Sensitizers (metformin) are used to treat insulin resistance. In people with type 2 diabetes, due to being overweight, they have insulin resistance i.e. the body's cells are resistant to insulin, and therefore insulin cannot work effectively. Metformin assists by reducing insulin resistance at the insulin receptors on the body's cells, thereby allowing the insulin that the body produces to activate the insulin receptors thereby allowing insulin to work effectively and lower blood glucose levels.
Secretagogues: (Sulphonylureas are the most commonly used tablets) These are used to stimulate (kick start) the pancreas (beta-cells) to make more and release more insulin thereby increasing the amount of insulin circulating and thus lowering blood glucose levels.
SGLT2-inhibitors (SGLT2-i): these are oral tablets that act directly on the kidneys. They inhibit the reabsorption of glucose from the blood circulating in the kidneys back into the blood circulating in the body, thereby reducing blood glucose levels. The excess glucose from the blood is then passed out of the urine. SGLT2i’s have a weight loss benefit, they have been proven to have significant protective effects on the kidneys, and have no hypoglycaemic risk as they do not have any effect on insulin levels