Written and medically reviewed by Dorcas Morak, Pharm.D
Type 2 diabetes is the most common form of diabetes, accounting for about 90% to 95% of all diabetes cases. More than 40 million Americans are estimated to have diabetes, and the number continues to grow each year. While type 2 diabetes cannot be cured, it can often be managed successfully with the right combination of medication, blood sugar monitoring, healthy lifestyle habits, and regular medical care. Understanding your treatment options—and their costs—can help you stay consistent with a treatment plan that works for you.
What Are the Early Signs and Symptoms of Type 2 Diabetes?
Common symptoms include increased thirst, frequent urination, fatigue, blurred vision, slow-healing cuts or wounds, increased hunger, and unexplained weight loss. Some people also experience frequent infections or numbness and tingling in their hands or feet.
Many people have few or no noticeable symptoms during the early stages of type 2 diabetes, which is why routine screening is important, especially for adults with risk factors such as obesity, a family history of diabetes, or high blood pressure.
How Do Doctors Diagnose Type 2 Diabetes?
Doctors can diagnose type 2 diabetes using several blood tests. The A1C test, which measures average blood sugar over the previous two to three months, is one of the most common. An A1C of 6.5% or higher on two separate tests generally confirms a diabetes diagnosis.
Other diagnostic tests include a fasting plasma glucose test, an oral glucose tolerance test, or a random blood glucose test in someone experiencing classic diabetes symptoms.
Is Metformin Still the First-Line Treatment for Type 2 Diabetes?
Metformin (Glucophage®) is typically the first medication prescribed for type 2 diabetes because it reduces glucose production in the liver and improves the body's response to insulin. It's widely available as a low-cost generic, has decades of safety data, and remains the foundation of treatment for many patients.
How Do GLP-1 Receptor Agonists Help Treat Type 2 Diabetes?
GLP-1 receptor agonists include semaglutide (Ozempic®, Rybelsus®) and dulaglutide (Trulicity®). These medications lower blood sugar, promote weight loss, and may reduce the risk of major cardiovascular events in appropriate patients. While many GLP-1 medications are injectable, oral semaglutide (Rybelsus®) is also available.
These newer medications can be highly effective but are often among the most expensive diabetes treatments without insurance coverage.
How Do SGLT2 Inhibitors Lower Blood Sugar?
SGLT2 inhibitors such as empagliflozin (Jardiance®), dapagliflozin (Farxiga®), and canagliflozin (Invokana®) help the kidneys remove excess glucose through the urine. In addition to lowering blood sugar, many also help reduce the risk of heart failure progression and chronic kidney disease in appropriate patients.
When Might Someone with Type 2 Diabetes Need Insulin?
Some people require insulin shortly after diagnosis if their blood sugar is very high or symptoms are severe, while others may not need insulin until later as type 2 diabetes progresses.
Long-acting insulins such as insulin glargine (Lantus®, Basaglar®), insulin degludec (Tresiba®), and insulin detemir (Levemir®) help maintain steady blood sugar levels and are often used alongside other diabetes medications.
What Other Medications Treat Type 2 Diabetes?
Additional medication options include:
- Sulfonylureas: glipizide (Glucotrol XL®), glimepiride (Amaryl®)
- DPP-4 inhibitors: sitagliptin (Januvia®), linagliptin (Tradjenta®)
- Thiazolidinediones (TZDs): pioglitazone (Actos®)
Doctors often combine medications from different classes to improve blood sugar control while considering each patient's overall health and treatment goals.
How Do Doctors Choose the Right Diabetes Medication?
Treatment decisions depend on several factors, including A1C levels, body weight, cardiovascular disease, kidney function, risk of low blood sugar, other medical conditions, medication side effects, and cost.
Current treatment guidelines increasingly recommend medications that provide heart and kidney protection for patients who may benefit from those additional effects.
What Blood Sugar Goals Do Doctors Typically Recommend?
Blood sugar goals vary from person to person, but many adults with type 2 diabetes aim for:
- An A1C below 7% (individualized based on age and overall health)
- A fasting blood sugar between 80 and 130 mg/dL
- A blood sugar below 180 mg/dL about one to two hours after meals
Your healthcare provider will recommend goals that are appropriate for your individual health needs.
Can Diet and Exercise Help Control Type 2 Diabetes?
Healthy eating, regular physical activity, weight management, quality sleep, and avoiding tobacco all play important roles in managing type 2 diabetes. Losing even 5% to 7% of body weight can improve insulin sensitivity and blood sugar control, and some people may be able to reduce the number or dosage of diabetes medications under their healthcare provider's supervision.
Lifestyle changes should complement—not replace—prescribed medications unless your healthcare provider recommends otherwise. Why Is It Important to Manage Type 2 Diabetes Early? Keeping blood sugar under control helps reduce the risk of serious long-term complications, including:
- Heart disease
- Stroke
- Chronic kidney disease
- Nerve damage (diabetic neuropathy)
- Vision loss (diabetic retinopathy)
Routine A1C testing, annual dilated eye exams, kidney function monitoring, regular foot exams, and follow-up visits with your healthcare provider are all important parts of long-term diabetes care.
Why Do Type 2 Diabetes Medication Costs Vary?
Older medications such as metformin and glipizide are widely available as inexpensive generics, while many newer medications—including GLP-1 receptor agonists and some SGLT2 inhibitors—remain brand-name products with higher list prices.
Your out-of-pocket costs can vary based on insurance coverage, deductibles, formulary placement, pharmacy pricing, and whether a generic alternative is available.
Save on Type 2 Diabetes Medications with the RxLess® Assurance Plan
Managing type 2 diabetes often means taking prescription medications for years, making medication costs an ongoing concern. The RxLess® Assurance Plan helps patients compare prices on FDA-approved prescription medications at participating pharmacies nationwide. Whether you're taking metformin, glipizide, sitagliptin (Januvia®), insulin glargine, or any other diabetes medications, comparing prices before you fill your prescription may help lower your out-of-pocket costs.
Download the free RxLess® app to compare prescription prices and save whenever you fill a prescription at a participating pharmacy.
