Diabetes medications, including not only insulin or other medications obtained by injection or pump, but also some medications that can be taken orally as pills or inhaled.
The doctor will consider exactly which medications are needed, which may include more than one type of diabetes medication. The goal of treatment is to achieve optimal blood glucose control, and oral medications can achieve this in many ways.
Acarbose
Mechanism: Blocking the enzymes that help digest starch slows the rise in blood sugar. This drug belongs to a group of drugs called “alpha-glucosidase inhibitors. Side effects of these drugs include stomach upset (gas, diarrhea, nausea, cramps).
Alogliptin
Alogliptin
Mechanism: It raises insulin levels when blood sugar is too high and tells the liver to reduce sugar synthesis. Doctors may call this drug a “dipeptidyl peptidase-4 (DPP-4) inhibitor. These drugs do not cause weight gain and can be taken alone or together with other drugs, such as metformin.
Bromocriptine
Mechanism: This drug elevates levels of dopamine, a chemical in the brain. In combination with diet and exercise, this drug is approved to improve blood sugar control in adults with type 2 diabetes. This drug is not used to treat type 1 diabetes.
Carboglitazone
Mechanism: Increases the amount of glucose excreted in the urine and prevents the kidneys from reabsorbing glucose. Doctors call this drug a “sodium-glucose co-transport protein 2 (SGLT2) inhibitor”. Side effects may include:
- Vaginal yeast infections;
- Urinary tract infections;
- Dizziness and fainting;
- Ketoacidosis or ketosis;
- Increased risk of fracture;
- Decreased bone mineral density.
Chlorosulfonylurea
Mechanism: It lowers blood sugar by causing the pancreas to release more insulin. Doctors may refer to this drug as a “sulfonylurea. This drug is not used as often as the newer sulfonylureas. Side effects of sulfonylureas may include:
- Low blood sugar;
- stomach upset;
- Rash or itching;
- weight gain.
Colesevelam
Mechanism: Reduces “bad” low-density lipoprotein (LDL) cholesterol and improves blood sugar control in adults with type 2 diabetes. Doctors would call this drug a “bile acid chelator.
Dagliflozin
Dagliflozin
Mechanism: Increases the amount of glucose excreted in the urine and prevents the kidneys from reabsorbing glucose. Doctors call this drug an “SGLT2 inhibitor”.
Engelepine
Mechanism: Increases the amount of glucose excreted in the urine and prevents the kidneys from reabsorbing glucose. Doctors call this drug an “SGLT2 inhibitor”.
Glimepiride
Mechanism: It lowers blood sugar by making the pancreas release more insulin. Doctors call this medication a “sulfonylurea”. Side effects of sulfonylureas may include:
- Low blood sugar;
- stomach upset;
- Rash or itching;
- weight gain.
Glipizide
Mechanism: It lowers blood sugar by causing the pancreas to release more insulin. Doctors call this drug a “sulfonylurea. Side effects of sulfonylureas may include:
- Low blood sugar;
- Stomach upset;
- Rash or itching;
- weight gain.
Glibenclamide
Mechanism: It lowers blood sugar by causing the pancreas to release more insulin. Doctors call this medication a “sulfonylurea”. Side effects of sulfonylureas may include:
- Low blood sugar;
- stomach upset;
- Rash or itching;
- weight gain.
Inhaled insulin
How to use: Place a cartridge containing one dose of this powdered rapid-acting insulin into an inhaler and use it before a meal or shortly after you have just started eating.
Mechanism of action: Insulin rapidly passes from the lung cells into the bloodstream. It is not a substitute for long-acting insulin (it cannot be inhaled). This medicine should not be used if you have long-term lung disease, such as asthma or chronic obstructive pulmonary disease (COPD), or if you smoke. This medicine is not recommended for the treatment of diabetic ketoacidosis.
Ligliptin
Mechanism: It raises insulin levels when blood sugar is too high and tells the liver to reduce sugar synthesis. Doctors call this drug a “DPP-4 inhibitor”. These drugs do not cause weight gain. They can be taken alone or with other drugs, such as metformin.
