Changing your diet and getting plenty of physical activity are often the first lines of defense to treat diabetes. But sometimes they’re not enough, and your blood glucose levels may still be too high. Then what? Your doctor may prescribe oral medication. Today, there are many different oral medications available to treat type 2 diabetes. There’s no single pill that works best for everyone. With your doctor’s guidance, you may need to try several different pills, combinations of pills, or pills plus insulin to find the right solution. Diabetes medications aren’t a cure-all. You’ll still need to stay on track with lifestyle changes such as eating well and exercising regularly. This will give you the greatest shot at controlling blood glucose levels because you’re tackling the disease with three different strategies. Although your doctor has many to choose from, most oral diabetes medications fit into one of six classes of drugs. Here’s a look at what those six classes include. It’s important to know your options, since you may try a few before finding the right treatment. 1. Sulfonylureas Examples: Glipizide (Glucotrol and Glucotrol XL), glyburide (Micronase, Glynase, and Diabeta), and glimepiride (Amaryl) How they work: These drugs stimulate the pancreas to produce more insulin to help drive down glucose. 2. Meglitinides Examples: Repaglinide (Prandin) and nateglinide (Starlix) How they work: Like sulfonylureas, meglitinides trigger insulin production in the pancreas. 3. Biguanides Examples: Metformin (Glucophage) How they work: This medicine lowers blood glucose levels by reducing how much glucose your liver churns out. It also helps treat insulin resistance. When insulin works the way it should, blood glucose levels stay within a healthy range. Metformin use reduces daily food intake and usually lowers body weight. 4. Thiazolidinediones Examples: Rosiglitazone (Avandia) and pioglitazone (Actos) How they work: These drugs also help treat insulin resistance. In addition, they reduce glucose production in the liver. 5. Alpha-glucosidase inhibitors Examples: Acarbose (Precose) and miglitol (Glyset) How they work: When you take the medication with a meal, it blocks the breakdown of starchy foods, such as bread and pasta, in the intestine as well as slows the breakdown of certain sugars. This way, your blood glucose levels don’t rise as much after eating. 6. DPP-4 inhibitors Examples: Sitagliptin (Januvia) and saxagliptin (Onglyza) How they work: One of the newer classes of drugs on the market, they prevent the breakdown of GLP-1, a compound that exists naturally in your body to increase insulin production. Normally, GLP-1 gets broken down quickly. DPP-4 inhibitors allow GLP-1 to hang around much longer so it can lower blood glucose levels when they’re too high.