Diabetes medications: Finding the right option for you
2/13/2025 by Elizabeth Miles, APRN, C.N.P.
If you are among the 38 million Americans living with diabetes, you're likely taking at least one medication to control your blood sugar. There are many medications approved for treating type 1 or type 2 diabetes, so choosing the right one can be challenging. Your choice will depend on many things, including:
- Type of diabetes you have.
- How much your blood sugar needs to be lowered.
- Other health conditions.
- Your risk for hypoglycemia (low blood sugar).
- Cost and insurance coverage.
Options for type 1 diabetes
If you have type 1 diabetes, you require insulin to control your blood sugar. There are different kinds of insulin and other ways to take it:
- Types of insulin:
- Analog insulins: This type includes long-acting insulin and rapid-acting mealtime insulin. They work well but can be expensive.
- Human insulins: This includes NPH (neutral protamine hagedorn) and regular insulin, which can also manage diabetes safely.
- Ways to take insulin:
- Insulin injections: Most people inject insulin through pens or syringes under the skin.
- Insulin pump: This device gives a steady flow of insulin through a small tube under the skin. It often uses rapid-acting insulin and can help keep blood sugar levels stable. Some insulin pumps can work with a continuous glucose monitor (CGM), pause insulin during low blood sugar or adjust insulin delivery rates automatically.
Options for type 2 diabetes
Some people with type 2 diabetes can manage their blood sugar by eating healthy and exercising. However, most will eventually need medication to keep their blood sugar levels within the goal range.
There are many different medications used to treat type 2 diabetes. You can discuss options with your clinician to decide the best medication for you. You can start by reviewing your options here.
Diabetes is progressive, and sometimes medicines stop working as well as they used to. When this happens, your clinician might change your medicine or add new ones. This approach could include adding insulin to your treatment plan and does not mean you are doing anything wrong.
Sometimes, you may require a temporary adjustment to your medication, like adding insulin, even if your current diabetic medications keep your blood sugar within goal. This adjustment could occur due to an infection or surgery.
Options for diabetes in pregnancy and gestational diabetes
Type 1 diabetes: If you have type 1 diabetes, you will continue to require insulin, including during pregnancy. Your insulin requirements will change throughout pregnancy.
Type 2 diabetes: If you have type 2 diabetes before pregnancy, you will likely need insulin during pregnancy.
Gestational diabetes: If you are diagnosed with diabetes during pregnancy, this is called gestational diabetes. Many women with gestational diabetes can control their blood sugar with diet and exercise alone. If that is not enough, medications are prescribed. In the U.S., insulin is still the first-line treatment for gestational diabetes.
How do you choose the right medication?
- Understand your options.
- Personalize your treatment.
- Consult your healthcare clinician.
- Monitor and adjust medications per your clinician’s orders.
The key thing to remember is that there are many ways to treat diabetes, and each person is unique. Talk with your healthcare clinician to learn which options may be best for you.
Elizabeth Miles, APRN, CNP, is a family nurse practitioner in the Department of Endocrinology, Diabetes, Metabolism, and Nutrition. She specializes in managing type 1 and type 2 diabetes and has over 15 years of experience in endocrinology. Elizabeth is an Instructor in Medicine and Associate Program Director for the Mayo Clinic School of Health Sciences Nurse Practitioner Program.