In Australia, Metformin is overwhelmingly the most common first-line medication for Type 2 Diabetes, often started alongside lifestyle changes for most patients due to its effectiveness in improving insulin sensitivity and reducing liver glucose production with minimal weight gain or hypoglycemia risk. If Metformin isn't tolerated or sufficient, other popular options include Sulfonylureas, newer classes like SGLT2 inhibitors (e.g., dapagliflozin) and GLP-1 agonists (e.g., dulaglutide) for added benefits like weight loss and cardiovascular protection, and DPP-4 inhibitors (gliptins) as alternatives.
Biguanide (Metformin)
This is usually the first form of medication for people living with type 2 diabetes.
If you continue to experience diarrhoea you may be switched onto a slow-release version of the medication. Taking Metformin can cause vitamin B12 deficiency. Signs of this are feeling very tired, muscle weakness, sore or red tongue, mouth ulcers, vision problems, pale or yellow skin.
Drinking plenty of fluids each day may help. Drink plenty of water during exercise or in hot weather. Check with your doctor if you have severe nausea, vomiting, or diarrhea that does not stop. This may cause you to lose too much water.
Common Type 2 Diabetes Medications
Medically reviewed by Carmen Pope, BPharm. Last updated on Sep 8, 2025. Metformin is widely considered the safest first-line medication for type 2 diabetes.
With well-established potent plasma glucose-reducing effects, Metformin has been used as a first-line drug to treat type 2 diabetes mellitus (T2DM). Interestingly, relative to its clear pharmacological benefit, mechanisms underlying metformin actions have been revealed in an overly simplified manner until recently.
Other serious side effects
Call your doctor or call 111 now if: you have a very dry or sticky mouth, feel very thirsty, sleepy or tired, are not peeing (or peeing very little), and have a fast heartbeat – these can be signs of dehydration.
Common side effects include upset stomach, dry mouth, and drowsiness. A side effect is considered serious if the result is: death; life-threatening; hospitalization; disability or permanent damage; or exposure prior to conception or during pregnancy caused birth defect.
With gastroparesis, you may have that "stuffed" feeling, bloating, discomfort, or pain after eating even a small amount of food. This can happen soon after you start eating or long after you finish your meal if your stomach isn't emptying properly. Other symptoms include heartburn, nausea, vomiting, and poor appetite.
Certain supplements like St. John's wort, vitamin E, and niacin can affect glucose levels and may interact with certain medications.
Pain or a burning sensation in your mouth or throat. Rough tongue. Sticky, thick or stringy spit.
Medications used by people with diabetes such as Glipizide and Metformin may cause changes to the oral cavity, such as candidiasis, burning mouth, xerostomia, and the chance of getting periodontal disease and caries.
Including drugs which have been affected by the availability of 60-day prescriptions, the top 10 drugs by prescription counts were:
Top 10 countries or territories for number of adults (20–79 years) with diabetes in 2021 and 2045. The highest comparative diabetes prevalence rates in 2021 are reported in Pakistan (30.8%), French Polynesia (25.2%) and Kuwait (24.9%) (Table 3.5).
Specifically, drugs that slow down breathing rate, such as opioids, alcohol, antihistamines, CNS depressants, or general anesthetics, should not be taken together because these combinations increase the risk of life-threatening respiratory depression.
When each factor— people, places, and products—are properly understood and supported, the medication management process thrives and the patients benefit.
People can experience hallucinations when they're high on illegal drugs such as amphetamines, cocaine, LSD or ecstasy. They can also occur during withdrawal from alcohol or drugs if you suddenly stop taking them. Drug-induced hallucinations are usually visual, but they may affect other senses.
If you have heart failure, dapagliflozin reduces the amount of work your heart has to do to pump blood around your body. This helps improve the symptoms of heart failure such as breathlessness, tiredness and swelling in your lower legs. It also reduces the chances of your heart getting weaker.
Long-term event-free survival projections
At age 55 years, the estimated survival free from the primary endpoint was 11.8 years (95% CI: 9.8-13.9 years) with dapagliflozin and 9.8 years (95% CI: 8.2-11.5 years) with placebo (difference: 2.0 years [95% CI: −0.6 to 4.6 years]; P = 0.14) (Central Illustration A).
Dapagliflozin is not suitable for some people. To make sure it's safe for you, tell your doctor if you: have ever had an allergic reaction to dapagliflozin or any other medicine. have sugar (glucose) and ketones (a type of chemical) in your pee – there are home tests for this.
According to its proponents, you use the pinch method by holding the thumb and index finger of one hand just above the wrist of the other hand and then exerting a little bit of pressure on the wrist. Doing this will supposedly cause the release of insulin and break down glucose.
If you have diabetes and you're aged 12 or over, you'll get a letter every 1 or 2 years asking you to have diabetic eye screening.
Combining Farxiga with diuretics (water pills) or lithium (Lithobid) can also be problematic. You should avoid or limit alcohol while taking Farxiga. Drinking can raise the risk of rare but serious Farxiga side effects, including dehydration, low blood sugar (glucose), and ketoacidosis (too much acid in the blood).