Type 2 Diabetes Medicines That May Do More Than Control Your Blood Sugar

This article is for people who have type 2 diabetes (T2D), or anyone who wants to learn more about medicines for diabetes. The goal of this patient education activity is to improve understanding of medicines for diabetes that may help beyond controlling your blood sugar.

You will learn about:

• How diabetes can impact your risk for heart disease, and which medicines can help reduce that risk

• What kinds of side effects diabetes medicines may have

• Medicines for diabetes that can affect your weight

• Questions to ask your doctor

When you have diabetes, lowering your blood sugar to a healthy level (80 to 130 mg/dL) is very important. Having blood sugar that is too high for too long and not controlled can lead to problems in different parts of your body, such as your eyes, kidneys, and even your heart.

Having diabetes gives you a high chance (risk) for getting a type of heart disease associated with cholesterol buildup in the arteries. This increases the risk for having a heart attack, stroke, death from heart problems, or for developing heart failure (another kind of heart disease).

When recommending medicine to help treat your diabetes, your doctor or healthcare team member may talk to you about different options while also considering factors such as your diet and lifestyle, risk for heart disease, your other health conditions (like high cholesterol), and possible side effects of medicines.

While there are several medicines for diabetes that can help lower blood sugar, there are currently 2 types of medicines that can also help reduce the risk for heart disease at the same time:

• GLP-1 RAs (glucagon-like peptide-1 receptor agonists) work in many parts of the body to lower and keep blood sugar at a healthy level (mostly after meals), slow down digestion, and decrease appetite. These include dulaglutide, liraglutide, and semaglutide, which are available in the form of a shot

• SGLT2 (sodium-glucose cotransporter-2) inhibitors work in the kidneys to remove extra sugar in the blood through urine. These include canagliflozin, dapagliflozin, and empagliflozin, which are available as pills

These medicines are very different from each other. Talk to your doctor or healthcare team member about which may be right for you based on your diabetes goals and risk for heart disease.

Like all medicines, medicines for diabetes can have side effects. Some may be mild, while others may be more serious and require changes to your medicine or medical care by your doctor or healthcare team member.

Depending on the medicine, some common side effects include:

• Stomach issues, such as nausea, diarrhea, vomiting, heartburn, constipation, gas, or pain/cramping

• Weakness, dizziness, drowsiness, or nervousness

• Flu-like symptoms, such as headache, runny nose, or sore throat

• Skin reactions, such as redness, pain, or rash (with pills or shots)

• Urinary tract infections (UTIs)

• Swelling

Serious side effects of certain diabetes medicines can include an increased risk for pancreatitis (inflammation of the pancreas), heart failure, cancer, or bone fractures.

While lowering your blood sugar is important, you want to keep it at a healthy level and not too low (below 70 mg/dL, or hypoglycemia).

Two types of medicines, insulin and sulfonylureas, can help lower your blood sugar, but may sometimes lower it too much, especially if taken with other medicines for diabetes.

Symptoms of hypoglycemia can include sweating; feeling tired, dizzy, moody, or hungry; or having a fast heartbeat or shaking. Talk to your doctor or healthcare team member about what you can do if you experience hypoglycemia.

Maintaining a healthy weight by eating a nutritious diet and getting enough physical activity is an important part of managing your diabetes and taking care of your heart.

Some medicines for diabetes, such as thiazolidinediones (TZDs), sulfonylureas, and insulin, can cause weight gain as a side effect. If weight gain is a concern for you, let your doctor or healthcare team member know when discussing your treatment options for diabetes.

These healthy habits can help lower your blood sugar and your risk for heart disease:

• Be physically active for least 30 minutes, 3 to 4 times a week

• Choose meals with the right portions of whole grains, fruits and nonstarchy vegetables, high fiber, and low saturated and trans fats

• Avoid foods and drinks with added sugar

• Drink plenty of water

• Limit alcohol

• Don't smoke

• Get 7 to 9 hours of sleep each night

• Practice relaxation techniques to manage stress

With so many medicines available to help treat diabetes, choosing the ones for you with your doctor or healthcare team member should focus on:

• Getting your blood sugar to a healthy level

• Lowering your risk for heart disease

• Reducing side effects, such as hypoglycemia or weight gain

• Your preferences for a pill or shot

Remember, a healthy lifestyle with a proper diet and physical activity, along with taking your medicines for diabetes, will help you get the best results for your controlling your blood sugar and keeping your heart healthy.

At your next visit, talk with your doctor or healthcare team member about any concerns you may have about your medicines for diabetes.

Questions you can ask can include:

• Which medicines for diabetes do you recommend for me?

• What are the possible side effects, and what should I do if I have them?

• What else can I do to keep my blood sugar at a healthy level?

You have successfully completed the program Type 2 Diabetes Medicines That May Do More Than Control Your Blood Sugar.

View Additional Materials on this topic that you may find useful:

Living With Diabetes

Manage Blood Sugar

Healthy Weight

Diabetes Medicines

Medicines for Diabetes Control

PDF Downloads

Patient Handout