Alternatives to Metformin

Oral Diabetes Medications

Fortunately, there are many different types of oral medications available to treat type 2 diabetes, including:
 
  • Sulfonylureas
  • Meglitinides
  • Thiazolidinediones
  • Alpha glucosidase inhibitors
  • Dipeptidyl peptidase inhibitors
  • Ergot alkaloids 
  • Combination medications.
     
Sulfonylureas
Sulfonylureas are medications that force the pancreas to produce more insulin. Because of this, they are very effective, but are also more likely to cause dangerously low blood sugar (hypoglycemia). These medications include:
 
Meglitinides
Meglitinides are similar to sulfonylureas, in that they force the pancreas to produce more insulin. However, they are short-acting and are less likely to cause dangerously low blood sugar. They are usually taken before every meal. Meglitinides include:
 
Thiazolidinediones (Glitazones)
These medications mainly work by decreasing insulin resistance and are therefore less likely to cause dangerously low blood sugar. These medications include:
 
Alpha Glucosidase Inhibitors
These 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:
 
Dipeptidyl Peptidase Inhibitors
This is a relatively new class of oral diabetes drugs. Currently, there are two medications available in the group -- sitagliptin (Januvia®) and saxagliptin (Onglyza). These drugs increase incretin levels in the body. Incretin is a hormone that helps to control blood sugar.
(Alternatives to Metformin Continued: Page 3)
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Written by/reviewed by: Kristi Monson, PharmD; Arthur Schoenstadt, MD
Last reviewed by: Kristi Monson, PharmD;
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