Many people feel worried when the doctor says, “Let us start a tablet.” Some think it means the disease is serious, and some think tablets are bad for the kidneys. Let me clear these fears with simple facts.
Metformin: the usual first choice
Metformin helps the body respond better to its own insulin and lowers the sugar made by the liver. It has been used for decades, is cheap, and rarely causes low sugar by itself. Some people get stomach upset or loose motions at first. Taking it with food, or using a slow-release form, often helps. It is not harmful to healthy kidneys, but your doctor checks kidney tests before and during use.
Other common tablets
- Sulfonylureas (like glimepiride, gliclazide): make the pancreas release more insulin. They can cause low sugar if meals are skipped.
- DPP-4 inhibitors (like sitagliptin, vildagliptin, teneligliptin): gentle medicines that raise the body’s own helpful hormones after meals. Low sugar risk is small.
- SGLT2 inhibitors (like dapagliflozin, empagliflozin): help the kidneys pass extra sugar in urine. They can also protect the heart and kidneys in selected people.
- Pioglitazone: improves insulin action but may cause swelling and weight gain. It is not for everyone.
- Alpha-glucosidase inhibitors (like acarbose): slow digestion of starch.
Common myths
- “Tablets damage the kidney.” Poorly controlled sugar damages the kidney far more than properly chosen tablets.
- “Once I start, I can never stop.” Medicine needs change with time, weight and lifestyle. Your doctor reviews it.
- “Natural remedies can replace tablets.” Please do not stop prescribed medicines for herbal products without speaking to your doctor.
How to take medicines safely
Take them at the same time every day. Do not double a missed dose. Carry a list of your medicines. Tell your doctor about any new medicine, including herbal ones. Check HbA1c every three months at first, and get kidney and liver tests as advised.
The big picture
Medicines are tools, not punishments. The best results come when tablets, food and walking all work together.
If you live in Gopanpally, Gowlidoddi, Nallagandla or Tellapur, or work in the Financial District or Nanakramguda, a simple blood sugar check is available at our clinic in Gopanpally, Gachibowli. You can read more about our diabetes care or contact us to book a visit.
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Your family doctor,
Akhila Reddy
MBBS, DNB (Family Medicine) | TSMC Reg. No. APMC/FMR/74261
AMC Hospital, Gopanpally, Gachibowli, Hyderabad
This article is for general health education and does not replace a check-up. Every person is different, so please speak to your doctor before changing any medicine. In an emergency, call 108 or go to the nearest hospital.
References
- American Diabetes Association. Pharmacologic Approaches to Glycemic Treatment: Standards of Care in Diabetes-2025. Diabetes Care 2025;48(Suppl 1). https://diabetesjournals.org/care/issue/48/Supplement_1
- UK Prospective Diabetes Study Group. Effect of intensive blood-glucose control with metformin (UKPDS 34). Lancet 1998;352:854-865.
- World Health Organization. Diabetes fact sheet. https://www.who.int/news-room/fact-sheets/detail/diabetes