July 16, 2024
This comprehensive article provides you with a complete guide to the best medication for lowering A1C levels safely and possible complications. From metformin to insulin, you will discover the best options for blood sugar monitoring and see which medication type works best for you.


First of all, let us get you familiar with what A1C is and why it is significant to lower it. Glycated hemoglobin, commonly referred to as A1C, is a blood test used to assess your average blood sugar levels over the last 2-3 months. High A1C levels can lead to various health complications, including nerve damage, kidney disease, and vision loss.

A1C levels between 5.7 and 6.4% are characterized as pre-diabetes. People with insecure A1C levels (usually greater than 6.5%) are usually diagnosed with diabetes, whether type 1 or type 2. Fortunately, several medicines can help manage A1C levels, including lifestyle modifications, medication interventions, or both. Let’s take a closer look at the different options available.

Top 5 Medicines Proven to Lower A1C: A Comprehensive Guide

The following is an in-depth summary of the top 5 medicines for lowering A1C levels:

1. Metformin

Metformin is a standard medication for type 2 diabetes used to decrease A1C levels. Metformin works to decrease glucose production by the liver and raise insulin sensitivity in muscle cells, promoting more efficient use of glucose in the body. Generally, it is advised to take metformin with meals to prevent side effects such as stomach upset and diarrhea.

Benefits: Metformin is an effective option for individuals who require moderate A1C reduction, particularly those who are obese or have other metabolic syndrome components.

Potential side effects: Metformin can cause side effects such as gastrointestinal issues and vitamin B-12 deficiency, impacting cognitive and neurologic function.

2. Glucagon-like peptide-1 (GLP-1) receptor agonists

GLP-1 receptor agonists, approved by the FDA, are injectable medications that help decrease A1C levels by signaling beta cells in the pancreas to produce insulin and suppress glucagon levels. In addition, this medicine slows food transit in the gastrointestinal tract and may decrease appetite.

Benefits: GLP-1 receptor agonists generate weight loss and lower cardiovascular disease risk compared to other medications available.

Potential side effects: Common side effects for this class of medication include diarrhea, nausea, and vomiting. In some rare cases, an allergic reaction can occur.

3. Sodium-glucose cotransporter-2 (SGLT2) inhibitors

SGLT2 inhibitors are oral medications that prevent glucose absorption and regulate renal sodium-glucose cotransporters, resulting in lower glucose levels in the blood. These medications are commonly used in combination with other diabetes medications as they have a significant glycemic control effect.

Benefits: SGLT2 inhibitors can lower systolic blood pressure and reduce chances of heart and kidney diseases. They demonstrate a considerable reduction in A1C levels and aid in weight loss.

Potential side effects: Genital and urinary tract infections, diabetic ketoacidosis (DKA) and dehydration, and hypotension are potential side effects of SGLT2 inhibitors.

4. Dipeptidyl peptidase-4 (DPP-4) inhibitors

DPP-4 inhibitors are oral medications that enhance insulin secretion and suppress glucagon, decreasing glucose levels in the bloodstream. These medications can be used in combination with other diabetes medications or as a single therapy.

Benefits: DPP-4 inhibitors are tolerable, do not cause hypoglycemia, and improve pancreatic beta cell function in those people diagnosed with type 2 diabetes.

Potential side effects: Headaches, upper respiratory tract infections, and exerting pancreatic beta cell recovery, which could cause a need for insulin therapy, are potential side effects of DPP-4 inhibitors.

5. Insulin

Insulin is a hormone produced by the pancreas to regulate blood glucose levels. Insulin therapy is necessary for some individuals who need to supplement their insulin, leading to more sustainable blood glucose levels.

Benefits: Insulin therapy may be induced to control Type 1 or Type 2 diabetes, and it’s also helpful for those people who are diagnosed with high blood glucose after surgeries or birth.

Potential side effects: Hypoglycemia, weight gain, and injection site infections are some of the side effects associated with insulin therapy.

The Most Recommended Medicines for Reducing A1C Levels: Expert Opinion

When it comes to medications for controlling A1C levels, doctors usually focus on evidence-based models and patient characteristics. However, several medications are commonly prescribed to critical patients with a positive diagnosis of diabetes or prediabetes. The most recommended medicines for A1C control include:

  • Metformin
  • GLP-1 receptor agonists
  • SGLT2 inhibitors
  • DPP-4 inhibitors
  • Insulin

Every patient who has diabetes or prediabetes will differ depending on their biology and treatment plan. Therefore, expert advice, medication history, and patient needs need to be taken into account when selecting the first-line drug to control A1C levels.

