Healthy lifestyle choices — including diet, exercise and weight control — provide the foundation for managing type 2 diabetes. However, you may need medications to achieve target blood sugar (glucose) levels. Sometimes a single medication is effective. In other cases, a combination of medications works better.

The list of medications for type 2 diabetes is long and potentially confusing. Learning about these drugs — how they're taken, what they do and what side effects they may cause — will help you discuss treatment options with your doctor.

Several classes of type 2 diabetes medicines exist. Each works in different ways to lower blood sugar. A drug may work by:

  • Stimulating the pancreas to produce and release more insulin
  • Inhibiting the production and release of glucose from the liver
  • Blocking the action of stomach enzymes that break down carbohydrates
  • Improving the sensitivity of cells to insulin

Each class of medicine has one or more drugs. Some of these drugs are taken orally, while others must be injected. And some type 2 diabetes pills contain a combination of two classes of drugs.

Here's an at-a-glance comparison of common diabetes medications. More medications are available depending on your needs and situation. Ask your doctor about your options and the pros and cons of each.

Oral medications
Medications Action Advantages Possible side effects
Meglitinides
  • Repaglinide (Prandin)
  • Nateglinide (Starlix)
Stimulate the release of insulin Work quickly Severely low blood sugar (hypoglycemia); weight gain; nausea; back pain; headache
Sulfonylureas
  • Glipizide (Glucotrol)
  • Glimepiride (Amaryl)
  • Glyburide (DiaBeta, Glynase)
Stimulate the release of insulin Work quickly Hypoglycemia; weight gain; nausea; skin rash
Dipeptidy peptidase-4 (DPP-4) inhibitors
  • Saxagliptin (Onglyza)
  • Sitagliptin (Januvia)
  • Linagliptin (Tradjenta)
Stimulate the release of insulin; inhibit the release of glucose from the liver Don't cause weight gain Upper respiratory tract infection; sore throat; headache; inflammation of the pancreas (sitagliptin)
Biguanides
  • Metformin (Fortamet, Glucophage, others)
Inhibit the release of glucose from the liver; improve sensitivity to insulin May promote modest weight loss and modest decline in low-density lipoprotein (LDL), or "bad," cholesterol Nausea; diarrhea; rarely, the harmful buildup of lactic acid (lactic acidosis)
Thiazolidinediones
  • Rosiglitazone (Avandia)
  • Pioglitazone (Actos)
Improve sensitivity to insulin; inhibit the release of glucose from the liver May slightly increase high-density lipoprotein (HDL), or "good," cholesterol Heart failure; heart attack; stroke; liver disease
Alpha-glucosidase inhibitors
  • Acarbose (Precose)
  • Miglitol (Glyset)
Slow the breakdown of starches and some sugars Don't cause weight gain Stomach pain; gas; diarrhea
Injectable medications
Medications Action Advantages Possible side effects
Amylin mimetics
  • Pramlintide (Symlin)
Stimulate the release of insulin; used with insulin injections May suppress hunger; may promote modest weight loss Hypoglycemia; nausea or vomiting; headache; redness and irritation at injection site
Incretin mimetics
  • Exenatide (Byetta)
  • Liraglutide (Victoza)
Stimulate the release of insulin; used with metformin and sulfonylurea May suppress hunger; may  promote modest weight loss Nausea or vomiting; headache; dizziness; kidney damage or failure

No single diabetes treatment is best for everyone, and what works for one person may not work for another. Your doctor can determine how a specific medication or multiple medications may fit into your overall diabetes treatment plan and help you understand the advantages and disadvantages of specific diabetes drugs.

Oct. 22, 2011