People with type 2 diabetes may be able to take pills or other non-insulin injections to manage their condition. Your doctor may also prescribe insulin if they determine that it might best help you manage blood sugar levels.
How you treat type 2 diabetes can depend on many factors, including how your body naturally produces the hormone insulin to regulate blood sugar levels.
If your body doesn’t effectively use this important hormone or is more resistant to it, your doctor might prescribe more than just lifestyle changes, such as eating and physical activity. They may also prescribe medications, either pills you take or possibly insulin through injections or a small pump device.
This is different for those with type 1 diabetes, which is an autoimmune condition in which the pancreas does not make any insulin, and you must take it another way.
Your doctor and healthcare team are best equipped to determine your management plan and what, if any, diabetes medications you may need to manage your blood sugars effectively and stay healthy.
Various medications may help treat T2D, but the ones your doctor prescribes may depend on many factors.
People with T1D cannot use only pills to manage their autoimmune condition and require insulin through injections or an insulin pump. For those with type 2, pills may be used instead of insulin, and some people may take them alongside insulin.
Some people with T2D can benefit from taking medication and insulin, or other types of injected medications. These may include the following:
| Medication | Name brands | How it works | Typical dosage |
|---|---|---|---|
| Metform | Glucophage, Fortamet, Riomet, Glumetza | – lowers glucose from your liver – boosts insulin sensitivity, – may lower cholesterol – may help with weight loss | 2x a day with meals; extended-release 1x per day |
| Sulfonylureas | glimepiride (Amaryl); glyburide (Diabeta, Glynase PresTabs; glipizide (Glucotrol) | help the pancreas release insulin after meals | 1x day with meal |
| Meglitinides | Repaglinide (Prandin), nateglinide (Starlix) | quickly stimulate the pancreas to release insulin after eating | 1x day with a meal |
| Thiazolidinediones | Pioglitazone (Actos) | – makes your body more sensitive to insulin – may increase HDL cholesterol | same time each day |
| Dipeptidyl-peptidase 4 inhibitors (DPP-4s) | linagliptin (Tradjenta) saxagliptin (Onglyza) sitagliptin (Januvia) alogliptin (Nesina) | help stabilize insulin levels and lower how much glucose your body makes | once per day |
| Alpha-glucosidase inhibitors | Acarbose (Precose) miglitol (Glyset) | slow the breakdown of carbs in bloodstream | at start of a meal |
| Sodium-glucose cotransporter-2 inhibitors (SGLT2s) | canagliflozin (Invokana) dapagliflozin (Farxiga) empagliflozin (Jardiance) ertuglifozin (Steglatro) | – stop kidneys from reabsorbing glucose – may help with weight loss – may lower blood pressure | some are combined with other types of medications into a single pill |
| GLP-1s | Wegovy, Victoza, Ozempic, Moujaro, Rybelus, Zepbound, Byetta, Bydureon BCise | – help manage blood sugars – reduce appetite – may support weight loss | once weekly or daily depending on medication |
Always consult your doctor if you are concerned about the side effects of any prescribed medication for diabetes, or if you believe a medication you’re on is not working as well as it should be.
If your doctor prescribes insulin for managing your diabetes, you may take it in a number of different forms.
Syringe and vial
You can take injections using a standard needle and syringe by loading the insulin into the syringe. Then, you inject it just under your skin, rotating the site each time.
Prefilled Insulin pens
Insulin pens are a bit more convenient than a regular needle. They’re prefilled and less painful to use than a regular needle.
Insulin pump
Insulin pumps are wearable devices that people with diabetes use to deliver insulin. They are connected to a spot on your body and continuously give insulin for 2 to 4 days.
Insulin pumps work by delivering a programmed amount of insulin through a small tube called a cannula, inserted just under the top layer of your skin. Your doctor will work with you to determine how much insulin you need each day.
Inhaled insulin
Afrezza is an inhaled form of insulin that’s been available in the United States since 2015.
This is prescribed to help manage blood sugar in adults with diabetes, for T1D and T2D. The drug comes as powder with a cartridge and device for inhaling.
You take it at the beginning of each meal, and it may start working in as little as a few minutes to lower blood sugar levels. It’s also out of your system in a couple of hours, compared to traditional fast-acting insulin, which may still be present in your body for hours afterward.
It may not be a case of either pills or insulin unless you live with T1D and need insulin.
Your doctor will make a recommendation based on the type of diabetes you have, how long you’ve had it, and how much insulin your body makes naturally.
Pills may be easier to take than insulin, but each kind comes with potential side effects. It may take a little trial and error to find the one that works best for you. Pills can stop working, even if they’ve been effective for some time.
If you start out with only pills and your T2D gets to a point where those medications are not working as well, your doctor may discuss adding insulin to your treatment plan — possibly along with other medications, or as the sole medication.
While insulin can be more noticeably effective than medications, it does carry increased risks. This may include low blood sugar (hypoglycemia).
Your healthcare team can help you understand how insulin works and what you’d need to do to monitor your blood sugar and insulin levels, to effectively manage your condition.
Questions to ask your doctor
Ask your healthcare team about the various methods of delivering insulin, and be sure to report lumps, bumps, and rashes on your skin to them.
If your healthcare team would like to prescribe a pill, here are a few questions you might want to ask:
- What is the purpose of this medication?
- How should I take it and store it?
- What are the potential side effects, and what can be done about them?
- How often should I check my glucose levels?
- How will I know if the medication works?
If you have type 1 diabetes or if you must take insulin, you might know you’ll have to monitor your blood glucose levels carefully and adjust your insulin accordingly.
People who live with type 2 diabetes may be able to manage their condition with lifestyle changes, but they may also be able to take pills or other injected medications that are not insulin. People with type 1 diabetes must take insulin.
For those who receive an insulin prescription, you may be able to deliver that insulin with a vial and syringe, a prefilled plastic pen, an insulin pump device, or inhaled insulin. Your care team can help you understand what option is best for you.