Which Medicine is the Ultimate Solution for Lowering A1C: An In-Depth Analysis

Choosing the perfect medication to control A1C is based on the individual’s biological answer and their reaction to drug medications. Different A1C medications come with varying degrees of effectiveness, cost, accessibility, potential side effects, and other individual medication history related elements. Some factors that should be considered include:

  • Severity of diabetes
  • Side-effect profile
  • Effectiveness of medications
  • Clinical evidence-based practices
  • Cost
  • Patient-specific variations in pharmacokinetics

Based on these variables, Metformin is usually the first-line therapy for patients with type 2 diabetes, owing to its effectiveness, accessibility, and low-cost profile. If metformin fails, combination therapy or the addition of insulin may be prescribed to control blood glucose levels optimally.

A1C Lowering Medicines: From Metformin to Insulin, Which One Works Best?

There are several different categories of diabetes medication, including:

  • Biguanides, such as Metformin
  • Sulfonylureas
  • GLP-1 receptor agonists
  • SGLT2 inhibitors
  • DPP-4 inhibitors
  • Thiazolidinediones
  • Meglitinides

The effectiveness of a medication is related to many factors such as duration of diabetes, medication history, baseline A1C levels, concurrent illnesses, reliable administration, and other related medical conditions. As with all medications, effectiveness may vary depending on individual cases. However, Metformin, GLP-1 receptor agonists, and SGLT2 inhibitors have shown a significant reduction in A1C levels in most clinical studies that have been conducted.

The Best Medications to Control A1C: A Comparison Study

Several clinical studies have made head-to-head comparisons between diabetes medications to provide patients with recommendations on which medicine is the most effective. For instance, a comparison study demonstrated that GLP-1 receptor agonists helped control the patient’s A1C levels, BMI, and reduced the frequency of hypoglycemia. This was due to their capacity to increase insulin action and decrease appetite.

SGLT2 inhibitors have also shown superior results in clinical trials. In a recent study, patients were switched to the treatment of SGLT2 inhibitors from other kidney-protective medications. The result was a decrease in A1C levels, which positively affected other comorbidities such as cardiovascular disease and chronic kidney disorders.

Medicines with the Highest Success Rate in Lowering A1C: A Review of Clinical Trials

Two recent observational studies compared diabetes medications’ effectiveness in managing A1C levels, BMI, and heart disease risks. The results of these studies recommended SGLT2 inhibitors and GLP-1 receptor agonists due to their low hypoglycemic risk and effectiveness in reducing A1C levels. These studies also discovered that these classes of medications demonstrated cardiovascular-protective endpoints, making them a popular choice for patients with higher risks of heart disease.

A Holistic Approach to Reducing A1C Levels: The Top Medications to Try

The best way to control A1C levels is to opt for a more holistic approach using complementary therapies. A few holistic approaches that can be used to lower A1C levels include:

  • Sleep hygiene
  • Mindfulness-based stress reduction
  • Visual imagery
  • Counseling
  • Acupuncture

When opting for medication intervention, the following should be considered:

  • Metformin and SGLT2 inhibitors are best suited for weight-loss methods, especially in patients with additional comorbidities such as obesity and hypertension.
  • DPP-4 inhibitors are well-tolerated and preferable in patients who are concerned about hypoglycemia or weight gain.
  • If insulin therapy is needed, it is essential to choose FDA-approved rapid-acting and long-acting insulins which have a more predictable pharmacokinetic profile.
  • GLP-1 agonists are suitable for patients who cannot tolerate other agents and are associated with better cardiovascular outcomes in patients with pre-existing heart disease.


A1C levels are essential for managing and preventing diabetes-related complications. Patients should work with their healthcare providers to determine the best medication for them. The five drugs we discussed in this article, metformin, GLP-1 receptor agonists, SGLT2 inhibitors, DPP-4 inhibitors, and insulin are all effective in controlling blood glucose levels. Patients should be aware of their particular preferences, cost, and concurrent comorbidities to select the ultimate medication for their needs.

Lowering A1C should be approached holistically and ideally include complementary therapies, medication interventions, or both. With the collaboration of healthcare practitioners and patients, it’s no longer impossible to manage and prevent diabetes-related complications effectively.

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