What medicines are used to treat diabetes?

If you have diabetes, you may need medicines to help manage your blood sugar levels. There are many different medicines available.

Some medicines come in tablet form, while others need to be injected. These include insulin and other non-insulin treatments.

There are tips you can follow to use your medicines safely and effectively.

What is insulin?

Insulin is a hormone naturally made by your pancreas. It helps your body move sugar from the food you eat into your cells, where it can be used as energy.

If you have diabetes, your body may not have enough insulin to control your blood sugar levels. Insulin can be given as a medicine to help you maintain healthy blood sugar levels.

Insulin is currently only available as an injection — it cannot be taken as a tablet.

What devices are available to deliver insulin?

A range of devices can be used to deliver doses of insulin. These include:

• insulin pens
• insulin pumps
• insulin jets
• syringes

If you are registered with the National Diabetes Services Scheme (NDSS), you can get subsidised diabetes equipment.

Insulin pens

Insulin pens look similar to pens you would use for writing. Some are pre-fitted with insulin. Others have refillable insulin cartridges. The required dose of insulin is automatically measured and delivered by a needle attached to the pen.

Your doctor, pharmacist, or diabetes educator can:

• advise you on the best medicine for you
• advise you on the best pen for you
• tell you how to use the pen

How do I use my insulin pen device?

Follow these steps to inject medicine using a pen device.

1. If you have a reusable insulin pen, insert an insulin cartridge. If you are using a disposable pen, it will have pre-filled insulin.
2. Attach a new needle to the pen.
3. Prime (prepare) your pen before using it by dialling in 2 units of medicine. Hold the pen upright, and expel (eject) the dose into the air. This makes sure that the needle is working and that no air bubbles are injected into your skin.
4. Dial in your correct dose, hold the pen at a right angle to your skin and inject. Hold the pen in position for 10 seconds.
5. Remove the needle from the pen immediately after use and safely dispose of it in a sharps bin.

There are some tips you can follow to ensure safe and effective use of an insulin pen.

You can ask your doctor or diabetes educator for advice.

If any medicine leaks or spills when you are using an insulin delivery device, do not take another dose. Monitor your blood sugar level until your next dose is due, then continue to take your medicine as normal.

Avoid injecting in areas of skin where there are scars, stretch marks or lumps.

Don’t inject through your clothing — this blocks your view of the injection site. This makes it hard to tell if the insulin has been injected properly.

Always keep your pen separate from the needle until you need to use it. Do not carry the pen around loaded with a needle.

Never withdraw insulin out of an insulin pen. This can contaminate the pen.

Insulin pumps

Insulin pumps are also known as continuous subcutaneous insulin infusion, or CSII. They are devices worn on the body 24 hours a day. They automatically deliver a continuous dose of insulin according to your needs.

The pump works with an ‘infusion set' that helps the insulin enter your body. This is made up of:

• thin plastic tubing
• an adhesive (sticky) patch
• a small needle-like device called a cannula

Infusion sets need changing regularly — usually every 3 days.

How do I use my insulin pump?

There are some things to remember to use your insulin pump properly.

Some pumps can be linked to a continuous glucose monitoring (CGM) sensor. If your pump is not linked to a CGM, you will need to monitor your blood sugar levels. You may need to do this 4 to 8 times a day.

Pumps use fast-acting insulin. This type of insulin will disappear from your body quickly once the pump is disconnected. If this happens, your blood sugar level will start to rise. This can raise your chance of complications like high blood sugar (hyperglycaemia) and high ketone levels (ketoacidosis). If you need to disconnect your pump, make sure it is back in place within one hour.

Move your cannula site (the place on your body where the cannula goes) every 3 days. This can help reduce the chances of infection.

If your pump is leaking insulin, or you notice damp patches on your clothes, check that your infusion set is connected correctly. If your pump is not working properly, contact the manufacturer and your diabetes educator for advice.

Insulin syringes

Syringes come in different sizes. Talk with your doctor or diabetes educator about which size is best for you. They can also advise if a pen device may be more suitable for you.

Syringes can be useful if you need to take 2 different types of insulin mixed in different amounts.

How do I use my insulin syringe?

When using your insulin syringe, remember to:

• keep a supply of spare needles and syringes — use new equipment for each injection
• always dispose of your needles and syringes safely in a sharps bin
• follow the advice of your doctor or diabetes educator
• Insulin jets

Insulin jets can deliver insulin to your body without using a needle. This can be useful for people who don't like needles or are unable to use needles.

You draw the insulin into the nozzle and it is delivered at high speed, so it penetrates your skin. In Australia, these are less common.

What devices are available to deliver non-insulin medicines?

Other diabetes medicines are available that also need to be injected. GLP-1RA is the name for a type of medicine that may be prescribed for people with type 2 diabetes.

These medicines are injected using pre-filled pens. Some pens come with their own needles, and others can use insulin pen needles.

These devices are used in a similar way to insulin pens. Your doctor or diabetes educator can show you how to use them.

Resources and support

Visit Diabetes Australia for information and resources. You can also:

• call Diabetes Australia on 1800 177 055
• find resources for Aboriginal and Torres Strait Islander people
• get multicultural resources

The National Diabetes Services Scheme (NDSS) has a range of resources, support services and subsidised diabetes products. The NDSS website also has a range of diabetes resources in languages other than English.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.