Alpha Glucosidase Inhibitors
These diabetes medications prevent the breakdown of sugar and carbohydrates in the digestive tract, slowing their absorption. These medications are used to decrease blood sugar levels after meals. These medications include:
Other Dipeptidyl Peptidase Inhibitors
Besides Januvia, there are three other medications in this class: saxagliptin (Onglyza®), linagliptin (Tradjenta®), and alogliptin (Nesina®). These drugs increase incretin levels in the body. Incretin is a hormone that helps to control blood sugar.
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 two approved medications in this class: Invokana® (canagliflozin) and Farxiga™ (dapagliflozin). 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.