You may be taking more than one oral medicine to treat your type 2 diabetes. You may be taking insulin by injection or through an insulin pump alone or along with oral diabetes medicine. Taking these medicines as prescribed can help keep your blood sugar levels within your target range. For information on these medicines, see the Medications section of the topic Type 2 Diabetes: Living With the Disease.

You may need to take:

• Aspirin. If you are age 30 or older, talk to your health professional about taking a low-dose aspirin daily to prevent heart attack, stroke, or other large blood vessel disease (macrovascular disease).⁸
• A diuretic, an angiotensin-converting enzyme (ACE) inhibitor, angiotensin II receptor blocker, or other medicine if you have high blood pressure or have protein in your urine. These medicines can slow or prevent further damage to your kidneys.
• Medicines for digestive problems. The type of medicine will depend on the problem you are having. For example, if you have gastroparesis, you may take metoclopramide (Reglan), domperidone (available in Europe and Canada), or erythromycin.
• Nonprescription pain relievers, creams, or prescription oral or injection medicines if you have pain from peripheral neuropathy.
• Medicines such as sildenafil (Viagra), vardenafil (Levitra), or tadalafil (Cialis) if you have erection problems. These medicines can make heart problems worse in some people, especially those who take nitrate medicines (such as nitroglycerin). Check with your doctor before taking any of these medicines.

Medication Choices

Medicines for some complications include:

• Aspirin after a heart attack or stroke or to prevent these.
• Statins such as atorvastatin (Lipitor), simvastatin (Zocor), or pravastatin (Pravachol), to help prevent heart attack or stroke.
• Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARBs) for diabetic nephropathy.
• Phosphodiesterase-5 inhibitors (PDE-5 inhibitors) such as Viagra, Levitra, or Cialis if you have erection problems. Check with your doctor before taking any of these medicines.
• Fibrates such as gemfibrozil (Lopid) or fenofibrate (Tricor) to help lower triglycerides and increase HDL levels.

What to Think About

Keep your blood sugar levels tightly within a normal or near-normal range by taking your oral diabetes medicine (and, in some cases, insulin) as prescribed.

If you have high cholesterol, take cholesterol-reducing medicines (such as statins) to keep your LDL cholesterol level less than 100 mg/dL (2.60 mmol/L), your triglyceride level less than 150 mg/dL (1.7 mmol/L), and if possible, your HDL cholesterol level more than 40 mg/dL (1.02 mmol/L) for men and 50 mg/dL (1.28 mmol/L) for women. See the topic High Cholesterol.

If you have high blood pressure, take medicines to keep your blood pressure consistently below 130/80 mm Hg. If your systolic blood pressure is between 130 mm Hg and 139 mm Hg or your diastolic blood pressure is between 80 mm Hg and 89 mm Hg, you may try some lifestyle or behavioral therapy for 3 months before starting medicine.⁶ For more information, see the topic High Blood Pressure (Hypertension).