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
ClassGeneric NameBrand NameCommentsHow
SulfonylureasChlorpropamide
first-generation
DiabineseUse with caution in the elderly. May cause lowsWith meal
Tolazamide
first-generation
TolinaseMay cause lowsWith 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 lows30 minutes before a meal
Glimepiride
third-generation
AmarylTake 1 time a day. May cause lowsWith meal
BiguanidesMetforminGlucophageNot used with congestive heart, renal or liver problems. Check creatinine clearance if over 65 years of age.With meal
Alpha-Glucosidase InhibitorsAcarbose
Miglitol
Precose
Glyset
May have side effects in the gastrointestinal
tract.
With first bite of food
ThiazolidinedionesRosiglitazone
Pioglitazone
Avandia
Actos
May reduce the effectiveness of birth control pills.
Check liver enzymes as directed.
Take at same time each day
MeglitinidesRepaglinidePrandinTake with each meal. May cause lowsBefore meals
DPP-4 InhibitorsLinagliptinTradjentaOnce a dayWith or without food
SitagliptinJanuviaOnce a dayWith or without food
SaxagliptinOnglyzaOnce a dayWith food
VildagliptinGalvusOnce a day
GLP-1 AgonistExenatideByettaTwice dailyInjections
SGL2 InhibitorsCanagliflozinInvokanaTake 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.