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`Medication for Type
`2 Diabetes
`
`Type 2 Diabetes
`Find a Doctor &
`Schedule
`Prevention
`Diagnosis
`Medication
`Bariatric Surgery
`Support
`
`Making lifestyle changes—such as eating
`healthfully, exercising, and losing weight
`—is the most effective way to manage
`type 2 diabetes and prevent
`complications. If these changes aren’t
`enough, NYU Langone doctors may
`recommend medication to control blood
`sugar levels.
`
`Schedule an Appointment
`
`Browse our specialists and get the care
`you need.
`
`Find a Doctor & Schedule
`
`For some people, one medication may
`be sufficient to lower blood sugar levels.
`Others may need a combination of two
`or more medications. Medications are
`most effective when combined with
`lifestyle changes.
`
`https://nyulangone.org/conditions/type-2-diabetes/treatments/medication-for-type-2-diabetes
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`Medication for Type 2 Diabetes | NYU Langone Health
`Many people with type 2 diabetes need
`to take medication to control blood
`sugar levels for the rest of their lives.
`Sometimes, however, losing weight and
`improving your overall health may
`eventually eliminate the need for
`medication.
`
`Oral Medications
`
`For people with mild to moderate type 2
`diabetes, medications taken by mouth
`are effective in controlling blood sugar
`levels. Some increase the body’s
`sensitivity to insulin, also described as
`decreasing insulin resistance. Others
`enhance the effects of hormones that
`help control blood sugar levels.
`
`Biguanides
`
`One commonly prescribed medication
`for type 2 diabetes is metformin, which
`belongs to a class of medications known
`as biguanides. is medication is taken
`daily by mouth.
`
`e medication makes your liver and
`muscles more sensitive to insulin and
`reduces glucose production in the liver.
`is allows the body to use glucose more
`efficiently.
`
`In rare instances, metformin can cause
`mild gastrointestinal symptoms, such as
`stomach upset and diarrhea. ese
`symptoms can be avoided if the
`
`https://nyulangone.org/conditions/type-2-diabetes/treatments/medication-for-type-2-diabetes
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`Medication for Type 2 Diabetes | NYU Langone Health
`medication is started at a low dosage
`and is slowly increased.
`
`Sulfonylureas
`
`Doctors commonly prescribe
`sulfonylurea medications, such as
`glyburide, glipizide, and others, to lower
`blood sugar levels in people with type 2
`diabetes.
`
`ese medications increase insulin
`production in the pancreas.
`Sulfonylurea medications are often
`prescribed in combination with
`metformin.
`
`Side effects can include hypoglycemia,
`or low blood sugar levels, and increased
`hunger and weight gain. Your doctor
`monitors you carefully in order to avoid
`these.
`
`Thiazolidinediones
`
`Medications belonging to a class called
`thiazolidinediones, or glitazones,
`reverse insulin resistance by improving
`insulin sensitivity in muscle, liver, and
`fat cells. ey also help prevent the liver
`from releasing excess glucose.
`
`Taken once daily, glitazones are often
`prescribed in combination with other
`medications for type 2 diabetes. Because
`they increase insulin sensitivity, they
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`https://nyulangone.org/conditions/type-2-diabetes/treatments/medication-for-type-2-diabetes
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`Medication for Type 2 Diabetes | NYU Langone Health
`may reduce the amount of medication
`needed to increase insulin production.
`
`ese medications can cause uid
`retention, which may exacerbate
`congestive heart failure in people who
`have that condition. ey may also
`increase the risk of bladder cancer, as
`well as fractures in people with
`osteoporosis. Your doctor weighs your
`risk of these conditions into account
`when recommending these
`medications.
`
`Gliptins
`
`Gliptins, also called DPP4 inhibitors,
`block the action of an enzyme called
`DDP4. ey enhance the effects of a
`hormone that stimulates insulin
`production and prevents the liver from
`releasing too much glucose. Our doctors
`may prescribe these medications for
`people who have difficulty controlling
`blood sugar levels after meals.
`
`Gliptins, taken daily, are prescribed
`alone or in combination with
`metformin. ese medications are
`generally well tolerated but may cause
`hypoglycemia in people who are using
`them with other medications for type 2
`diabetes.
`
`Meglitinides
`
`https://nyulangone.org/conditions/type-2-diabetes/treatments/medication-for-type-2-diabetes
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`Meglitinides, also known as glinides,
`rapidly lower blood sugar levels by
`stimulating the pancreas to release
`insulin after meals. ese medications
`are often prescribed for people with
`moderately high glucose levels. Because
`meglitinides work rapidly for a short
`period of time, they’re most effective
`when taken before meals.
