One ergot alkaloid, bromocriptine (Cycloset®) is approved for treating type 2 diabetes. Bromocriptine is actually an older medication that has been used for quite some time for other uses, although it was only recently approved for treating diabetes.
Bromocriptine works uniquely, compared to other diabetes medications. It works as a dopamine receptor agonist, which means that it binds to and stimulates dopamine receptors. It is thought that stimulating dopamine receptors in the brain at certain times of the day "resets" the biological clock and improves metabolism. It is thought that seasonal changes in the metabolism of wild animals are due to similar mechanisms.
Sodium-Glucose Co-Transporter 2 InhibitorsSGLT2 inhibitors work by causing glucose to be lost from the bloodstream into the urine. There are three approved medications in this class: Invokana® (canagliflozin), Farxiga™ (dapagliflozin), and Jardiance® (empagliflozin). These medications tend to lower blood pressure and cause a small amount of weight loss, which can often be desirable effects in people with type 2 diabetes.
Bile Acid SequestrantsOften overlooked as a diabetes drug, Welchol® (colesevelam) is a bile acid sequestrant that was initially approved for treating high cholesterol but was later approved for treating type 2 diabetes. It helps to lower both blood sugar and cholesterol levels, which can be very useful in many people with diabetes. The downside is that the usual dosage involves taking six tablets a day. It can also bind with (and therefore interact with) some other drugs.
There are a variety of combination medications available, including:
- Alogliptin and metformin (Kazano®)
- Alogliptin and pioglitazone (Oseni®)
- Glipizide and metformin (Metaglip®)
- Glyburide and metformin (Glucovance®)
- Linagliptin and metformin (Jentadueto®)
- Pioglitazone and glimepiride (Duetact®)
- Pioglitazone and metformin (Actoplus Met®, Actoplus Met XR)
- Repaglinide and metformin (PrandiMet®)
- Rosiglitazone and glimepiride (Avandaryl®)
- Rosiglitazone and metformin (Avandamet®)
- Sitagliptin and metformin (Janumet®)
- Sitagliptin and metformin XR (Janumet® XR)
- Saxagliptin and metformin (Kombiglyze™ XR)
- Sitagliptin and simvastatin (Juvisync®), which is no longer available.