The facts about non-insulin injectables
Managing diabetes isn’t always a straightforward process. Even the most perfect management plan needs tweaking every so often to help you continue to reach your blood sugar goals. It’s perfectly normal to have to start or change prescription medications as time goes on.
There are two main types of diabetes. Type 1 diabetes is thought to be caused by an autoimmune reaction. This is when the body attacks itself by mistake. This reaction stops your body from making insulin. With Type 2 diabetes, your body doesn’t use insulin well and can’t keep blood sugar at normal levels. About 90-95% of people with diabetes have Type 2.
Thankfully, you have more diabetes medication options than ever to help you find the right fit.
Before 2005, Type 2 diabetes treatment options were either oral medications or insulin. Common oral medications include metformin, glipizide and miglitol (Glyset®). Now you can choose from non-insulin injectables as well.
The first, called Byetta®, became available in 2005. And ever since, there’s been an explosion of new options. Among the ranks are Trulicity® and Ozempic®. In May 2022, another injectable called Mounjaro® was approved. In clinical trials, it was even more effective at lowering people’s hemoglobin A1C than both semaglutide (Ozempic) and insulin.
What makes these new medications so great? “The main advantage is that these non-insulin injectable medications are stronger than oral medications,” says Susan Gustavsson. She’s a registered nurse who provides diabetes education at the Center for Endocrinology at Mercy Medical Center in Baltimore. These injectables can also come with side benefits. For example, some may help with weight loss.
When managing diabetes, it’s important to understand all your options. Here’s the lowdown on this new class of diabetes medication.
How do non-insulin injectable medications work?
They perform 3 main actions. First, they slow down how quickly food leaves your stomach. This prevents spikes in blood sugar, or blood glucose. Then they prompt your pancreas to pump out more insulin. (Insulin is a hormone. It helps shuttle sugar from your blood into your cells to make energy.)
Lastly, they lower the amount of sugar released into your bloodstream to begin with. Together, this trifecta helps keep blood sugar stable.
These medications can also reduce how much food you eat in the first place, says Benjamin U. Nwosu, MD. He’s the chief of pediatric endocrinology at Cohen Children’s Medical Center in New Hyde Park, New York. “They increase levels of gut hormones that increase satiety.” In other words, they help you feel fuller faster.
How are non-insulin injectables different from oral diabetes medications?
They both have the same goal, to lower blood sugar. But they work in different ways.
As Gustavsson noted above, oral medications aren’t as strong as non-insulin injectables. And they generally don’t target as many actions. Some tablets, such as metformin, improve how insulin works in the body. “Other kinds stimulate the pancreas to secrete more insulin. Or they prevent the kidneys from reabsorbing glucose,” Gustavsson explains.
Recommended reading: What to expect when taking metformin.
What are the major pros and cons of non-insulin injectables?
These medications can be very effective for people with Type 2 diabetes. But you may want to consider several things when talking to your doctor.
The major pros of non-insulin injectables include:
- A low risk of hypoglycemia (also called low blood sugar). And that’s a good thing. When your blood sugar dips below normal levels, it can cause serious side effects. Examples include confusion, blurred vision and even seizures.
- Added health benefits. Several of these medications have been shown to help people with Type 2 diabetes lose weight. And some may even protect against heart attacks and stroke.
- Not having to take medication as often. Some of these injectables are taken once or twice a day. But others can be injected just once a week, says Dr. Nwosu. Examples include Trulicity and Bydureon BCise®.
The major cons of these medications include:
- Stomach-related side effects. These medications may cause nausea, vomiting and diarrhea, Gustavsson says.
- Injection site reactions. Just as with any shots, you may get pain, redness or swelling at the injection site.
- Cost. Generic insulins and oral medications can be cheaper than these newer injectables.
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Do I need to check my blood sugar if I’m on one of these medications?
Your doctor is the best person to ask when — and how often — you should check your blood sugar. Non-insulin injectables don’t come with a risk of low blood sugar. So you may not have to check as often. But that depends on your overall health, your A1C levels and the other medications you take.
If you do need to check your blood sugar often, you may want to look into a continuous glucose monitor, says Dr. Nwosu. It allows you to keep an eye on your blood sugar without as many finger pricks.
(Check the Optum Store for deals on blood sugar monitoring supplies.)
Will I be on a non-insulin injectable for life?
Not necessarily. Again, diabetes management should be tailored to your needs. If non-insulin injectables work for you, great. You might take them long term, says Gustavsson. But if the cost or side effects are too much, your doctor can change any of these medications.
With weight loss or lifestyle changes, you may also be able to lower your dose or come off these medications completely. (Can you put Type 2 diabetes into remission? Find out here.)
Don’t be afraid to advocate for yourself and your needs. Managing diabetes can be tough. But your health care team wants you to succeed. And so do we. Make sure you use our prescription discount card each time you go to the pharmacy. You could save up to 80%.