Which medicines treat type 2 diabetes?
Metformin usually comes first; when it is not enough, a second medicine is added for your goal. Most people start with metformin, which helps your insulin work and cuts the glucose your liver releases (healthdirect — Metformin). The second medicine depends on what matters most — avoiding hypos, your weight, tablets rather than injections, or protecting your heart and kidneys — and your doctor decides. The classes and goals are compared in our guide to type 2 diabetes medicines. The medicines in this section:
- Metformin — the usual first medicine; it does not cause weight gain and is unlikely to cause hypoglycaemia on its own (healthdirect).
- Semaglutide for type 2 diabetes — a GLP-1 medicine: the Rybelsus tablet and the Ozempic injection.
- Liraglutide — another GLP-1 medicine, the Victoza injection pen.
- Sitagliptin — a DPP-4 inhibitor (gliptin), the medicine in Januvia and, with metformin, Janumet.
- Glimepiride — a sulfonylurea; it helps your body release more insulin, and sulfonylureas can cause hypos and weight gain (Diabetes Victoria).
- Repaglinide — a search of the Australian register for repaglinide returns no product (ARTG search).
What is semaglutide, and is it for weight loss?
Semaglutide is a GLP-1 medicine: Rybelsus (a daily tablet) and Ozempic (a weekly injection) are registered for type 2 diabetes, while Wegovy is the semaglutide product for chronic weight management. GLP-1 medicines increase the insulin you make after a meal, reduce the glucose your liver makes and help you feel full for longer (healthdirect). The brands, doses and weight honesty are covered in semaglutide: Rybelsus, Ozempic and Wegovy.
How do you take Rybelsus?
Alone, fasting, and 30 minutes before anything else. Take the tablet on an empty stomach, swallowed whole with up to half a glass of water, and wait at least 30 minutes before the first food, drink or other tablets of the day — waiting less may reduce how much semaglutide is absorbed (Rybelsus PI). The two questions this rule raises have their own pages: can you eat sooner than 30 minutes after Rybelsus? and can ibuprofen be taken with Rybelsus? The doses (3, then 7, then 14 mg) and the PBS position are on the Rybelsus page.
Which diabetes medicines can cause hypos?
Mainly sulfonylureas and insulin. Taken on their own, metformin, gliptins, SGLT2 inhibitors, glitazones and acarbose do not usually cause hypoglycaemia (Diabetes Victoria); GLP-1 medicines usually do not with metformin, but can with a sulfonylurea — which is why a doctor may lower the sulfonylurea or insulin dose when one is added.
Sources
- healthdirect — Diabetes medicines; healthdirect — Metformin
- Diabetes Victoria — Medicines for type 2 diabetes
- Rybelsus Product Information (Australia), AusPAR, October 2022
- ARTG search (searched 25–26 September 2026)
