Some people have too much sugar in their blood. This can cause them to become sick. Blood sugar is another name for blood glucose.

People with type 2 diabetes have high amounts of blood sugar. It can cause:

• symptoms such as needing to go to the toilet to pass more water than normal or always feeling thirsty
• problems with how you see
• damage to blood vessels in the feet and legs
• heart problems
• kidney problems
• higher chance of having a stroke.

When someone learns they have type 2 diabetes, their doctor might suggest changing:

• what and how much they eat
• how much movement they do each day
• how much alcohol they drink
• how much tobacco product they use.

These changes can help drop blood sugar and take care of other health problems they might have.

Read more about ways to help your health here.

Most people with type 2 diabetes will also need to take medicines. There are many medicines that can drop the level of blood sugar. Lowering blood sugar when it is too high can help stop health problems happening or getting worse.

There are many medicines that can help take care of type 2 diabetes. Finding the medicines that work best for you is important. Talk with your health professionals. Together you can make the right decisions.

There are many medicines that can help take care of type 2 diabetes. Each medicine works in a different way to take care of blood sugar levels. How you take the medicine and how often you take it is different for each medicine. Each medicine can also have side effects.

Health professionals are very familiar with these medicines. There is lots of good research to show the best way to use these medicines.

Metformin is the first medicine most people take for type 2 diabetes.

Many people will also need extra medicines to help. They are:

• sulfonylureas
• sodium-glucose transporter 2 (SGLT2) inhibitors
• dipeptidyl peptidase 4 (DPP-4) inhibitors
• glucagon-like peptide-1 (GLP-1) analogues
• insulin
• glitazones
• acarbose.

The person who prescribes your medicines should give you instructions on how to take them. You can also ask the pharmacist when you pick up the medicine from the pharmacy.

Medicine instructions are important. They help make sure the medicine works the way it should.

Medicines for type 2 diabetes will help drop your blood sugar levels. After taking them for a while you may have:

• more energy
• better sleep, and
• less days away from work.

Having type 2 diabetes can put you at higher chance of other health problems. These problems can lead to heart and kidney disease and even stroke.

There are medicines to manage other problems like heart and kidney disease that can come with type 2 diabetes. Some people may need to take more than one type of medicine to keep healthy.

Looking after all your medicines

Tell your doctor, nurse or pharmacist about all the medicines you are taking. Some of these medicines may change your blood sugar levels. Or your diabetes medicine might change how other medicines work.

If you take more than one medicine talk with your health professional about:

• a Home Medicines Review by a pharmacist. They check you are only taking the medicines you need and that you are using them safely. The check might also find other medicines you take that can affect blood sugar levels.
• keeping a medicines list. These lists can help you track your medicines including prescription, over-the-counter, herbal and natural medicines.
• using the free MedicineWise App on your phone. This app can record medicines, remind you to take medicines and store other important health information.

Sometimes you might notice a side effect after taking a new medicine. If this happens to you, keep taking the medicine. Make sure you talk to your doctor, nurse or pharmacist about it. You might be able to take the medicine in a different way or change to another type.

You can also call Medicines Line on 1300 MEDICINE (1300 633 424). healthdirect Australia will answer your call. If you need more help they will put you through to an NPS MedicineWise pharmacist. You can ask questions about any medicine you take. Even ones you buy without a prescription.

Metformin is the active ingredient in some diabetes medicines. It can help drop how much sugar is in your blood stream.

It is the medicine that most people with type 2 diabetes start taking when they need more help. Metformin does not cause weight gain and may even help weight loss. It may also lower your chance of heart and blood vessel problems. It does this by dropping the amount of ‘bad fats’ in the blood stream. (Learn more about ‘bad fats’ here).

There are many brands of metformin. Some are only metformin, others have a mix of medicines in them.

What else should I know?

Some people who take metformin may have stomach problems. The larger the amount of metformin taken (dose), the worse these problems can be. Slowly increasing how much metformin you take can help. People who do this find they have fewer side effects.

Stomach problems from taking metformin can be:

• loose poo (diarrhoea)
• feeling like throwing up (nausea)
• throwing up (vomiting)
• stomach cramps and bloating.

Sulfonylureas are medicines that get the pancreas to make more insulin. More insulin helps drop blood sugar levels.

People may take a sulfonylurea if they cannot take metformin. They may also take it with metformin if they need more help managing blood sugar levels.

Sulfonylurea medicines can have different active ingredients with names like:

• glibenclamide
• gliclazide
• glimepiride
• glipizide

What else should I know?

People who take some sulfonylurea medicines can be at risk of hypoglycaemia. This is when blood sugar levels go very low. You need to take care of hypoglycaemia quickly. It can cause problems like falls, feeling confused and fainting.

Your doctor, nurse or pharmacist can explain more about hypoglycaemia and how to take care of it.

Other side effects from taking some sulfonylureas are:

• weight gain
• feeling like throwing up
• throwing up
• headaches
• allergic reactions.

Sodium–glucose co-transporter 2 (SGLT2) inhibitors are medicines that move sugar from the blood into the urine. This is how they drop blood sugar levels and help take care of diabetes. These medicines are also called ‘flozins’ because of their active ingredient names:

• dapagliflozin
• empagliflozin
• ertugliflozin

People take these medicines when metformin or sulfonylureas are not enough, or when they cannot take them.

What else should I know?

