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There are a variety of medications, along with insulin formulations, which help people with diabetes achieve better blood glucose control. The Diabetes Medication
Summary describes these drugs, their actions and the role they play in helping people with diabetes attain a healthy blood glucose range. As is true
with any medication, those for diabetes are only effective when taken as prescribed. Be sure to learn about your medications and how and when to take them. Any side effects and how to respond to them should also be
well-understood. Orinase, Tolinase, Diabenase, Micronase, Glynase, Glucotrol, Diabeta, Dymelor, Amaryl
- Stimulates insulin production in pancreas and increases insulin sensitivity at the cellular level.
- Side Effects: Skin rash, jaundice, sensitivity to sunlight, hypoglycemia, (may be profound)
- Caution: Renal or liver disease, allergies to sulfa.
- Contraindication: Pregnancy, Type I DM.
- Dosing: Up to 30 minutes before meals. Actual mg's vary with drug strength.
Glucophage
- Increases insulin sensitivity at the cellular level with no effect on pancreas therefore there is no danger of hypoglycemia from this drug.
- Side Effects: GI, usually nausea, vomiting, bloating, diarrhea (up to 30% of patients). These symptoms may lessen after 2-3 weeks of therapy.
- Contraindications: Renal or liver disease, excessive alcohol intake, pregnancy, Type I DM
** The
drug should be withheld 48 hours after any X-ray studies using Iodine containing contrast media.
Dosing: 500mg bid (with meals) increasing by 500 mg per week to a maximum of 2500mg.
Alpha-Glucosidase Inhibitors |
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Acarbose (Precose)
- Works in small intestine to slow carbohydrate and delay glucose absorption. It binds to carbohydrate and so some is not digested.
- Side Effects Nausea, diarrhea, flatulence (77%).
- Caution: Renal disease
- Contraindications: Type I DM, Cirrhose, inflammatory bowel disease, Colonic ulcerations. Partial intestinal obstruction.
- Dosing: 25 mg tid with the first bite of food. Titrate to 50mg tid. Maintenance dose is 50-100 mg tid.
Insulin therapy is necessary to treat all people with Type 1 diabetes, and for others who do not produce
enough of their own insulin to keep blood sugar levels within target ranges. The type of insulin preparation and the schedule selected for each individual depends upon total insulin needs, blood sugar
management goals, age, lifestyle and other factorsShort Acting: Lispro (Humalog) works within 15mm. and peaks in 30-90mm. gone 2hrs. Regular works in
30mm. and peaks in 90-120mm. gone in 3 1/2 hrs.
- Intermediate Acting: NPH, Lente: begins 2hrs. after injection, peak in 6-10 hours. gone in 20-24 hrs. Lente and Regular should not be mixed generally. If they are mixed, it must be used immediately.
- 70/30, 60/40, 50/50: Combinations of NPH and Regular premixed. The effect is that of Regular and NPH combined.
- Long Acting: Ultralente: Begins action in 4-6 hours and lasts for up to 36 hrs. at a low level. Used in conjunction with doses of Regular insulin at mealtime. Ultra- lente is usually given at
suppertime or bedtime.
The insulin pump is a small, battery-operated device that supplies a continuous amount of insulin to the
body. The pump contains a battery, a motor, and a supply of insulin. The pump is connected to the body by tubing and a single needle or soft cannula. The insertion site is rotated every 1 to 3 days. Insulin that
is delivered continuously is called the basal dose. The dose given before meals is called a bolus dose. The decision to use an insulin pump requires careful consultation with your diabetes care team. 
Summary of the Current Available Diabetes Medications and their Actions.
Common Names |
Begins to work In |
Time Lapse for Its Peak Action |
Duration of Its Action |
Role in Blood Glucose Management |
Humalog or Lispro |
15 mins |
30 - 60 mins |
about 4 hours |
Action covers meals eaten at same time |
Regular |
30-60 mins |
2 - 3 hrs |
3 - 6 hrs |
Action covers meals eaten within 30-60 minutes |
Lente or NPH |
2 - 4 hrs |
4 - 10 hrs |
10 - 16 hrs |
Action covers insulin needs for about 1/2 the day or overnight. Often combined with Regular, Lispro or Humalog insulin
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Ultralente |
8 - 14 hrs |
minimal |
24-36 hrs |
Action provides a low level of insulin support for about 1 full day. Usually combined with Regular, or Lispro insulin.
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Oral Medications
For people with type 2 diabetes who produce insulin of their own, oral medications may be used alone or
incombination with a small amount of supplemental insulin.
Class of Drug |
Common Names |
Role in Blood Glucose Management |
Sulfonylureas |
Glyburide
Glipizide
Tolbutamide
Tolazamide
Chlorpropamide
Glimepiride |
Stimulates beta cells of pancreas to secrete more of its own insulin. May cause hypoglycemia (low blood sugar) if diet is too low in carbohydrate, meals are skipped, or exercise is too much for the diet-medication balance. |
Meglitinides |
Prandin
Repaglinide |
Stimulates beta cells of pancreas to secrete more of its own insulin. Newer class of beta-cell stimulator, more rapidly
absorbed and cleared from blood than sulfonylureas. Can be used to help manage blood sugar changes after specific meals. |
Biguanides |
Metformin
Glucophage |
Increases insulin sensitivity of liver cells, thus reducing liver cell production of sugar. Liver cells add sugar to the
blood when not adequately stimulated by insulin. Not advised to those who drink alcohol heavily, or those with kidney problems |
Alpha-glucosidase Inhibitors |
Acarbose
Precose |
Reduces digestion of starch into sugar in the intestines. Less sugar is absorbed into the blood after meals. May cause
digestive tract side effects. |
Thiazolidinediones |
Troglitazone
Rezulin |
Increases insulin receptor sensitivity on muscle and adipose (fat) cells. Increases insulin uptake from blood into target
cells. Makes insulin more effective and less is required. |
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