The Best Time to Take Blood Sugar Medication Based on the Type You Use

The best time of day to take medication for diabetes varies, depending on the type of medication. Some medications should be taken with food to lessen the chance of side effects, while others work best on an empty stomach. 

1. Biguanides

Metformin is a biguanide, and it is available as a regular tablet, an extended-release (ER) tablet, and a solution:

• How it works: Metformin decreases the amount of glucose made by the liver and the amount absorbed from food. It also alters how your body responds to insulin, making insulin more effective.
• How often to take it: Regular metformin is given one to three times a day, while ER metformin should be taken once daily.
• When to take it: It’s best taken with meals to minimize stomach upset. Take regular metformin with your meals, and take ER metformin with your evening meal. Combination medications containing metformin should also be taken with food.

2. DPP-4 Inhibitors

Dipeptidyl peptidase-4 (DPP-4) inhibitors include medications such as Januvia (sitagliptin) and Tradjenta (linagliptin):

• How they work: DPP-4 inhibitors block the DPP-4 enzyme, which increases the levels of incretin hormones. Incretin hormones help to regulate glucose and insulin levels.
• How often to take them: Take your medication once every day.
• When to take them: Take at the same time each day, with or without food.

3. DPP-4 Inhibitors with Metformin

DPP-4 inhibitors combined with metformin include medications such as Janumet (sitagliptin/metformin) and Jentadueto (linagliptin/metformin):

• How they work: DPP-4 inhibitors work alongside metformin to lower blood sugar levels.
• How often to take them: Take your medication twice daily.
• When to take them: Since they contain metformin, take them with food to reduce stomach upset, a potential side effect.

4. GLP-1 Receptor Agonists

Glucagon-like peptide-1 (GLP-1) receptor agonists regulate blood sugar by stimulating insulin release and inhibiting the release of glucagon. They also slow the release of food from the stomach and reduce hunger.

These medications include:

• Adlyxin (lixisenatide)
• Bydureon (exenatide)
• Byetta (exenatide)
• Ozempic (semaglutide)
• Rybelsus (semaglutide)
• Trulicity (dulaglutide)
• Victoza (liraglutide)

 Dosing instructions will vary by specific product:

• Adlyxin: Take one hour before the first meal of the day.
• Byetta: Administer within one hour of your morning and evening meals.
• Rybelsus: Take in the morning on an empty stomach, at least 30 minutes before food or other medications.
• Victoza: Give daily, around the same time, with or without food.
• Other injectable GLP-1s: Administer once a week, on the same day, with or without food.

5. Dual GLP-1/GIP Receptor Agonists

Mounjaro (tirzepatide) is currently the only dual glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist approved for type 2 diabetes:

• How it works: Like GLP, GIP is also a gut hormone involved in appetite and glucose regulation. GIP and GLP-1 work together to have a greater effect on glucose control.
• How often to take it: Mounjaro is given an injection once a week.
• When to take it: Take on the same day each week, at any time.

6. Meglitinides

Meglitinides include nateglinide and repaglinide:

• How they work: Meglitinides reduce blood sugar by stimulating the pancreas to release more insulin.
• How often to take them: At least once per day, though frequency may vary based on meal patterns.
• When to take: Take within 30 minutes before a meal.

7. SGLT2 inhibitors

Sodium-glucose co-transporter 2 (SGLT2) inhibitors include medications such as Farxiga (dapagliflozin) and Jardiance (empagliflozin):

• How they work: SGLT2 inhibitors lower blood sugar by blocking the reabsorption of glucose in the kidneys. Excess glucose is then excreted in the urine.
• How often to take them: Take once per day
• When to take them: It is best to take SGLT2 inhibitors in the morning, as taking them too late in the day could cause nighttime urination.

SGLT2 inhibitors also come in combination tablets with metformin. ER versions should be taken with food in the morning, and regular-release versions should be taken twice a day, with one dose at breakfast and another at dinner.

SGLT2 inhibitors are also available in combination with DPP-4 inhibitors. They should be taken once daily in the morning, with or without food.

8. Sulfonylureas

Sulfonylureas are a type of blood sugar-lowering medication that includes glimepiride, Glucotrol XL (glipizide), and Diabeta (glyburide):

• How they work: Sulfonylurea drugs help the pancreas release more insulin
• How often to take them: Take your medication once per day.
• When to take them: Take your dose in the morning, 30 minutes before breakfast.

9. Thiazolidinediones

Pioglitazone is the only available thiazolidinedione in the United States:

• How it works: Pioglitazone improves the body’s response to insulin
• How often to take it: Take it once a day.
• When to take it: Take it at the same time each day, with or without food.

Tips to Help You Remember

Medications only work if you take them. The following are helpful tips to keep you on track with taking your diabetic medications:

• Ask your pharmacist for help. Many pharmacies have apps for your phone as well as refill and pickup reminders. 
• Keep your medication visible. Keeping your medication tucked away in a cabinet or drawer may lead to missed doses. Keeping your medication somewhere where you will see it every day will help remind you to take it. Always practice medication safety and keep medication away from children and pets. 
• Know your medication. Knowing what the medication is for and how it works is important, especially if you take multiple medications.
• Make it part of your routine. Associating daily activities with taking your medication can help you remember to take it. These can include activities like brushing your teeth, sitting down for a meal, or showering. 
• Use a pill organizer. Pill organizers can separate your medications by day and time. This will make it easier to take and ensure you don’t miss a dose. 
• Set an alarm. Setting a daily alarm on your watch or cellphone can help remind you, especially if your routine changes.