Oral Diabetes Medications Summary Chart

What Oral Medications Are Available for Type 2 Diabetes?
Type 2 diabetes results when the body is unable to produce the amount of insulin it needs to convert food into energy or when it is unable to use insulin appropriately. Sometimes the body is actually producing more insulin than is needed by a person to keep blood glucose in a normal range. Yet blood glucose remains high, because the body's cells are resistant to the effects of insulin. Physicians and scientists believe that type 2 diabetes is caused by many factors, including insufficient insulin and insulin resistance. They increasingly believe that the relative contribution each factor makes toward causing diabetes varies from person to person.

It is important to know the name of your diabetes medicine (or medicines), how it is taken, the reasons for taking it and possible side-effects.

MED GROUP DESCRIPTOR
Drug Class

DRUG NAME

ACTION

SIDE EFFECTS

Notes

DOSING

FREQUENCY/DAY

INSULIN SECRETAGOGUES

Sulfonylureas*

MICRONASE*

(glyburide)

DIABETA*

(glyburide)

Action: Stimulates pancreas to release more insulin right after a meal and then over many hours

Side effects: Potential for hypoglycemia

1–2 times/day

Take with meals

to avoid hypoglycemia

GLYNASE PRESTABS*
(micronized glyburide)

1–2 times/day

With meals

GLUCOTROL*

(glipizide)

1–2 times/day

30 minutes pre-meal

GLUCOTROL XL*

(glipizide extended release)

1–2 times/day

With meals

AMARYL*

(glimepiride)

1 time/day

With meals

Meglitinides*

PRANDIN*

(repaglinide)

Action: Stimulates pancreas to release more insulin right after a meal

Side effects: Potential for hypoglycemia

2–4 times/day,

0–30 min pre meals

Skip meal, skip dose

Add meal, add dose to total of 4 doses/day

D-Phenylalanine Derivative*

STARLIX*

(nateglinide)

Action: Stimulates insulin production.

Side effects: Potential for hypoglycemia

1–3 times/day,

0–30 min pre meals

Skip meal, skip dose

GLUCOSE SUPPRESSORS

Biguanides

GLUCOPHAGE

(metformin)

Action: Reduces the amount of glucose the liver releases between meals

Side effects: Gas, diarrhea, upset stomach, . nausea, abdominal pain

In rare cases, lactic acidosis may occur in people with abnormal liver or kidney function

Notes: Take with food to decrease gas, diarrhea

2–4 times/day

Take with meals to avoid stomach

upset

GLUCOPHAGE XR

(metformin sustained release)

1–2 times/day

With meals

FORTAMET

(metformin extended release)

1 time/day

With meals

GLUMETZA

(metformin extended release)

1 time/day

With meals

RIOMET

(metformin oral solution)

2–3 times/day

With meals

MED GROUP DESCRIPTOR
Drug Class

DRUG NAME

ACTION

SIDE EFFECTS

Notes

DOSING

FREQUENCY/DAY

INSULIN SENSITIZERS

Thiazolidinediones

AVANDIA

(rosiglitazone)

Action (both): makes body more sensitive to effects of insulin.

Side effects (both): Weight gain, fluid retention, osteopenia, increase in congestive heart failure in those at risk.

Talk with your healthcare provider and have your liver function test done at recommended intervals.

Contact your healthcare provider if you have the following symptoms:

nausea, vomiting, fatigue, loss of appetite, shortness of breath, severe edema or dark urine.

Notes (rosiglitazone):

· May cause myocardial ischemia in some patients

1–2 times/day

Same time daily

ACTOS

(pioglitazone)

1 time/day

Same time daily

DPP-4 INHIBITORS

JANUVIA

(sitagliptin phosphate)

Action: Improves the level of the body’s insulin after a meal and lowers the amount of glucose made by your body.

Side effects: stuffy nose, sore throat, occasional diarrhea and stomach discomfort.

1 time/day unrelated to food Same time daily

STARCH BLOCKERS

Alpha-Glucosidase Inhibitors

GLYSET

(Miglitol)

Action: Delays absorption and breakdown of carbohydrates from intestines

Side effects: Gas, diarrhea, stomach upset.

3 times/day

With first bite of meal

Precose

(Acarbose)

3 times/day

With first bite of meal

MED GROUP DESCRIPTOR
Drug Class

DRUG NAME

ACTION

SIDE EFFECTS

Notes

DOSING

FREQUENCY/DAY

FIXED COMBINATIONS

GLUCOVANCE*

(glyburide and metformin)

Check with your doctor about taking any of these.

Combines the action of each pill used in the combination. May decrease the number of pills you need to take

1–2 times/day

With meals

METAGLIP*

(glipizide and metformin)

1–2 times/day

With meals

AVANDAMET

(rosiglitazone and metformin)

1–2 times/day

With meals

ACTOPLUS MET

(pioglitazone and metformin)

1–2 times/day

With meals

AVANDARYL*

(rosiglitazone and glimepiride)

1 time/day

With first meal

DUETACT (pioglitazone and glimepride)

1 time/day before first meal

JANUMET (sitagliptin and metformin)

2 times/ day, taken with food

Other drugs are on the horizon as well, as scientists work to improve the variety of medications to treat type 2 diabetes. Frequently physicians will prescribe one type of oral medication and discover it isn't really helping to control blood glucose that much. In the past, this would have meant that the patient would likely be put on insulin. Now, physicians can try another type of medication to see if it helps correct problems. Physicians often notice that a particular medication works well for a period of time and then begins to work less well for a patient. Now they can mix and match medications that work on different aspects of the diabetes problem to see if that will improve blood glucose control.

Find more information about oral medications in The Joslin Guide to Diabetes available from Joslin’s Online Store.