lasts longer in the body.

The 3 main types of insulin analogs are:

insulin analog time length
  1. Long-acting. Also called basal insulinBasal insulinA type of injected insulin that is absorbed slowly and starts to lower blood sugar within 4 to 6 hours after injection. Its strongest effect is 10 to 18 hours after injection depending on the product. This gives the body a low level of insulin to manage blood sugar between meals and overnight., this type is not taken with food. It works slowly and lasts longer to control blood sugar between meals and when you sleep. Learn about long-acting insulin analogs from Novo Nordisk.
  1. Fast-acting. Also called bolusBolusBolus insulin (prandial or mealtime insulin) is an extra amount of insulin taken to cover an expected rise in blood sugar during or after a meal or snack. It can also be taken when blood sugar is high. insulin. Depending on the medicine, this type of insulin may be taken just before a meal, at meal time, or shortly after starting a meal. Learn about fast-acting insulin analogs from Novo Nordisk.
premixed insulin analog
  1. Premixed. This type is a mixture of fast‑acting and intermediate-acting insulins. It works to control blood sugar at meal time and works for anywhere from 16 to 24 hours. Learn about a premixed insulin analog from Novo Nordisk. 

Each type of insulin helps manage blood sugar. But no one type is right for everyone. Each person’s insulin need is different and may change over time. Your doctor will prescribe the insulin that is best for you.

Looking for financial savings and support?

NovoCare® provides resources to help you understand your options and connect you to affordability support.

Visit Novo Nordisk Savings

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