Diabetes medications — a plain-English overview
Metformin, sulfonylureas, DPP-4 inhibitors, GLP-1 agonists, SGLT2 inhibitors, insulin: what each class does and the trade-offs.
Educational overview only. Your medication is between you and your doctor.
The major classes
- Metformin — first-line for Type 2. Cheap, safe long-term, low hypo risk.
- Sulfonylureas — push the pancreas to make more insulin. Cheap but hypo risk.
- DPP-4 inhibitors — weight-neutral, well-tolerated, modest A1c effect.
- GLP-1 agonists — semaglutide, tirzepatide. Powerful A1c reduction, weight loss, cardiovascular protection.
- SGLT2 inhibitors — flush sugar through kidneys. Heart and kidney benefits.
- Insulin — rapid, short, intermediate, long-acting, mixed. Required in Type 1.