10 Injectable Drugs Commonly Prescribed for Type 2 Diabetes

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Type 2 diabetes affects about 30 million Americans, making it one of the most common chronic medical conditions. It occurs when your pancreas can’t make enough insulin to meet your body’s needs. Insulin is a hormone your body uses to convert sugar from foods into energy. Without it, sugar—or glucose—remains in your blood. This causes high blood sugar levels—or hyperglycemia. In type 2 diabetes, your body’s cells also become resistant to insulin’s actions.

Over time, uncontrolled high blood sugar can cause serious health problems. This includes heart disease, kidney failure, nerve damage, stroke, and vision loss. While there is no cure, type 2 diabetes is a treatable disease. Treatment involves lifestyle changes and medications. Oral medications are the mainstay of type 2 diabetes management. However, most people will eventually need injectable medicines.

Type 2 Diabetes Injectable Drug Classes

Doctors follow expert practice guidelines when choosing medicines to treat type 2 diabetes. In the past, this meant choosing among various types of insulin. Today, doctors have more options when oral medicines are not enough to control the disease. Classes of type 2 diabetes injectable drugs include:

  • Amylin analogs mimic a hormone called amylin. This class keeps glucose levels from going too high after meals. It slows the movement of food through the stomach. It can also decrease appetite and give you a sense of feeling full, which can lead to weight loss. Nausea is a common side effect that usually improves with time.

  • GLP-1 agonists act like another hormone, glucagon-like peptide-1. These drugs also regulate blood glucose after meals and decrease appetite. They stimulate insulin production as well. Nausea is also common with this class when you first start.

  • Insulin replaces the insulin your body would normally make. There are various types of insulin depending on how quickly they act and how long they work. There are also different strengths and mixes of different types of insulin. Low blood sugar—or hypoglycemia—is the most common side effect.

Injectable medications are part of a comprehensive treatment plan for type 2 diabetes. Managing the disease usually means making lifestyle changes as well. This includes eating a balanced diet, getting regular physical activity, and maintaining a healthy weight.

Common Type 2 Diabetes Injectable Drugs

There are a variety of ways to use insulin. Short-acting forms are for use just before meals. Long-acting insulin provides a base level of glucose control throughout the day. Finding the right approach for you may involve some trial and error. Here are 10 injectable drugs commonly prescribed for type 2 diabetes:

  1. Albiglutide (Tanzeum) is a GLP-1 agonist. It comes as a pre-filled pen. You inject it once weekly under the skin. It does not matter when you give it as far as meals. If you want to change the day of the week you use it, you must wait at least four days from your last dose.

  2. Dulaglutide (Trulicity) is also a GLP-1 agonist for once weekly injection under the skin. It also comes in a pre-filled dosage form. Like Tanzeum, you can give it without regard to meals. You can change days of the week, but you must wait at least three days from your last dose.

  3.  Insulin aspart (NovoLog, NovoLog FlexPen) is a rapid-acting insulin you inject under the skin. It comes in two forms. One is for use 5 to 10 minutes before a meal. You can use the other 15 minutes before or after a meal. Ask your doctor or pharmacist about your dosing.

  4. Insulin detemir (Levemir) is a long-acting insulin you inject under the skin. The usual dose is once daily with your evening meal or before bedtime. Sometimes, doctors recommend twice daily dosing.

  5. Insulin glargine (Lantus, Lantus Solostar, Toujeo) is another long-acting insulin. You inject it under the skin once daily at the same time every day.

  6. Insulin isophane (Humulin N, Novolin N) is NPH insulin, an intermediate-acting insulin. You need to gently mix it before injecting it under the skin. NPH should look cloudy or milky in the vial. Do not use it if it is clear or you see particles or clumps in it.

  7. Insulin isophane/insulin regular 70/30 (Humulin 70/30, Novolin 70/30) is a mix of 70% NPH insulin and 30% regular insulin. This means it has both intermediate-acting and short-acting insulin. You need to eat a meal within 30 to 45 minutes of giving it. It needs gentle mixing before giving it. Do not use it if it is clear or you can see particles or clumps.

  8. Insulin lispro (Humalog) is a rapid-acting insulin for injection under the skin. Like NovoLog, it also comes in two forms with slightly different dosing. Ask your doctor or pharmacist about your dosing.

  9. Insulin regular (Humulin R, Novolin R) is a short-acting insulin you inject under the skin. You need to eat a meal within 30 minutes of giving it. Regular insulin should be clear and colorless. Do not use it if it is cloudy or discolored.

  10. Liraglutide (Victoza) is a GLP-1 agonist. Like others in the class, it comes as a pre-filled dosage form that you inject under the skin. However, you use it once daily with or without food.

The goal of these treatments is to maintain good blood sugar control without causing dangerously low blood sugar levels. This means you will need to closely monitor your blood sugar. Your doctor may recommend a finger stick blood glucose monitor or a continuous blood glucose monitor. With time and practice, you will learn how different foods and activities affect your blood sugar.
Because type 2 diabetes is so common, there is a lot of research into its causes and treatments. Researchers continue to study how the disease develops to see if they can prevent it. There are also studies looking at treating the disease and its complications. Talk with your doctor for more information.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2019 Nov 15

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