Metformin
Metformin
Mechanism: Improves the ability of insulin to transfer sugar into cells (especially muscle cells) and also stops the liver from releasing stored sugar. They should not be used if you have kidney damage or heart failure. Doctors call these drugs “biguanides”. Side effects of biguanides include:
- Stomach upset (nausea, diarrhea);
- A metallic taste in your mouth.
Miglitol
Mechanism: Blocking the enzymes that help digest starch, which slows the rise in blood sugar. This drug is part of a group of drugs that doctors call “alpha-glucosidase inhibitors.” Side effects of alpha-glucosidase inhibitors include stomach upset (gas, diarrhea, nausea, cramps).
Naglinide
Mechanism: It causes the pancreas to release more insulin, but only when blood sugar levels are too high. Doctors call these drugs “glinides”. Side effects of glinides may include:
- Low blood sugar;
- Stomach upset.
- Stomach upset.
Pioglitazone
Mechanism of action: Helps insulin work better in muscle and fat. The drug reduces the amount of sugar released by the liver and makes fat cells more sensitive to the effects of insulin. It may take several weeks for these drugs to lower blood sugar. Doctors will discuss the heart risks of this drug (called a “thiazolidinedione”) with patients. The side effects of these drugs are relatively rare and may include:
- Hepatic enzyme levels that are higher than normal;
- hepatic failure;
- Respiratory tract infections;
- Headache;
- Fluid retention.
Riglitazone
Mechanism: It causes the pancreas to release more insulin, but only when blood sugar levels are too high. Doctors call these drugs “biguanides”. Side effects of these drugs include:
- Low blood sugar;
- Stomach upset.
- Stomach upset.
Rosiglitazone
Mechanism of action: Helps insulin work better in muscle and fat. The drug reduces the amount of sugar released by the liver and makes fat cells more sensitive to the effects of insulin. Such drugs may take several weeks to lower blood sugar. Doctors will discuss the heart risks of this drug (which may be called a “thiazolidinedione”) with patients. Side effects of thiazolidinediones are relatively rare and may include:
- Hepatic enzyme levels above normal;
- hepatic failure;
- Respiratory tract infections;
- Headache;
- Fluid retention.
Saxagliptin
Mechanism: It raises insulin levels when blood sugar is too high and tells the liver to reduce sugar synthesis. Doctors call this drug a “DPP-4 inhibitor”. These drugs do not cause weight gain. They can be taken alone or with other drugs, such as metformin.
Selegiline
Selegiline
Mechanism: It raises insulin levels when blood sugar is too high and tells the liver to reduce sugar synthesis. Doctors call this drug a “DPP-4 inhibitor”. These drugs do not cause weight gain. They can be taken alone or with other drugs, such as metformin.
Tolazamide
Tolazamide
Mechanism: It lowers blood sugar by making the pancreas release more insulin. Doctors may refer to this drug as a “sulfonylurea. This drug is not used as often as the newer sulfonylureas. Side effects of these drugs include:
- Low blood sugar;
- stomach upset;
- Rash or itching;
- weight gain.
Toluenesulfonylurea
Mechanism: It lowers blood sugar by causing the pancreas to release more insulin. Doctors call this drug a “sulfonylurea. It is not used as often as the newer sulfonylureas. Side effects of these drugs include:
- Low blood sugar;
- stomach upset;
- Rash or itching;
- weight gain.
Compounded medications
Several diabetes medications combine two medications into one; these medications include:
- Alogliptin/metformin;
- Alogliptin/pioglitazone;
- Daglitazone/Metformin;
- Engliptin/Ligliptin;
- Engliptin/Metformin;
- Glipizide/Metformin;
- Glibenclamide/Metformin;
- Ligliptin/Metformin;
- pioglitazone/glimepiride;
- Riglitazone/Metformin;
- Rosiglitazone/Glimepiride;
- Roglitazone/Metformin;
- Saxagliptin/Metformin;
- Sektagliptin/Metformin.