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Type 2 Diabetes: Oral Medications to Treat Diabetes

Overview of Oral Diabetes Medications

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Updated November 21, 2008

Type 2 Diabetes: Oral Medications to Treat Diabetes
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Why Treat Your Diabetes?

If your blood sugar stays high for a long time, you may have a higher chance of diabetes complications such as heart attack, stroke, kidney damage, blindness, and amputations. Keeping your blood sugar at a good level might lower your chance of these problems.

How is Type 2 Diabetes Treated?

The first step in controlling your blood sugar is to eat a balanced diet and exercise. Even small changes can make a big difference. You may also need to take medication to help keep your blood sugar under control.

Quick facts about diabetes pills:

  • Different kinds of diabetes pills work in different ways to control your blood sugar (blood glucose).
  • Combining two different kinds of diabetes pills can work better to lower your blood sugar than a single medicine.
  • But combining two kinds of diabetes pills can make it more likely that your blood sugar will drop too low (hypoglycemia).
  • Most diabetes pills can cause weight gain. One kind, metformin (Glucophage), does not make you gain weight.

What Oral Medications Are Available to Treat Diabetes?

There are seven classes of oral medications for the treatment of type 2 diabetes as well as combinations of drugs from different classes:

Sulfonylureas
Sulfonylureas stimulate your pancreas to make more insulin, which helps lower your blood glucose. Available sulfonylureas include:

  • Amaryl (glimepiride)
  • DiaBeta (glyburide)
  • Diabinese (chlorpropamide)
  • Glucotrol (glipizide)
  • Glucotrol XL (glipizide long-acting)
  • Glynase (glyburide)
  • Micronase (glyburide)
  • tolazamide
  • tolbutamide

Possible side effects of the sulfonylureas are:

  • low blood glucose
  • upset stomach
  • skin rash
  • weight gain

Biguanides
Biguanides lower the amount of glucose made by your liver. Available biguanides include:

  • Glucophage (metformin)
  • Glucophage XR (metformin long-acting)
  • Riomet (metformin liquid)

Possible side effects of the biguanides are:

  • nausea, diarrhea, or an upset stomach when you first start taking this type of medicine – these side effects are likely to go away after a while
  • rarely, a serious condition called lactic acidosis

Alpha-Glucosidase Inhibitors
Alpha-glucosidase inhibitors work by slowing down the digestion of foods high in carbohydrate, such as rice, potatoes, bread, milk, and fruit. Available alpha-glucosidase inhibitors include:

  • Glyset (miglitol)
  • Precose (acarbose)

Possible side effects of the alpha-glucosidase inhibitors are:

  • stomach pain, gas, bloating, or diarrhea – these symptoms usually go away after you have taken these pills for a while

Thiazolidinediones
Thiazolidinediones make you more sensitive to insulin. Available thiazolidinediones include:

  • Actos (pioglitazone)
  • Avandia (rosiglitazone)
If you have heart failure, you should not take this type of pill. This type of pill can cause congestive heart failure or make it worse. Studies have shown that Avandia is associated with an increased risk for heart attacks and chest pain or discomfort from blocked blood vessels.

Possible side effects of the thiazolidinediones are:

  • congestive heart failure is the most serious side effect
  • anemia
  • an increased risk of getting pregnant even if you’re taking birth control pills
  • increased risk of bone fracture in women

Meglitinides
Meglitinides stimulate your pancreas to make more insulin. The only available meglitinide is:

  • Prandin (repaglinide)

Possible side effects of Prandin are:

  • low blood glucose
  • weight gain
  • upset stomach
  • back pain or a headache

D-phenylalanine Derivatives
D-phenylalanine derivatives help your pancreas make more insulin quickly for a short period of time right after meals. The only available D-phenylalanine derivative is:

  • Starlix (nateglinide)

Possible side effects of Starlix are:

  • low blood glucose
  • weight gain
  • dizziness

DPP-IV Inhibitors
DPP-IV Inhibitors lower your blood glucose by helping your body make more insulin when it’s needed, especially right after meals. It also helps keep your liver from putting stored glucose into your blood. The only available DPP-IV Inhibitor is:

  • Januvia (sitagliptin)

Possible side effects of Januvia are:

  • runny nose
  • sore throat
  • headache

Combination Diabetes Pills
Combination pills contain two different types of diabetes pills. Several combination pills are available, including:

Actoplus Met is a combination of Actos (pioglitazone) and Glucophage (metformin) – one pill lowers the amount of glucose made by your liver. Both types help your insulin work the way it should.

Avandamet is a combination of Avandia (rosiglitazone) and Glucophage (metformin) – one pill lowers the amount of glucose made by your liver. Both types help your insulin work the way it should.

Avandaryl is a combination of Avandia (rosiglitazone) and Amaryl (glimepiride) – one pill helps your insulin work the way it should. The other pill helps your body make more insulin.

Duetact is a combination of Actos (pioglitazone) and Amaryl (glimepiride) – one pill helps your insulin work the way it should. The other pill helps your body make more insulin.

Glucovance is a combination of Glucophage (metformin) and Micronase (glyburide) – one pill helps your body make more insulin. The other pill lowers the amount of glucose made by your liver and helps your insulin work the way it should.

Janumet is a combination of Januvia (sitagliptin) and Glucophage (metformin) – one pill helps your body make more insulin when it’s needed, especially right after meals. It also helps keep your liver from putting stored glucose into your blood. The other pill lowers the amount of glucose made by your liver and helps your insulin work the way it should.

Metaglip is a combination of Glucotrol (glipizide) and Glucophage (metformin) – one pill helps your body make more insulin. The other pill lowers the amount of glucose made by your liver and helps your insulin work the way it should.

Which Oral Diabetes medication Should I Take?

Because of the large number of medications available to treat type 2 diabetes, you may be confused about which medication is best for you.

Your doctor will work with you to pick the most appropriate diabetes drug or combination of drugs depending on your individual circumstances, including how well your diabetes is controlled and if you exercise and eat a proper diet.

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