Medication therapies for type 2 diabetes

Medications Used to Manage Type 2 Diabetes

Most people with type 2 diabetes can keep their blood glucose levels within a healthy range with lifestyle changes and sometimes one or more of the following four types of oral medication, especially early in the disease process.

Alpha-glucosidase inhibitors

The only drug of this type used in Canada is acarbose (Glucobay^®). Acarbose lowers blood glucose levels by slowing down the body’s absorption of glucose in the intestines. Its side effects mostly affect the digestive system, but may go away over time.

Biguanides

The only drug of this type used in Canada is metformin (Glucophage^®, Glumetza^®, Glycon^®). Metformin works by increasing the body’s response to its own insulin. Its side effects are primarily stomach upset and loose bowels. It can be safely used in combination with other drugs used to treat diabetes.

Insulin secretagogues

These drugs lower blood glucose levels by stimulating the body to produce more insulin. They are all associated with moderate weight gain.

There are two types of drug in this group. The sulfonylureas include gliclazide (Diamicron^®), glimepiride (Amaryl™), glyburide (Diabeta^®, Euglucon^®), chlorpropamide (generic) and tolbutamide (generic).

The nonsulfonylurea drugs are nateglinide (Starlix^®) and repaglinide (GlucoNorm^®). Both are particularly useful in reducing high blood sugar levels after eating.

Insulin sensitizers

The two insulin sensitizers available in Canada are pioglitazone (Actos^®) and rosiglitazone (Avandia^®). They work by increasing the body’s response to its own insulin, although the exact mechanism by which they work is not yet understood. Side effects may include fluid retention and moderate weight gain.

Combination therapies

Instead of taking two separate medications to manage type 2 diabetes, sometimes a “fixed dose combination therapy” is available that combines both medications in a single pill. Ask your healthcare professional for more information on such alternatives.

There are two combination medications available in Canada for the treatment of type 2 diabetes: Avandaryl^® (containing glimepiride and rosiglitazone) and Avandamet^® (containing metformin and rosiglitazone).