What oral medications are approved to treat diabetes?

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What oral medications are approved to treat diabetes?

Over 40 medications have been approved by the Food and Drug Administration for the treatment of diabetes. It’s beyond the scope of this article to review all of these drugs. Instead, we’ll briefly review the main drug classes available, how they work and present the names of a few drugs in each class. Your healthcare team will decide if medication is right for you. If so, they’ll decide which specific drug(s) are best to treat your diabetes.

Diabetes medication drug classes include:

  • Sulfonylureas: These drugs lower blood glucose by causing the pancreas to release more insulin. Examples include glimepiride (Amaryl®), glipizide (Glucotrol®) and glyburide (Micronase®, DiaBeta®).
  • Glinides (also called meglitinides): These drugs lower blood glucose by getting the pancreas to release more insulin. Examples include repaglinide (Prandin®) and nateglinide (Starlix®).
  • Biguanides: These drugs reduce how much glucose the liver produces. It also improves how insulin works in the body, and slows down the conversion of carbohydrates into sugar. Metformin (Glucophage®) is the example.
  • Alpha-glucosidase inhibitors: These drugs lower blood glucose by delaying the breakdown of carbohydrates and reducing glucose absorption in the small intestine. An example is acarbose (Precose®).
  • Thiazolidinediones: These drugs improve the way insulin works in the body by allowing more glucose to enter into muscles, fat and the liver. Examples include pioglitazone (Actos®) and rosiglitazone (Avandia®).
  • GLP-1 analogs (also called incretin mimetics or glucagon-like peptide-1 receptor agonists): These drugs increase the release of insulin, reduce glucose release from the liver after meals and delay food emptying from the stomach. Examples include exenatide (Byetta®), liraglutide (Victoza®), albiglutide (Tanzeum®), semaglutide (Rybelsus®) and dulaglutide (Trulicity®).
  • DPP-4 inhibitors (also called dipeptidyl peptidase-4 inhibitors): These drugs help your pancreas release more insulin after meals. They also lower the amount of glucose released by the liver. Examples include alogliptin (Nesina®), sitagliptin (Januvia®), saxagliptin (Onglyza®) and linagliptin (Tradjenta®).
  • SGLT2 inhibitors (also called sodium-glucose cotransporter 2 inhibitors): These drugs work on your kidneys to remove glucose in your body through your urine. Examples include canagliflozin (Invokana®), dapagliflozin (Farxiga®) and empagliflozin (Jardiance®).
  • Bile acid sequestrants: These drugs lower cholesterol and blood sugar levels. Examples include colestipol (Colestid®), cholestyramine (Questran®) and colesevelam (Welchol®).
  • Dopamine agonist: This medication lowers the amount of glucose released by the liver. An example is bromocriptine (Cyclocet®).

Many oral diabetes medications may be used in combination or with insulin to achieve the best blood glucose control. Some of the above medications are available as a combination of two medicines in a single pill. Others are available as injectable medications, for example, the GLP-1 agonist semaglutide (Ozempic®) and lixisenatide (Adlyxin®).

Always take your medicine exactly as your healthcare prescribes it. Discuss your specific questions and concerns with them.

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