Understanding Your Diabetes Medications
A plain-language overview of diabetes medication classes, proper insulin storage, blood sugar monitoring, and how your community pharmacist supports your diabetes care in Ottawa.
Type 1 and Type 2 Diabetes: A Quick Overview
Diabetes is a condition in which the body cannot properly regulate blood sugar (glucose). In Type 1 diabetes, the immune system destroys the insulin-producing cells in the pancreas, so the body makes little or no insulin. Insulin therapy is essential. In Type 2 diabetes — by far the more common form — the body becomes resistant to insulin or does not produce enough. Type 2 is often managed with lifestyle changes and oral medications first, with insulin added later if needed.
Diabetes Canada estimates that over 11 million Canadians are living with diabetes or prediabetes. Effective medication management, combined with healthy eating and physical activity, can significantly reduce the risk of complications such as heart disease, kidney disease, and vision loss.
Common Diabetes Medication Classes
Your healthcare team will choose medications based on your type of diabetes, kidney function, heart health, weight goals, and other individual factors. Many people with Type 2 diabetes take more than one medication.
Metformin
OralHow it works: Reduces glucose production in the liver and improves insulin sensitivity. Usually the first medication prescribed for Type 2 diabetes.
Note: Generally well tolerated. Take with food to reduce stomach upset. Kidney function should be monitored.
SGLT2 Inhibitors — e.g., empagliflozin (Jardiance), dapagliflozin (Farxiga)
OralHow it works: Cause the kidneys to excrete excess glucose in the urine, lowering blood sugar while also providing heart and kidney protection.
Note: Can increase risk of urinary tract and genital infections. Stay well hydrated.
GLP-1 Agonists — e.g., semaglutide (Ozempic, Rybelsus), liraglutide (Victoza)
Injectable or oralHow it works: Mimic a natural hormone that stimulates insulin release, reduces appetite, and slows stomach emptying.
Note: Often associated with weight loss. Common side effects include nausea, especially when starting.
Sulfonylureas — e.g., gliclazide (Diamicron), glipizide
OralHow it works: Stimulate the pancreas to produce more insulin.
Note: Can cause hypoglycemia (low blood sugar). Carry a fast-acting sugar source (glucose tablets, juice) with you.
Insulin — e.g., rapid-acting, long-acting, premixed
InjectableHow it works: Replaces or supplements the body's own insulin to control blood sugar.
Note: Must be stored correctly. Your pharmacist can train you on injection technique and device use.
Insulin Storage and Blood Sugar Monitoring
Proper storage is critical for insulin to remain effective. Here are the key rules:
- Unopened insulin: store in the refrigerator at 2–8°C until the expiry date.
- In-use insulin (vials or pens): most can be kept at room temperature below 25°C for 28–30 days. Check your product label.
- Never freeze insulin — freezing destroys it.
- Avoid leaving insulin in a hot car, direct sunlight, or near heating vents.
- Check insulin for unusual appearance before each injection — cloudiness or particles in clear insulin means it should not be used.
Blood sugar monitoring helps you and your healthcare team understand how well your medications are working. Your pharmacist can help you choose a glucometer, teach you how to use it, and interpret your readings. Ask about continuous glucose monitors (CGMs) if fingerstick testing is difficult.
How Your Pharmacist Supports Your Diabetes Care
In Ontario, pharmacists play an active role in diabetes management. At Longfields Pharmacy, we can:
- Explain how each medication works and what to expect when you start.
- Train you on insulin injection technique and pen device use.
- Help you navigate Ontario Drug Benefit (ODB) coverage and prior authorizations.
- Review your full medication list to identify any interactions or duplications.
- Provide blister pack (PillPack) services to simplify complex medication schedules.
- Discuss lifestyle strategies that complement your medications.
Frequently Asked Questions
Does metformin cause low blood sugar (hypoglycemia)?
Metformin on its own does not usually cause hypoglycemia because it works by reducing glucose production in the liver rather than stimulating insulin release. However, when metformin is combined with insulin or sulfonylureas, the risk of low blood sugar increases. Always monitor as directed by your healthcare team.
How should I store my insulin?
Unopened insulin should be stored in the refrigerator (2–8°C). Once opened, most insulin vials and pens can be kept at room temperature (below 25°C) for up to 28–30 days — check your specific product's label. Keep insulin away from direct sunlight, heat, and freezing temperatures. If insulin appears cloudy, discoloured, or has particles (unless it is an intermediate-acting type that should be cloudy), do not use it.
Is Ozempic (semaglutide) covered by OHIP or my drug plan in Ontario?
Coverage varies. Under the Ontario Drug Benefit (ODB) program, GLP-1 agonists like Ozempic may be covered for eligible patients with Type 2 diabetes who meet specific criteria. Private insurance coverage also varies by plan. Your pharmacist at Longfields can help you navigate your coverage options and submit prior authorization requests if needed.
What is the difference between Type 1 and Type 2 diabetes medication needs?
People with Type 1 diabetes produce little or no insulin, so insulin therapy is essential and not optional. People with Type 2 diabetes have insulin resistance and may initially manage with oral medications or non-insulin injectables; insulin is often added later as the condition progresses. The medication classes described on this page mainly apply to Type 2 diabetes management.