Diabetes Medications

Healthy habits like eating well, being physically active and managing weight are important parts of diabetes care. Sometimes, lifestyle changes alone are not enough to keep your blood glucose (sugar) in a healthy range. If that happens, your healthcare professional may recommend medication to help manage your blood sugar and lower your risk of heart disease, kidney disease and stroke.

You and your healthcare professional will work together to choose a treatment plan that fits your needs. Your plan may be based on your:

  • Lifestyle and daily routine
  • Overall physical health
  • Cardiovascular risk factors, such as high blood pressure or high cholesterol
  • How your body responds to medications
  • Insurance coverage and cost considerations

Your healthcare professional may prescribe more than one medication to help control your blood glucose and protect your overall health. Diabetes can affect many parts of the body including your heart and kidneys, because high blood sugar overtime can damage blood vessels and organs. Some medications help lower blood sugar, while others can also protect the heart and kidneys. Make sure you understand why each medication is being prescribed, how it works, what side effects to watch for and what to do if they occur.

Never stop taking a medication or change your dose without talking to your healthcare professional.

Many people living with diabetes also use a blood sugar monitor to check glucose levels throughout the day. Tracking your numbers helps you understand how food, drinks and activity affect your blood sugar and can guide healthier choices.

Combination Therapy

There are many types (or classes) of diabetes medications, and they work in different ways.

Metformin is a common medication used to treat Type 2 diabetes and is often one of the first medications prescribed. Depending on your health needs, especially if you have heart disease, kidney disease, or obesity, your healthcare professional may recommend other medications as part of your plan.

If you have additional risk factors for cardiovascular disease and lifestyle changes plus metformin are not controlling your blood sugar well enough, you may need additional medications. Your healthcare professional may add a glucagon-like peptide-1 receptor agonist (GLP-1 receptor agonist) or sodium-glucose cotransporter 2 inhibitor (SGLT-2 inhibitor) to your treatment plan.

GLP-1 receptor agonist medications help the body release insulin when it is needed, slow digestion, and help control appetite. This helps improve blood sugar levels and reduce body weight. Some medications in this group can also help protect the heart.

SGLT-2 inhibitor medications help remove extra sugar from the body through the urine. Some medications in this group can also help lower the risk of heart failure and slow kidney disease.

Cardiovascular-Kidney-Metabolic Health Connection

Some diabetes medications do more than lower blood sugar. They may also help protect the heart and kidneys. This is part of a treatment approach used to support cardiovascular-kidney-metabolic health (CKM health), which focuses on caring for the heart, kidneys and metabolic (how the body creates, stores and uses energy) system together.

Insulin

Insulin is a hormone made by the pancreas. It helps move sugar from the blood into the body’s cells, where it is used for energy. People living with Type 1 diabetes do not make insulin. People living with Type 2 diabetes may not make enough insulin or may not use it well. Some people need insulin therapy to help keep blood sugar in a healthy range.

Various types of insulin may be prescribed for both types of diabetes to help regulate blood glucose. All insulin used for diabetes treatment must be administered into the fatty tissue under the skin. Insulin cannot be taken as a pill because it would break down in the digestive system. You can deliver insulin using a:

  • Syringe: A small needle is used to manually inject insulin.
  • Insulin pen: A pen-shaped device that contains insulin and uses a needle to make injections easier.
  • Insulin pump: A small device that delivers insulin throughout the day using a tiny tube attached to a needle under the skin.

Insulins differ in how quickly they start working, when they peak, how long they last and how they are made. They include:

  • Rapid-acting insulin begins working about 15 minutes after injection, peaks in 1-2 hours, and lasts 2-4 hours.
  • Rapid-acting inhaled insulin starts working in about 10 to 15 minutes, peaks in 30 minutes, and leaves the system in about 1.5 to 3 hours It’s inhaled at the beginning of meals and often used in combination with long-acting injectable insulin.
  • Short-acting insulin usually starts working in about 30-60 minutes, peaks 2-3 hours after injection and lasts 3-6 hours.
  • Intermediate-acting insulin begins working 2-4 hours after injection, peaks at 4-12 hours and lasts 12-18 hours.
  • Long-acting insulin reaches the bloodstream about 1.5 to 4 hours after injection, does not peak and lowers blood sugar steadily for about 24 hours.
  • Ultra long-acting insulin reaches the bloodstream in 6 hours, does not peak, and lasts 36 hours or more.

Your healthcare professional will work with you to determine which insulin type and dosage best supports your health and daily routine. Some people may need one daily injection, while others may need multiple doses. Your healthcare team will guide you through how and when to take insulin, how to rotate injection sites and what to do if your blood sugar becomes too high or too low.

Possible side effects of insulin include low blood glucose (hypoglycemia) and weight gain.

Medications to lower cardiovascular disease risks

People living with diabetes have a higher risk of heart attack, stroke and heart failure. It’s important to understand which medications you take and how they protect your heart and blood vessels. In addition to medications that lower blood sugar (including insulin), your healthcare professional may prescribe the following:

  1. Medications to prevent heart disease and stroke
    Newer antihyperglycemic medications (such as GLP-1 receptor agonists and SGLT-2 inhibitors) do more than lower blood sugar. They are also recommended for individuals with Type 2 diabetes who have cardiovascular disease or are at high cardiovascular risk. These medications have been shown to:

    • Lower glucose levels.
    • Slow the food moving through the stomach. (GLP-1 receptor agonists)
    • Lower absorption of glucose in the kidneys (SGLT-2 inhibitors)
    • Lower the risk of heart attack, stroke, heart failure and slow the progression of chronic kidney disease.

    Learn more about these and other heart disease medications.

  2. High blood pressure medication
    If untreated, high blood pressure can damage blood vessels, the heart, kidneys and other organs. You may be prescribed one or more types of medication to bring your blood pressure into target range. Take your medications exactly as prescribed and notify your healthcare team right away if you experience any side effects.

    While many people with high blood pressure must take medications long-term, your dose may be lowered by your healthcare professional after maintaining normal blood pressure for a year or more. Stopping treatment completely is usually not recommended.

    Learn how to make the most of your prescribed treatment for high blood pressure and what types of blood pressure medications are available.

  3. Cholesterol medication
    In addition to eating a heart-healthy diet, maintaining or reaching a healthy body weight and getting regular physical activity, you may also need medication to lower your cholesterol and lower your risk of heart disease. Your healthcare professional will decide whether one or more medications are right for you.

    Several types of medications can lower cholesterol levels. Statins are a medication class commonly recommended for most people because they have been shown to significantly lower the risk of heart attack and stroke.

    Statins work by lowering the liver’s production of cholesterol, with their main effect being a reduction in LDL (“bad”) cholesterol.

    Learn more about the types of cholesterol-lowering medications.

  4. Aspirin therapy
    Diabetes is a major risk factor for cardiovascular disease and stroke. Depending on your medical history and overall risk, your healthcare professional may recommend a low-dose aspirin regimen. Aspirin helps “thin” the blood and prevent blood clots from forming. Blood clots can block arteries, especially when those arteries are already narrowed by plaque.

    Aspirin is not right for everyone. Your healthcare professional can help you weigh the potential benefits and risks before starting aspirin therapy.

    Learn about aspirin and heart disease.

Last Reviewed: Jul 24, 2026

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