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Diabetes Medications
Information about diabetic medications and insulin

Oral Medications

Generic/Brand
How it works
What you should know
Glyburide: Micronase, Diabeta, Glynase Encourages the pancreas to produce more insulin May cause low blood sugar.
Caution if you have an allergy to sulfa medication.
Glipizide:
Glucotrol, Glucotrol XL
Encourages the pancreas to produce more insulin May cause low blood sugar.
Caution if you have an allergy with sulfa medication.
Glimepride:
Amaryl
Encourages the pancreas to produce more insulin May cause low blood sugar.
Caution if you have an allergy with sulfa medication.
Repaglinide:
Prandin
Encourages the pancreas to produce more insulin in response to carbohydrates at a meal. May cause low blood sugar.
Caution with sulfa allergy. Taken 0-30 minutes before each meal that carbohydrates are consumed.
Nateglinide:
Starlix
Encourages the pancreas to produce more insulin in response to carbohydrates at a meal. May cause low blood sugar. Caution with sulfa allergy. Taken 0-30 minutes before each meal that carbohydrates are consumed.
Metformin:
Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet (liquid form)
Helps the body use insulin more efficiently. Decreases the glucose produced by the liver. Possible gastrointestinal upsets. May subside in 2-3 weeks. Use cautiously in people with kidney or respiratory disease and those taking medicine for heart failure or those over 80. Not recommended for people with liver disease or who drink alcohol excessively. Take with meals to decrease possible GI effects.
Acarbose: Precose Slows the digestion of carbohydrate foods. Possible gastrointestinal upsets: Excess gas (flatulence) or bloating. Take with the first bite of each meal. Caution use with inflammatory bowel disease, other intestinal diseases or bowel obstruction.
Miglitol: Glyset Slows the digestion of carbohydrate foods. Possible gastrointestinal upsets: Excess gas (flatulence) or bloating. Take with the first bite of each meal. Caution use with inflammatory bowel disease, other intestinal diseases or bowel obstruction.
Rosiglitazone: Avandia Helps the body use insulin more efficiently. May cause water retention. Monitor with liver function tests. Not recommended for people with heart failure. May take 3-6 weeks to see the full effect on blood sugar.
Pioglitzaone:  Actos Helps the body use insulin more efficiently. May cause water retention. Monitor with liver function tests. Not recommended for people with heart failure. May take 3-6 weeks to see the full effect on blood sugar.
Sitigliptin Phosphate:  Januvia Helps pancreas make more insulin. Prevents the liver from releasing too much glucose. Does not usually cause hypoglycemia. Possible side effects: Upper respiratory infection, stuffy or runny nose, sore throat and headache.

Combination Medications

Avandamet Avandia and Metformin
Glucovance Glyburide and Metformin
Metaglip Glipizide and Metformin
ActosplusMet Actos and Metformin
Avandaryl Avandia and Amaryl
Janumet Januvia and Metformin
Duetact Actos and Amaryl

Injectible Medication – Non-Insulin

Generic/Brand
How it works
How given
What you should know
Exenatide: Byetta • Increases insulin production
• Decreases sugar production by the liver
• Reduces appetite
• Reduces high post-prandial(after-eating) glucose
• Delays stomach emptying
Injection is twice a day within 60 minutes of the morning and evening meals. Treats Type 2 diabetes. Caution use if you have GERD/reflux. May cause nausea when first starting drug but it should decrease over time. Talk to doctor/nurse about side effects you may experience.
Pramlintide: Symlin • Decreases sugar production by the liver
• Reduces appetite
• Reduces high post-prandial (after-eating) glucose
Injection is given at mealtimes. Treats Type 1 and Type 2 diabetes. Used with insulin to lower blood sugar, especially for after-eating glucose. May lower the amount of insulin you currently inject.

Insulin

SPEED OF ACTION/TYPE
INSULIN NAME BRAND/GENERIC
TIMING OF DOSE
Rapid-Acting
Starts working quickly and is effective for a short period of time.
(CLEAR)
Novolog (Aspart)
Humalog (Lispro)
Apidra (Glulisine)
Take 5-10 minutes before meal.
Short or Fast-Acting
Starts working relatively quickly and is effective for a fairly short period of time.
(CLEAR)
Novolin R (Regular human insulin)
Humulin R (Regular Humulin insulin)
Take 30 minutes before meal.
Intermediate-Acting
Starts working a little later but lasts a little bit longer.
(CLOUDY)
Novolin N (NPH human insulin)
Humalin N (NPH human insulin)
Take once or twice daily AM and/or PM
Long-Acting
Starts very slowly and lasts a long time – nearly without a peak
(CLEAR)
Lantus (Glargine)
Levemir (Detemir)
Usually taken once daily or twice if needed.

Pre-mixed Insulin – Combinations of the above types:

Rapid-Acting Mix
(CLOUDY)
Novolog Mix 70/30
Humalog Mix 75/25
Humalog Mix 50/50
All are a mix of rapid-acting and intermediate-acting insulin.
Take 5-10 minutes before meal.
Short or Fast-Acting Mix (CLOUDY) Novolin 70/30
Humulin 70/30
All are a mix of short-acting and intermediate-acting insulin.
Take 30 minutes before meal.

Marci Sloane, MS, RD, LD/N, CDE, is a registered and licensed dietitian/nutritionist and certified diabetes educator with a degree in Nutrition and Physiology from Teachers College at Columbia University. Marci is the author of The Diet Game: Playing for Life! More about Marci Sloane

The goal of Destination Diabetes is to be a useful and credible resource for the more than 20 million children and adults who have diabetes in the U.S. and their families. Destination Diabetes provides information on a wide range of diabetes health and wellness topics. Articles are written or reviewed by diabetes advisors who have experience in diabetes education.