The best time to take blood sugar medications based on the type you are using

The best time of day to take diabetes medications varies depending on the type of medication. Some medications need to be taken with food to reduce the risk of side effects, while others work best on an empty stomach.

1. Biguanides

Metformin is a biguanide and is available as a regular tablet, extended-release (ER) tablet, and solution:

• How it works: Metformin decreases the amount of glucose produced by the liver and the amount absorbed through food. It also changes the way your body responds to insulin, making it more effective.
• How often to take it: Regular metformin is given one to three times a day, while metformin ER should be taken once a day.
• When to take it: It is best taken with meals to minimize stomach upset. Take metformin regularly with your meals and take metformin ER with your evening meal. Combination medications containing metformin should also be taken with food.

2. DPP-4 inhibitors

Dipeptidyl peptidase-4 (DPP-4) inhibitors include drugs such as Januvia (sitagliptin) and Tradjenta (linagliptin):

• How they work: DPP-4 inhibitors block the DPP-4 enzyme, which increases levels of incretin hormones. Incretin hormones help regulate glucose and insulin levels.
• How often to take them: Take your medication once a day.
• When to take them: Take at the same time each day, with or without food.

3. DPP-4 inhibitors with metformin

DPP-4 inhibitors combined with metformin include drugs such as Janumet (sitagliptin/metformin) and Jentadueto (linagliptin/metformin):

• How they work: DPP-4 inhibitors work alongside metformin to lower blood sugar levels.
• How often to take them: Take your medication twice a day.
• When to take them: Since they contain metformin, take them with food to reduce stomach upset, a potential side effect.

4. GLP-1 receptor agonists

Glucagon-like peptide-1 (GLP-1) receptor agonists regulate blood glucose levels by stimulating insulin release and inhibiting glucagon release. They also slow the release of food from the stomach and reduce hunger.

These medications include:

• Adlyxin (lixisenatide)
• Bydureon (exenatide)
• Byetta (exenatide)
• Ozempic (semaglutide)
• Rybelsus (semaglutide)
• Trulicity (dulaglutide)
• Victoza (liraglutide)

Dosage instructions vary depending on the specific product:

• Adlyxin: Take one hour before the first meal of the day.
• Byetta: Administer within one hour of your morning and evening meals.
• Fishing: Take in the morning on an empty stomach, at least 30 minutes before meals or other medications.
• Victory: Give daily, at approximately the same time, with or without food.
• Other injectable GLP-1: Administer once a week, on the same day, with or without food.

5. GLP-1/GIP dual receptor agonists

Mounjaro (tirzepatide) is currently the only dual glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist approved for type 2 diabetes:

• How it works: Like GLP, GIP is also an intestinal hormone involved in the regulation of appetite and glucose. GIP and GLP-1 work together to have a greater effect on blood sugar control.
• How often to take it: Mounjaro receives an injection once a week.
• When to take it: Take the same day every week, at any time.

6. Meglitinides

Meglitinides include nateglinide and repaglinide:

• How they work: Meglitinides reduce blood sugar by stimulating the pancreas to release more insulin.
• How often to take them: At least once a day, although frequency may vary depending on dietary habits.
• When to take: Take within 30 minutes before a meal.

7. SGLT2 inhibitors

Sodium-glucose cotransporter 2 (SGLT2) inhibitors include drugs such as Farxiga (dapagliflozin) and Jardiance (empagliflozin):

• How they work: SGLT2 inhibitors lower blood sugar by blocking glucose reabsorption in the kidneys. Excess glucose is then excreted in the urine.
• How often to take them: Take once a day
• When to take them: It is best to take SGLT2 inhibitors in the morning, as taking them too late in the day could cause nighttime urination.

SGLT2 inhibitors also come in tablet form combined with metformin. The ER versions should be taken with food in the morning and the regular release versions should be taken twice daily, with one dose at breakfast and another at dinner.

SGLT2 inhibitors are also available in combination with DPP-4 inhibitors. They should be taken once a day, in the morning, with or without food.

8. Sulfonylureas

Sulfonylureas are a type of glucose-lowering medication that includes glimepiride, Glucotrol XL (glipizide), and Diabeta (glyburide):

• How they work: Sulfonylureas help the pancreas release more insulin
• How often to take them: Take your medication once a day.
• When to take them: Take your dose in the morning, 30 minutes before breakfast.

9. Thiazolidinediones

Pioglitazone is the only thiazolidinedione available in the United States:

• How it works: Pioglitazone improves the body’s response to insulin
• How often to take it: Take it once a day.
• When to take it: Take it at the same time each day, with or without food.

Tips to help you remember

Medicines only work if you take them. Here are some helpful tips to help you take your diabetes medications:

• Ask your pharmacist for help. Many pharmacies offer apps for your phone as well as refill and pickup reminders.
• Keep your medications visible. Keeping your medications stored in a cabinet or drawer can lead to forgotten doses. Keeping your medications in a place where you will see them every day will remind you to take them. Always practice medication safety and keep medications out of reach of children and pets.
• Know your medications. It is important to know what the medication is for and how it works, especially if you are taking multiple medications.
• Make it part of your routine. Associating daily activities with taking your medications can help you remember to take them. These may include activities like brushing your teeth, sitting down to a meal, or taking a shower.
• Use a pillbox. Pill organizers can separate your medications by day and time. This will make it easier to take and ensure that you don’t miss a dose.
• Set an alarm. Setting a daily alarm on your watch or cell phone can help remind you, especially if your routine changes.