Pamela Assid, DNP, RN, is a board-certified nursing specialist with over 25 years of expertise in emergency, pediatric, and leadership roles.
Do-Eun Lee, MD, has been practicing medicine for more than 20 years, and specializes in diabetes, thyroid issues and general endocrinology. She currently has a private practice in Lafayette, California. 
Most people with type 2 diabetes eventually need multiple medications to help them manage their blood sugar (glucose) levels. Finding the right treatment for your needs can take some time.
Understanding how combination therapy works and who it is best for can help you work with your healthcare provider to find the medication combination that’s right for you.
This article discusses combination therapy for type 2 diabetes—what it is, its benefits, risks, and more.

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Combination therapy is when two or more medications treat a condition, such as type 2 diabetes. Treatment for type 2 diabetes likely begins with oral anti-hyperglycemic (glucose-lowering) medication.
If blood glucose monitoring or laboratory blood tests indicate that glucose levels are not effectively managed with a single, oral anti-hyperglycemic medication, your healthcare provider will prescribe additional medication.
When determining the correct combination of diabetic medications, your healthcare provider will consider their effects on other health conditions, if applicable.

Over time, uncontrolled blood glucose levels can cause significant health complications.

When a single medication is insufficient to control blood glucose levels adequately, your healthcare provider will consider combination therapy to prevent long-term complications. Such complications include:
As a chronic and progressive disease, type 2 diabetes often requires treatment changes. Establishing a proactive relationship with your healthcare provider is key to ensuring blood glucose levels are managed effectively and efficiently.
Initial (or mono) therapy medication treatment for type 2 diabetes typically includes one of the following oral medications:
Your healthcare provider may prescribe the following medications in conjunction with the oral medications listed above for combination therapy:
Basal insulin creates a high risk of hypoglycemia, so your healthcare provider will closely monitor your glucose levels to ensure correct dosages when first prescribing it.
Medications that regulate blood glucose levels are generally safe. However, like any medication, there are possible side effects. These include:
Sometimes, type 2 diabetes medications can interact with other drugs. It is essential to review all of your medications, including over-the-counter (OTC) medications or supplements, with your healthcare provider or pharmacist.
Though many can often manage type 2 diabetes with diet, exercise, and medication, other treatment options are possible. These include:
Type 2 diabetes is a chronic, progressive disease that sometimes requires medications to control blood glucose levels adequately. Combination therapy for type 2 diabetes involves using two or more medications for treatment.
There are many options for combination therapy, including oral anti-hyperglycemic (glucose-lowering) medications and basal insulin. As with any medication, side effects or drug interactions are possible, so collaborating closely with your healthcare team is essential to ensuring optimal safety.
Managing a chronic and progressive condition like type 2 diabetes can be challenging. It's essential to work closely with your healthcare provider because you may require different treatments at different stages of type 2 diabetes.
If metformin alone does not effectively regulate blood glucose levels, a combination of anti-hyperglycemic medications, such as Avandia (rosiglitazone) or basal insulin, may be prescribed alongside it.
Type 2 diabetes affects people differently, and treatment options vary depending on other diagnosed health conditions. An appropriate nutrition plan and exercise regimen might be enough for some to manage blood sugar levels effectively. Others may need medication. Work with your healthcare provider to develop a treatment plan that is best for you.
Multiple studies have shown that prescription insulin is safe to take with other medications. When insulin is combined with other anti-hyperglycemic drugs to help regulate blood glucose levels, there is a risk of hypoglycemia. It is essential to tell your healthcare provider about any medication you are taking and work with them to monitor glucose levels continually.
American Association of Clinical Endocrinologists. Comprehensive type 2 diabetes management algorithm.
American Diabetes Association. Oral medications: getting it right.
U.S. Food and Drug Administration. FDA approves novel, dual-targeted treatment for type 2 diabetes.
National Institute of Child Health and Human Development. What are the treatments for diabetes?
National Institute of Diabetes and Digestive and Kidney Diseases. Insulin, medicines, & other diabetes treatments.
By Pamela Assid, DNP, RN
Pamela Assid, DNP, RN, is a board-certified nursing specialist with over 25 years of expertise in emergency, pediatric, and leadership roles.

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