Medications you take by mouth

Meglitinides

Medications

• Repaglinide
• Nateglinide

Action

• Trigger the release of insulin from the pancreas

Advantages

• Work quickly

Possible side effects

• Blood sugar levels drop too low — a condition called hypoglycemia
• Weight gain

Sulfonylureas

Medications

• Glipizide (Glucotrol XL)
• Glimepiride (Amaryl)
• Glyburide (DiaBeta, Glynase)

Action

• Trigger the release of insulin from the pancreas

Advantages

• Low cost
• Effective in lowering blood sugar

Possible side effects

• Blood sugar levels drop too low
• Weight gain
• Skin rash
• Nausea or vomiting if you drink alcohol

Dipeptidyl-peptidase 4 (DPP-4) inhibitors

Medications

• Saxagliptin (Onglyza)
• Sitagliptin (Januvia)
• Linagliptin (Tradjenta)
• Alogliptin (Nesina)

Action

• Cause the release of insulin when blood sugar is rising
• Limit the liver's ability to release glucose

Advantages

• Don't cause weight gain
• Don't cause blood sugar levels to drop too low when used alone or with metformin

Possible side effects

• Upper respiratory tract infection
• Sore throat
• Headache

Biguanides

Medications

• Metformin (Fortamet, Glumetza, others)

Action

• Limit the liver's ability to release sugar
• Improve cells' sensitivity to insulin

Advantages

• Very effective
• May lead to minor weight loss
• Low cost

Possible side effects

• Nausea
• Stomach pain
• Diarrhea
• Very rarely, the harmful buildup of lactic acid — a condition called lactic acidosis —in people with kidney failure or liver failure

Thiazolidinediones

Medications

• Rosiglitazone (Avandia)
• Pioglitazone (Actos)

Action

• Improve cells' sensitivity to insulin
• Limit the liver's ability to make and release sugar

Advantages

• May slightly increase high-density lipoprotein (HDL) cholesterol, the "good" cholesterol

Possible side effects

• Weight gain
• Fluid retention
• Increased risk of broken bones
• Increased risk of heart problems, including heart failure
• Possible increased risk of bladder cancer with pioglitazone

People with liver problems or a history of heart failure shouldn't take this kind of diabetes medicine.

Alpha-glucosidase inhibitors

Medications

• Acarbose
• Miglitol (Glyset)

Action

• Slow the body's ability to breakdown starches and some sugars

Advantages

• Don't cause weight gain
• Don't cause blood sugar levels to drop too low unless you take them with insulin or a sulfonylurea

Possible side effects

• Gas
• Stomach pain
• Diarrhea

Sodium-glucose transporter 2 (SGLT2) inhibitors

Medications

• Canagliflozin (Invokana)
• Dapagliflozin (Farxiga)
• Empagliflozin (Jardiance)
• Ertugliflozin (Steglatro)

Action

• Limit the kidneys' ability to take in sugar, which increases the amount of sugar that leaves the body in urine

Advantages

• May lead to weight loss
• May lower blood pressure

Possible side effects

• Urinary tract infections
• Yeast infections

Bile acid sequestrants

Medications

• Colesevelam (Welchol)

Action

• Lower cholesterol and have a small effect in lowering blood sugar when used with other diabetes medications

Advantages

• Likely safe for people with liver problems

Possible side effects

• Gas
• Constipation
• Indigestion
• Rise in blood fats called triglycerides