Oral Diabetes Prescription Medications

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Author: Jim Morelli, MS, RPh
Medical Editor: Louise Chang, MD

• What are oral diabetes medications and how do they work?
• For what conditions are diabetes pills used?
• Are there differences among types of oral diabetes medications?
• What non-insulin injectable drugs are approved for diabetes?
• What are the side effects of the non-insulin diabetes medications?
• What are the drug interactions with non-insulin diabetes medications?
• What are the warnings and precautions for non-insulin diabetes medications?
• What are some examples of oral medications used for diabetes?
• For related diabetes medication information:
  Insulin Diabetes Medications - on RxList

What are oral diabetes medications and how do they work?

Insulin is a hormone produced by cells in the pancreas called beta cells. Insulin helps the body use blood glucose (a type of sugar) for energy. People with type 2 diabetes do not make enough insulin and/or their bodies do not respond well to it, leading to elevated blood sugar levels. Oral diabetes medications bring blood sugar levels into the normal range through a variety of ways.

For what conditions are diabetes pills used?

Oral diabetes medications are only used to treat type 2 or non-insulin-dependent diabetes. Patients with type 1 diabetes are dependent on insulin for their treatment.

Are there differences among types of oral diabetes medications?

Medications that increase insulin production

The earliest oral diabetes drugs were the sulfonylureas. These work by stimulating the pancreas to produce more insulin. The oldest of these drugs still on the market is chlorpropamide (Diabinese), which has been used for more than 50 years. The second-generation sulfonylureas are taken once or twice a day. They include glipizide (Glucotrol, Glucotrol XL), glyburide (Micronase, DiaBeta, Glynase), and glimepiride (Amaryl).

Meglitinides also stimulate the release of more insulin from beta cells. Repaglinide (Prandin) and nateglinide (Starlix) are taken before each of three meals.

Medications that decrease glucose production and increase insulin sensitivity

One drug makes up the class of oral diabetes medications known as the biguanides, and that is metformin (Glucophage). It works by decreasing production of glucose by the liver and by making muscle more sensitive to insulin. The thiazolidinediones, rosiglitazone (Avandia) and pioglitazone (Actos), work in a similar way.

Medications that slow the breakdown of carbohydrates

Alpha-glucosidase inhibitors approach the blood glucose issue in a different way. By inhibiting the breakdown of starches in the intestine, these medications slow the rise in blood sugar normally seen after a meal. Examples include acarbose (Precose) and meglitol (Glyset).

Medications that increase insulin production and decrease glucose production

In the last category of oral diabetes medications is the DPP-4 inhibitor sitagliptin (Januvia). This drug works by inhibiting the action of an enzyme in the body that leads to increase in insulin release. It also decreases the production of glucose by the liver.