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Your doctor will take your A1C level into account when prescribing medication. For many adults living with diabetes, the A1C goal is less than 7%, though your individual goal may vary depending on a number of factors.
If your A1C is close to goal, your doctor may prescribe metformin. It’s often the first-line treatment for type 2 diabetes.
If you have a higher A1C or if metformin alone is not enough to meet your A1C and blood sugar goals, your doctor may prescribe a combination of medications. Each type of diabetes medication can lower your A1C by a certain amount.
If your A1C is over 9–10%, your doctor may recommend insulin therapy.
Type 2 diabetes is a progressive condition. Over time, your pancreas produces less insulin and your body becomes less sensitive to the effects of insulin.
This means that your treatment plan may need to change over time, too. You might start with one medication and then add others as the condition progresses. Some medications can help you manage your blood sugar for a longer time than others. At some point, your doctor may recommend insulin.
Your doctor will take into account all the medications and supplements you currently take when choosing which type 2 diabetes medication to prescribe in order to avoid potential drug interactions.
For instance, some type 2 diabetes medications can cause hypoglycemia when taken together, so you and your doctor should also consider your current treatment if you’re adding a new medication to your routine.
You may need to avoid some type 2 diabetes medications if you have certain conditions. For example, thiazolidinediones (Actos) aren’t recommended for people with liver problems or a history of heart failure.
On the other hand, certain type 2 diabetes medications may help treat other health conditions in addition to managing blood sugar. For instance, GLP-1 agonists (such as Ozempic) and SGLT2 inhibitors may help reduce the risk of heart attack and stroke and slow the progression of kidney disease.
In addition, some medications for other conditions, such as antidepressants and steroids, may raise blood sugar. Your doctor will need to take this into account when choosing a type 2 diabetes medication for you.
Type 2 diabetes medications come in both oral and injectable forms. You should speak with your doctor about how you prefer to take your meds.
It’s important that you feel you’ll be able to stick to your treatment plan. If you’re afraid of needles and don’t think you’ll be able to give yourself injections, it may be better to take oral medications.
If you do need to take injectables, talk with your doctor about ways to make self-injections easier.
Prices can vary widely from medication to medication. Speak with your doctor about how much specific medications cost and which ones are covered by your insurance.
If you’re having trouble affording the medication prescribed by your doctor, ask if generic versions are available. They may be less expensive than brand-name options. You may also qualify for financial assistance programs.