Medications

The management of diabetes involves a combination of healthy eating, regular exercise and medication.

Medications prescribed for diabetes come in several different forms:

  1. Oral medication, taken by mouth and swallowed.
  2. Injectable medication, injected into the fatty layer just under the skin surface.

Insulin

Insulin is a hormone naturally produced by the beta cells of the pancreas.

It allows glucose to enter the body’s cells where it is used for energy.

Type 1 diabetes & insulin

In people with type 1 diabetes, the body produces little or no insulin.

The cells that produce insulin have been destroyed by an autoimmune response.

Insulin replacement by daily injections or via an insulin pump is essential.

Type 2 diabetes & insulin

People with type 2 diabetes still produce insulin, but the insulin does not work as effectively as it needs to. This is known as insulin resistance.

To compensate, the body makes more insulin but eventually cannot keep up with this increased demand for insulin and is unable to make enough to maintain blood glucose levels.

Lifestyle changes such as physical activity and healthy eating can delay the need for tablets and/or insulin to stabilise blood glucose levels.

If insulin is required, it is important to understand that this is just the natural progression of the condition.

Your health care team will work with you to discuss your needs and ensure the right insulin is being used for you.

Types of insulin

There are several types of insulin including:

  • Rapid-acting insulin which begins to work within 2 to 20 minutes. You must eat soon after injecting this insulin.
  • Short-acting insulin which begins to work within half an hour, so you generally need to inject half an hour before eating.
  • Intermediate-acting insulin begins to work about 1 and a half hours after injecting and lasts for 16-24 hours.
  • Mixed insulin contains pre-mixed combinations of either a rapid or short-acting insulin and an intermediate- or long acting insulin. This makes injecting easier by giving two types of insulin in one injection.
  • Long-acting insulin has no pronounced peak and lasts for up to 24 hours.
  • Ultra long-acting insulin has a prolonged release that provides steady insulin in the body for up to 42 hours.

Hypoglycaemia

Hypoglycaemia is when blood glucose levels fall below 4mmol/L.

Find more information on symptoms and management of hypoglycaemia

Insulin administration

Insulin cannot be taken by mouth as it’s destroyed by the digestive enzymes (digestive juices) in the stomach.

With modern technology, injecting insulin has become easier and almost painless with a greater choice of devices.

Insulin pens

Insulin pens make injecting simpler and more convenient.

Reusable insulin pens are used with insertable 3ml insulin cartridges. Each cartridge contains 300 units of insulin. Insulin pens are made to fit specific brands of insulin, which cannot be interchanged.

Disposable insulin pens are also available, which come prefilled with insulin and are discarded when empty.

Pen needles can be used with any brand of pen and come in several different lengths. 4mm needles are recommended. Insulin only needs to be injected into the fatty layer just under the skin. The shorter needle length helps to reduce the chance of injecting the insulin into a muscle (this affects how quickly the insulin is absorbed). It also helps to reduce discomfort. 

Insulin for Life

People in many developing countries are unable to access insulin and monitoring strips, which affects their health and survival. If you no longer need unopened and in-date insulin (with at least three months to use-by date) and monitoring strips, please consider donating them to Insulin for Life. These are then donated overseas following specific requests from recognised organisations and with an agreed protocol. Diabetes SA serves as a collection point for insulin and diabetes equipment. You can simply drop off your supplies and we will box and send to Insulin for Life.

Sharps disposal

Disposing of sharps appropriately is very important. Used syringes, pen needles, lancets and introducer needles for pump infusion sets must be disposed of in a sharps container approved under Australian Safety Standards. Sharps containers must be puncture proof and have a secure lid. These containers are usually yellow and come in a range of sizes; they are available at Diabetes SA, as well as most pharmacies and some GP clinics or council offices. Diabetes SA provides a free service for members to dispose of sharps safely as do many pharmacies or councils.

Find out more about safe sharps disposal.

Medications for type 2 diabetes

Many people with type 2 diabetes will need medications and/or insulin to help keep their blood glucose levels in their target range.

While all diabetes medications assist with the management of blood glucose levels, they don’t all work in the same way.

Medications are grouped into different classes depending on how they work within the body. Medications within these classes all have their own ‘generic name’ which identifies the chemical in the medication that works within the body. The medications also have a ‘brand name’ or ‘trade name’ which is the name given to the medication by its manufacturer to market the medication.

Download: Diabetes and Medication – a guide to assist you in managing your diabetes

Often with type 2 diabetes, a single oral medication may be effective for managing blood glucose levels initially. Over time, however, as the condition progresses, or an individual’s circumstances change, additional medication may be added to existing medication to adequately manage blood glucose levels.

There are two types of injectable medications used in type 2 diabetes, insulin and non-insulin injectables. Your doctor will choose which injectable is right for you. It is important to note that insulin is used in the treatment of both type 1 and type 2 diabetes.

Medications for type 2 diabetes

In Australia there are seven classes of medicines used to treat type 2 diabetes:

  • Biguanides, commonly known as metformin is generally 1st line treatment
  • Sulphonylureas
  • Thiazolidinediones (Glitazones)
  • Alpha-glucosidase Inhibitors
  • Dipeptidyl peptidase 4 (DPP-4) inhibitors
  • Sodium-glucose transporter (SGLT-2) inhibitors
  • Non-insulin injectables known as incretin mimetics
  • Insulin injectables

Your doctor will discuss the type of medication best suited to you, when to take your medication and how much to take. It is important that you know about potential side effects. Speak to your diabetes educator, doctor or pharmacist if you experience any problems.

Helpful tips

  • Know the name of all your medications (it’s a good idea to keep a list with you)
  • Know the correct dose of your medications
  • Understand how your medications work
  • Know the correct time to take your medications
  • Know the side effects that your medications may cause

Information sheet: Medications for type 2 diabetes

Insulin

NPS Medicinewise – provide independent, evidence-based tools and information about medicines. Consumer medicine information (CMI) sheets for most prescription and some non-prescription medicines can also be found.