The flozins are a newer group of medicines for diabetes. Research is still learning about all the benefits and side effects they might have. Some benefits are:

• helping lower the chance of heart problems in some people
• helping keep kidneys working for longer in some people with kidney disease
• helping drop blood pressure in some people
• weight loss in some people.

People who take flozins may have a higher chance of some side effects like:

• urinary tract infections
• going to the toilet to pass water more than usual.

Taking flozins with some other diabetes medicines can raise the chance of having hypoglycaemia. This is when blood sugar levels go very low. You need to take care of hypoglycaemia quickly. It can cause problems like falls, feeling confused and fainting.

Another side effect that does not happen very often is diabetic ketoacidosis. Ketoacidosis tends to happen quickly. You need to look after ketoacidosis straight away. Someone with this problem will have signs like:

• feeling like throwing up
• feeing very thirsty
• feeling confused or unusually tired
• having stomach pain
• breath that smells fruity
• breathing faster or finding it harder to breathe.

Dipeptidyl peptidase-4 (DPP-4) inhibitors are a group of medicines that can help raise how much insulin is in the blood. They also stop the liver making a type of sugar called glucose. Both these actions help to lower how much glucose is in the blood.

Another name for these medicines is ‘gliptins’ because of their active ingredients:

• alogliptin
• linagliptin
• saxagliptin
• sitagliptin
• vildagliptin

People take these medicines when metformin or sulfonylureas are not enough, or when they cannot take them.

What else should I know?

The gliptins are a newer group of medicines for diabetes. Research is still learning about their helpful results and side effects.

People who take gliptins may have a higher chance of some side effects like:

• headaches
• feeling like you are unwell with a cold.

Taking gliptins with some other diabetes medicines can raise the chance of having hypoglycaemia. This is when blood sugar levels go very low. You need to take care of hypoglycaemia quickly. It can cause problems like falls, feeling confused and fainting.

Some very rare side effects from research studies are:

• allergic reactions
• swelling of the pancreas.

Glucagon-like peptide-1 (GLP-1) analogues are a group of medicines that can raise the amount of insulin in the blood. They also lower how much glucose the liver makes and slow down digestion of food in the stomach. These actions help drop blood sugar levels.

GLP-1 analogues are injected medicines. A health professional can show you how to give these injections. The number of injections is different for the different medicines.

GLP-1 analogue medicines have active ingredients like:

• dulaglutide (one injection each week)
• exenatide (two injections every day – one in the morning and one in the evening)
• liraglutide (one injection each day)
• semaglutide (one injection each week).

People take these medicines when metformin or sulfonylureas are not enough.

What else should I know?

GLP-1 analogues are a newer group of medicines for diabetes. Research is still learning about their helpful results and side effects. Using these medicines may help:

• lower the chance of heart problems in some people
• weight loss in some people.

People who take GLP-1 analogues may have a higher chance of some side effects like:

• feeling like throwing up
• having trouble going to the toilet (runny poo or unable to poo)
• having an upset stomach.

It can be helpful to start with smaller amounts of these medicines and increase how much you take over time. This can sometimes stop the side effects from happening.

Taking GLP-1 analogues with some other diabetes medicines can raise the chance of having hypoglycaemia. This is when blood sugar levels go very low. You need to take care of hypoglycaemia quickly. It can cause problems like falls, feeling confused and fainting.

Some very rare side effects are:

• allergic reactions
• swelling of the pancreas
• kidney problems.

The pancreas is an organ in our body near our stomach. It makes insulin. Insulin helps control the amount of sugar in our blood. After we eat, we need more insulin to help keep blood sugar at a normal level. People with type 2 diabetes may not produce enough insulin. They cannot lower their blood sugar without help.

People take insulin when other medicines for diabetes are not enough.

Companies can make insulin that works the same as insulin from our body. There are many types of insulin medicine. They are different in:

• how quickly or slowly they work
• the number of injections needed each day.

People who need a lot of insulin every day might use a pump instead of needles or injection pens.

What else should I know?

People who take insulin medicines can be at risk of hypoglycaemia. This is when blood sugar levels go very low. You need to take care of hypoglycaemia quickly. It can cause problems like falls, feeling confused and fainting.

Your doctor, nurse or pharmacist can explain more about hypoglycaemia.

Other unwanted results from taking insulin are:

• weight gain
• allergic reactions
• skin reactions at the place of injection.

Glitazones are medicines that help the body use insulin better. Insulin works to move sugar out of the blood stream into the cells of the body. When insulin works better, blood sugar levels go down.

People take these medicines when metformin or sulfonylureas are not enough, or when they cannot take them.

What else should I know?

People who take a glitazones may have a higher chance of side effects like:

• muscle and joint pain
• carrying excess fluid in the body
• weight gain
• headaches and dizziness
• problems with eyesight.

Taking a glitazone with some other diabetes medicines can raise the chance of having hypoglycaemia. This is when blood sugar levels go very low. You need to take care of hypoglycaemia quickly. It can cause problems like falls, feeling confused and fainting.

Acarbose is a medicine that stops foods turning into sugar in your body. This means less sugar goes into your bloodstream. This helps manage blood sugar levels. You can take acarbose by itself or with other diabetes medicines. If you need acarbose your health professionals will explain the way to take it.

What else should I know?

People who take acarbose may have a higher chance of side effects like:

• needing to pass wind
• stomach pain and bloating
• runny poo
• trouble eating certain foods.

Some very rare side effects are:

• liver problems
• skin reactions
• fluid build-up
• blockage of the intestines, or
• low levels of red blood cells (anaemia).