Diabetes and Medications

There are many classes of oral diabetes medications, all of which help in lowering blood glucose levels. These different classes of diabetes medications can be used in combination or with insulin to achieve control of the blood sugar.

Classes and actions of medications:

  • Sulfonylureas stimulate the pancreas to make more insulin. The second- and third-generation ones are the best.
  • Biguanides shut off the liver’s excess glucose production
  • Alpha-glucosidase Inhibitors slow absorption of carbs in the intestine
  • Thiazolidinediones increase the body’s sensitivity to insulin
  • Meglitinides stimulate the pancreas to make more insulin
  • DPP-4 Inhibitors help increase insulin release after meals and when glucose levels are high
  • GLP-1 Agonist lowers both glucagon and glucose levels
  • SGL2 Inhibitors causes glucose to be excreted in the urine
Class Generic Name Brand Name Comments How
Sulfonylureas Chlorpropamide
first-generation
Diabinese Use with caution in the elderly. May cause lows With meal
Tolazamide
first-generation
Tolinase May cause lows With meal
Glyburide
second-
generation
Micronase
Diabeta
Glynase Pres Tab
Take 1 to 2 times a day.
May cause lows
With meal
Glipizide
second-
generation
Glucotrol
Glucotrol XL
Take 2 times a day or once with (XL). May cause lows 30 minutes before a meal
Glimepiride
third-generation
Amaryl Take 1 time a day. May cause lows With meal
Biguanides Metformin Glucophage Not used with congestive heart, renal or liver problems. Check creatinine clearance if over 65 years of age. With meal
Alpha-Glucosidase Inhibitors Acarbose
Miglitol
Precose
Glyset
May have side effects in the gastrointestinal
tract.
With first bite of food
Thiazolidinediones Rosiglitazone
Pioglitazone
Avandia
Actos
May reduce the effectiveness of birth control pills.
Check liver enzymes as directed.
Take at same time each day
Meglitinides Repaglinide Prandin Take with each meal. May cause lows Before meals
DPP-4 Inhibitors Linagliptin Tradjenta Once a day With or without food
Sitagliptin Januvia Once a day With or without food
Saxagliptin Onglyza Once a day With food
Vildagliptin Galvus Once a day
GLP-1 Agonist Exenatide Byetta Twice daily Injections
SGL2 Inhibitors Canagliflozin Invokana Take 1 pill a day

These medications along with a balanced diet and exercise plan help control blood glucose levels. Medications should be taken at the same time each day or as directed by a health care provider.