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.