`
`e most common side effect of these
`medications is hypoglycemia, especially
`when taken with other medications for
`type 2 diabetes. Other side effects
`include headache, nausea, and stomach
`pain.
`
`Glucosidase Inhibitors
`
`Glucosidase inhibitors, sometimes
`called “starch blockers,” reduce blood
`sugar levels by blocking an enzyme
`called glucosidase. is enzyme helps
`break down carbohydrates in the small
`intestine, allowing carbohydrates to
`release sugar into the bloodstream.
`ese medications help slow the
`intestine’s absorption of carbohydrates.
`
`Taken at the beginning of meals,
`glucosidase inhibitors can help prevent
`a sharp increase in blood sugar levels.
`When taken with other medications to
`control blood sugar levels, these
`medications can cause hypoglycemia.
`Common side effects include bloating,
`nausea, diarrhea, and gas.
`
`https://nyulangone.org/conditions/type-2-diabetes/treatments/medication-for-type-2-diabetes
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`Gliflozins
`
`Gli ozins, or SGLT2 inhibitors, are a
`newer class of medications that prevent
`the kidneys from reabsorbing glucose.
`e excess sugar is eliminated in the
`urine.
`
`Gli ozins can be taken alone or in
`combination with metformin. Common
`side effects include vaginal yeast
`infections and urinary tract infections.
`
`Insulin
`
`For people with more severe type 2
`diabetes—meaning blood sugar levels
`that are consistently high—doctors
`usually prescribe insulin. Insulin is a
`hormone produced in the pancreas
`that’s responsible for signaling muscles
`and other body tissues to use sugar from
`food.
`
`ere are several different kinds of
`insulin, most of which are given by
`injection. When injected once a day,
`long-acting forms of insulin lower
`glucose levels for up to 24 hours. Short-
`acting forms, which are injected before
`meals, lower glucose levels immediately,
`preventing food from causing a spike in
`blood sugar levels.
`
`A new short-acting form of insulin
`comes in a powder that can be inhaled.
`It’s used before meals, allowing some
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`https://nyulangone.org/conditions/type-2-diabetes/treatments/medication-for-type-2-diabetes
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`Medication for Type 2 Diabetes | NYU Langone Health
`people to eliminate the need to inject
`short-acting insulin at mealtimes.
`
`Your doctor decides which type of
`insulin is best for you based on the
`severity of your condition.
`
`If insulin doesn’t control diabetes, you
`may bene t from a gastric bypass
`procedure, which is a type of weight loss
`surgery that reduces the size of the
`stomach.
`
`GLP-1 Agonists
`
`GLP-1 agonists mimic the action of
`glucagon-like peptide 1, a hormone that
`helps lower blood sugar levels after
`meals. ese medications help the body
`release more insulin and prevent the
`liver from releasing excess glucose after
`meals. Because they lower blood sugar
`levels after meals, GLP-1 agonists cannot
`be taken with short-acting forms of
`insulin, which have the same effect.
`
`GLP-1 agonists are given via an injection
`under the skin. Some formulations are
`given once or twice daily. Long-lasting
`versions can be used once a week. Some
`people experience nausea and vomiting
`when beginning treatment with a GLP-1
`agonist.
`
`https://nyulangone.org/conditions/type-2-diabetes/treatments/medication-for-type-2-diabetes
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`7/9
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`Novo Nordisk Exhibit 2520
`Mylan Pharms. Inc. v. Novo Nordisk A/S
`IPR2023-00724
`Page 00007
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`Medication for Type 2 Diabetes | NYU Langone Health
`
`Glucose
`Monitoring
`
`Your doctor may also teach you how to
`use a glucose monitor, a portable
`electronic device that uses a small drop
`of blood to measure your glucose level.
`It can determine your blood sugar levels
`in seconds. Regularly monitoring your
`blood sugar level helps to ensure your
`medication is working as it should.
`
`Our Research and
`Education in Type
`2 Diabetes
`
`Learn more about our research and
`professional education opportunities.
`• Endocrinology, Diabetes, and
`Metabolism Research
`• Endocrinology, Diabetes, and
`Metabolism Training
`
`Type 2 Diabetes
`Find a Doctor &
`Schedule
`Prevention
`Diagnosis
`Medication
`Bariatric Surgery
`Support
`
`We can help you nd a doctor. Call 646-929-7800 or
`browse our specialists.
`
`https://nyulangone.org/conditions/type-2-diabetes/treatments/medication-for-type-2-diabetes
`
`8/9
`
`Novo Nordisk Exhibit 2520
`Mylan Pharms. Inc. v. Novo Nordisk A/S
`IPR2023-00724
`Page 00008
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`Novo Nordisk Exhibit 2520
`Mylan Pharms. Inc. v. Novo Nordisk A/S
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