### Pills vs. Insulin for Diabetes Treatment If you have type 2 diabetes and lifestyle changes like exercise and healthy eating aren't enough, you might need medication to control your blood sugar. There are two main types of medication: pills and insulin. #### Pills 1. **Metformin**: Often the first pill prescribed, it lowers the amount of sugar your liver makes and helps your body use insulin better. It can also help with weight loss. However, it’s not suitable for people with liver disease, kidney problems, or heart failure. 2. **Sulfonylureas**: These help your body make more insulin but can cause weight gain and low blood sugar. 3. **Meglitinides**: These help your pancreas release more insulin quickly but don’t last as long. They can also cause low blood sugar and weight gain. 4. **Thiazolidinediones**: These make your body more sensitive to insulin but can have severe side effects like heart failure and anemia. 5. **DPP-4 Inhibitors**: These lower blood sugar slightly and can cause joint pain and pancreatitis. 6. **SGLT2 Inhibitors**: These prevent your kidneys from absorbing glucose, which is then excreted in urine. They may reduce the risk of heart attack and stroke but can cause infections and low blood pressure. 7. **GLP-1 Receptor Agonists**: These help your body make more insulin after eating. Most are injectable, but one form, Semaglutide, is available as a pill. #### Insulin If pills aren’t enough, your doctor may recommend insulin, which is taken as a shot. There are several types: 1. **Long-acting insulin**: Works over 24 hours and is usually taken at night. 2. **Intermediate-acting insulin**: Works for 12 to 18 hours. 3. **Short-acting insulin**: Works for 3 to 6 hours. 4. **Rapid-acting insulin**: Works for 2 to 4 hours. Low blood sugar is a common side effect of all insulin types. Choosing the right treatment should be a joint decision between you and your healthcare team. Always ask about the pros and cons of each medication and how to manage low blood sugar.