Taking medicine for type 2 diabetes

Information for the public

Your diabetes team should give you a medicine called metformin when you are diagnosed with type 2 diabetes. Metformin helps your body to use insulin better, which helps stop the problems caused by type 2 diabetes (such as heart disease later in your life).

If your blood glucose is very high or if your body is burning fat instead of sugar for energy, they should also give you insulin until your blood glucose is at a healthier level. If you are given insulin, your diabetes team will train you on how to take it and tell you how it works.

These medicines, combined with changes to your diet and exercise levels, should help get your blood glucose to the right level.

HbA1c is a measure of your blood glucose levels over the past 2 to 3 months. Plasma glucose is a measure of your blood glucose level at the time of measuring. If possible, you should aim to get:

an HbA1c level of 48 mmol/mol (6.5%) or less, or
a plasma glucose level of 4 mmol/litre to 7 mmol/litre, on 4 or more days a week, when fasting or before meals, or
a plasma glucose level of 5 mmol/litre to 9 mmol/litre, on 4 or more days a week, 2 hours after meals.

If changes to your diet and exercise levels combined with your current medication are not enough to get your blood glucose to these levels, your diabetes team will change your prescription for blood sugar lowering medicines:

If you are over 10, you may be offered medicines called liraglutide, dulaglutide or empagliflozin. Your team should discuss the options with you and help you choose a drug that will work for you.
If you are not yet taking insulin, you may be offered insulin in addition to your current medication. If you are given insulin, your diabetes team will train you on how to take it and tell you how it works.
If you are already taking insulin, its dose may be increased.

Questions to ask about your blood sugar lowering medicines

Why am I prescribed these medicines?
What are the pros and cons of each of the medicines I could take?
Is there a medicine I can have that I do not have to inject?