My Current Location Atlanta, GA 30308

Access Your Account

New to Healthgrades?

Join for free!

Or, sign in directly with Healthgrades:

Doctors and their Administrators:
Sign Up or Log In

How Diabetes Medication Lowers Blood Sugar Levels


Carmen Echols, MD    

Was this helpful? (77)
This content is selected and managed by the Healthgrades editorial staff and is brought to you by an advertising sponsor.

This content is created or selected by the Healthgrades editorial team and is funded by an advertising sponsor. The content is subject to the Healthgrades medical review process for accuracy, balance and objectivity. The content is not edited or otherwise influenced by the advertisers appearing on this page except with the possible suggestion of the broad topic area. For more information, read the HealthGrades advertising policy.


Diabetes: Why See a Specialist?

A diabetes specialist, called an endocrinologist, has the right skills and insight to help you stay in control of your diabetes.

Diabetes is a disease that affects various organs in the body. It’s progressive, which means it worsens over time. The medication that your doctor may prescribe for diabetes depends on the type of diabetes that you have. Type 1 diabetics are unable to produce sufficient amounts of insulin. Type 2 diabetics do produce insulin, but are unable to use it effectively to lower levels of sugar, also known as glucose, in the blood. Certainly, the mainstay of treatment of type 2 diabetes is making lifestyle changes, like altering your diet, increasing exercise, and losing weight; however, there are times when medications are necessary.

Oral Medications

The oral medications used to manage type 2 diabetes work on either the kidneys, pancreas, liver or intestine in order to control the amount of glucose in the blood.

Type 1 and type 2 diabetes may seem similar, but they’re actually very different diseases. Dr. Anthony Cardillo discusses the development and treatment of the two conditions.

Medical Reviewer: William C. Lloyd III, MD, FACS Last Review Date: Aug 13, 2015

2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.


The first-line medication for type 2 diabetes is metformin (Glucophage). Metformin decreases how much glucose the liver produces, decreases insulin resistance that is already in the blood, and decreases the absorption of carbohydrates in the intestines. Metformin can aid in appetite suppression and weight loss in diabetics. It must be taken with meals. Side effects associated with metformin include nausea, vomiting, and bloating.

DP-P-4 Inhibitors

Medications such as linagliptin (Tradjenta), alogliptin (Nesina), saxagliptin (Onlgyza), and sitagliptin (Januvia) are known as dipeptidyl-peptidase-4 inhibitors, or DP-P-4 inhibitors. To lower blood sugar levels, they increase insulin sensitivity and inhibit the release of glucagon, a hormone that increases blood sugar levels. Side effects include headaches and, rarely, pancreatitis.


Sulfonylureas like glimepiride (Amaryl), glipizide (Glucotrol), and glyburide (Diabeta) are an inexpensive and effective add-on treatment to metformin, if metformin alone is not enough to lower blood sugar levels. Like metformin, these medications must be taken with food. They lower blood glucose levels by stimulating the pancreatic beta cells, which make insulin, to increase insulin production. However, the effectiveness of the medication decreases as the pancreatic beta cell function decreases, which occurs as diabetes progresses. Side effects include severely low blood sugar levels, known as hypoglycemia.


Pioglitazone (actos) and rosiglitazone (Avandia) belong to a category of medication called thiazolidinediones, or TZDs. They act upon the liver to allow the liver to take glucose out of the bloodstream and store it, as well as reduce glucose production." Additionally, they increase insulin sensitivity in the fat tissue and the muscle. These medications should not be used in patients with advanced congestive heart failure; the side effects of edema and weight gain can aggravate this medical condition. Additionally, TZDs should be avoided in women who have osteopenia or osteoporosis due to increased risk of bone fractures.

SGLT2 Inhibitors

Medications such as empagliflozin (Jardiance), dapagliflozin (Farxiga), and canagliflozin (Invokana) are part of a new class of type 2 diabetes drugs, called SGLT2 inhibitors. They work to block the kidney from absorbing glucose and increase how much glucose you excrete through your urine. Side effects include increased urinary tract and genital yeast infections. Additionally, it is important that this medication not be used in an individual with certain degrees of renal impairment. Ask your healthcare provider if your kidneys are functioning well enough to start this medication.

Injectable Medications

GLP-1 receptors

Albiglutide (Tanzeum), dulaglutide (Trulicity), exenatide (Byetta), exenatide extended-release (Bydureon), liraglutide (Victoza), and lixisenatide (Adlyxin) make up a class of medications called GLP-1 receptors. They are a non-insulin injectable option that can be added either prior to or after long-acting insulin for the treatment of type 2 diabetes. Patients may report appetite suppression as a side effect of this medication, which leads to weight loss. Other side effects include nausea, vomiting, and, rarely, pancreatitis. These medications should not be used in anyone with a personal or family history of papillary thyroid cancer or multiple endocrine neoplasia type 2.


After a period of time, the beta cell function decreases in the type 2 diabetic, so the body doesn’t produce enough insulin on its own, and insulin therapies may be necessary. Basal insulin is added to maintain steady glucose control during the day. Mealtime insulin is shorter acting and is added to manage spikes in blood sugars related to eating carbohydrates at mealtimes. Side effects may include weight gain and hypoglycemia.

While these medications are proven to help people manage diabetes, lifestyle changes like diet and exercise are also key parts of the formula. Talk to your doctor about the right combination to treat your type 2 diabetes.

THIS CONTENT DOES NOT PROVIDE MEDICAL ADVICE. This content is provided for informational purposes and reflects the opinions of the author. It is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified healthcare professional regarding your health. If you think you may have a medical emergency, contact your doctor immediately or call 911.

Carmen Echols, MD

Carmen Echols, MD, is a board-certified family medicine physician with DeKalb Medical Physicians at Flat Shoals.
View her Healthgrades profile >

Was this helpful? (77)

© 2017 Healthgrades Operating Company, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades Operating Company, Inc. Use of this information is governed by the Healthgrades User Agreement.

View Sources

Medical References

Money-Saving Tips for Diabetics

Between medication, equipment and supplies, the costs of diabetes can add up. But there are ways to save.

Share via Email


Taking Control of My Diabetes


Frequently Asked Questions About Diabetes Basics

Up Next

Frequently Asked Questions About Diabetes Basics