A reference guide to prescription medications that help manage blood sugar — from the GLP-1 drugs dominating headlines to older workhorses that still have a role.
Treatment of type 2 diabetes has changed more in the past decade than in the previous fifty years. The arrival of GLP-1 receptor agonists (and now GLP-1/GIP dual agonists) has reshaped what's possible, with some patients achieving A1C and weight reductions that previously required bariatric surgery.
This page is a reference — not a prescription. Every drug listed has distinct benefits, trade-offs, and contraindications. Choose a treatment with your doctor based on your specific situation.
Our Ozempic vs. Wegovy vs. Mounjaro vs. Zepbound guide breaks down the four best-known GLP-1 drugs side-by-side, with weight-loss data and cost information.
This class mimics the gut hormone GLP-1, which stimulates insulin release, slows stomach emptying, and reduces appetite. GLP-1 drugs typically reduce A1C by 1–2 percentage points while promoting weight loss.
Ozempic is the semaglutide brand from Novo Nordisk, given by weekly injection and FDA-approved for type 2 diabetes. Since its approval, it has become wildly popular — both for diabetes and, off-label, for weight loss. Ozempic also carries a cardiovascular risk reduction indication for adults with type 2 diabetes and heart disease.
Wegovy is also semaglutide (same drug as Ozempic), dosed up to 2.4 mg weekly, and approved by the FDA for chronic weight management. It has additional FDA approvals for cardiovascular risk reduction and, more recently, for MASH (metabolic dysfunction–associated steatohepatitis), a form of fatty liver disease. Wegovy is made by Novo Nordisk.
Mounjaro (tirzepatide) is Eli Lilly's dual GLP-1/GIP agonist, approved for type 2 diabetes. Clinical trials have shown substantial weight loss as a secondary effect, and the drug has been prescribed off-label for weight loss. Lilly subsequently obtained a separate approval for weight management under the brand name Zepbound.
Zepbound is tirzepatide (same drug as Mounjaro), FDA-approved for chronic weight management in adults with obesity or overweight with a weight-related condition. It was also approved in 2024 for moderate-to-severe obstructive sleep apnea in adults with obesity — the first medication approved for sleep apnea linked to excess weight.
Rybelsus is oral semaglutide — the first pill in the GLP-1 class. Introduced by Novo Nordisk in 2019, it's taken daily for type 2 diabetes. The pill form requires specific dosing instructions (empty stomach, wait before eating) and produces less weight loss than the injectable versions.
Trulicity (dulaglutide) is a once-weekly GLP-1 injection from Eli Lilly, approved for type 2 diabetes. It helps stimulate the body's own insulin production and lowers A1C.
Byetta (exenatide) was one of the first GLP-1 drugs on the market. Developed by Amylin Pharmaceuticals, it's a twice-daily injection for type 2 diabetes and reduces A1C by roughly 1 percentage point. Exenatide has also shown preliminary benefits in some Parkinson's disease research.
Bydureon is an extended-release exenatide, given by once-weekly injection. AstraZeneca markets Bydureon in the U.S.
Liraglutide, marketed as Victoza by Novo Nordisk, is a once-daily GLP-1 injection for type 2 diabetes, approved by the FDA in 2010. Long-term safety concerns about pancreatitis and thyroid cancer have been raised and continue to be monitored.
These drugs work in the kidney, prompting the body to excrete more glucose in urine. They lower A1C modestly and also have cardiovascular and kidney-protective effects.
FARXIGA is an SGLT2 inhibitor approved for adults with type 2 diabetes. It reduces A1C by roughly 0.8 percentage points and has additional indications for heart failure and chronic kidney disease. Bristol-Myers Squibb and AstraZeneca developed dapagliflozin together.
Jardiance, made by Boehringer Ingelheim and Lilly, is an SGLT2 inhibitor used with diet and exercise to lower blood sugar in adults with type 2 diabetes. It also reduces the risk of cardiovascular death in patients with type 2 diabetes and established heart disease. Jardiance is not approved for type 1 diabetes.
Canagliflozin, developed by Johnson & Johnson, is another SGLT2 inhibitor for type 2 diabetes.
These drugs block an enzyme that breaks down the body's natural GLP-1, allowing endogenous hormone levels to stay elevated longer. They lower A1C by roughly 0.5 to 1 percentage point and are weight-neutral.
Januvia (sitagliptin) is a DPP-4 inhibitor originally developed by Merck, approved for once-daily dosing. It reduces A1C by up to 1 percentage point and lowers fasting plasma glucose by about 15 mg/dL. Janumet combines sitagliptin with metformin in a single pill.
Combined sales of Januvia and Janumet reached roughly $3 billion per year for Merck at their peak. A nitrosamine contamination was identified in Januvia in 2022; the FDA permitted continued sales while Merck identified and corrected the source. Januvia's patent protection expired in 2026, opening the door to generic sitagliptin.
Onglyza (saxagliptin) was the second DPP-4 inhibitor approved for the U.S. market, cleared by the FDA in 2009. It's marketed by AstraZeneca and Bristol-Myers Squibb, with a generic (saxagliptin) now available.
Pramlintide is an amylin analog that suppresses glucagon and slows gastric emptying. It can reduce A1C by up to a full percentage point and is given by injection. It's used less commonly than the drug classes above.
Most type 2 diabetes treatment starts with metformin (not covered above; it's been around for decades, is inexpensive, and works well). If A1C remains above target, doctors typically add a second medication based on the patient's specific situation:
Insulin remains essential for type 1 diabetes and for many people with advanced type 2 diabetes. The pharmacology of insulin is its own large topic.