Metformin vs Other Drugs: How It Compares to Common Diabetes Treatments

When it comes to managing type 2 diabetes, metformin, a first-line oral medication that lowers blood sugar by reducing liver glucose production and improving insulin sensitivity. Also known as Glucophage, it’s been the go-to starting point for millions of patients for over 60 years. But it’s not the only option. Today, doctors have a whole toolbox of drugs — from insulin injections to newer pills and injectables — each with different ways of working, side effects, and costs. So why does metformin still lead the pack? And when might another drug be a better fit?

Insulin, a hormone that directly lowers blood sugar by helping cells absorb glucose. Also known as human insulin or analogs like Lantus or Humalog, it’s powerful but requires careful dosing and carries a higher risk of low blood sugar. Unlike metformin, insulin doesn’t help with weight loss — in fact, many gain weight on it. Then there are sulfonylureas, older pills that force the pancreas to pump out more insulin. Also known as glipizide or glyburide, they’re cheap but can cause hypoglycemia and weight gain, making them less ideal for long-term use. Meanwhile, newer drugs like GLP-1 agonists, injectables like semaglutide that slow digestion, reduce appetite, and boost insulin only when needed. Also known as Ozempic or Wegovy, they’re effective for weight loss and heart protection but cost much more and need injections. Metformin doesn’t cause weight gain, rarely causes low blood sugar on its own, and has been linked to lower cancer risk and longer life in some studies. It’s not perfect — stomach upset is common at first, and it’s not safe for people with severe kidney problems — but for most, it’s the safest, cheapest, and most studied option.

What you’ll find in the articles below aren’t just comparisons — they’re real-world breakdowns of how metformin stacks up against other treatments, what side effects to expect, and how newer drugs are changing the game. You’ll see how metformin compares to drugs like sitagliptin, pioglitazone, and even newer agents that target not just blood sugar, but heart health and weight. Whether you’re newly diagnosed, switching meds, or just trying to understand why your doctor picked metformin, this collection gives you the facts without the fluff.