Guest Blog: Type 2 Diabetes Medications and Potential Risks

Tuesday 14 May 2013

Type 2 diabetes affects nearly 26 million people in the USA alone, and millions more worldwide. The first step in diabetes management is diet and exercise modifications, however many people find that a healthy lifestyle alone is not enough.

Type 2 Diabetes Medications and Potential Risks

Prescription medications, both oral and injectable, can be used to supplement diet and exercise in the treatment of diabetes. All medications work to lower blood sugar levels, but there are several different classes of drugs that work to achieve this in different ways.


The only member of this drug class is also one of the diabetes medications that has been used the longest. It is known as metformin, but sold under the following names: Glucophage, Glucophage XR, Riomet, Fortamet and Glumetza.
It is a sensitizer, which addresses insulin resistance. It works to lower blood sugar levels by decreasing the amount of glucose released from the liver.
The most common side effects include gas, bloating, diarrhea, upset stomach and appetite loss. Taking metformin with food minimizes these side effects. Metformin is unlikely to cause low blood sugar, which is a risk with other diabetes medications.
In rare cases, lactic acidosis can occur.


This drug class includes glimepiride, glyburide, glipizide and micronized glyburide. Market names are Amaryl, Diabeta and Micronase, Glucotrol /Glucotrol XL and Glynase.
Sulfonylureas stimulate the pancreas to release more insulin after a meal to control blood sugar. However, these medicines can cause blood sugar levels to drop too low, and patients should always carry a quick form of sugar in the event that it is needed.
Side effects include occasional skin rash, upset stomach and irritability. Patients should contact their physician if blood sugar levels are consistently low.

Meglintides, D-Phenylaline Derivatives & Alpha-Glucosidase Inhibitors

These drug classes include repaglinide (brand name Prandin), nateglinide (Starlix) and acarbose and miglitol (Precose and Glyset).
These medications are less likely than sulfonylureas to cause low blood sugar, however that is still a risk. These drugs slow the absorption of sugar into the blood stream or stimulate the pancreas to release more insulin right after a meal.
These medications must be taken with each meal. Side effects include gas, upset stomach, abdominal pain and diarrhea.

Thiazolidinediones (TZDs)

Actos (pioglitazone) is perhaps the most recognizable drug in this class, and has been the top-selling diabetes drug on the market. Like biguanides, TZDs are sensitizers. Actos increases the amount of glucose muscle cells absorb and keeps the liver from overproducing glucose.
Patients should alert their physician if any of the following side effects are experienced: nausea, vomiting, loss of appetite, shortness of breath, fatigue, dark urine or severe edema. Actos may cause swelling (edema) or fluid retention, which can contribute to weight gain. When used alone, TZDs do not cause low blood sugar.
Actos is also linked to an increased risk of congestive heart failure and bladder cancer. Takeda Pharmaceuticals, the manufacturer of Actos, faces thousands of lawsuits filed by patients who suffered adverse side effects.

Incretin Mimetics and DPP-4 Inhibitors

Incretin mimetics like Byetta (exenatide) act like - or mimic - incretin hormones. Incretin hormones like GLP-1 are responsible for stimulating the release of insulin. Byetta lowers blood sugar by increasing insulin production and also suppresses appetite, inhibits the production of excess glucose, and slows stomach emptying.
DPP-4 inhibitors like Januvia (sitagliptin) prevent the breakdown of incretin, thereby boosting insulin production.
The long-term use of Januvia and Byetta has been linked to mild side effects and life-threatening side effects like acute pancreatitis and pancreatic cancer.
The U.S. Food and Drug Administration (FDA) has not found conclusive evidence of a causal relationship between these and similar drugs (like Tradjenta) and pancreatic diseases, but continues to investigate.

Linda Grayling is a writer for She enjoys keeping up with the latest news in the medical field.

Disclaimer: This article is contributed by a Guest Blogger. Ping of Health does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this article. Ping of Health disclaims all responsibility for any losses, damage or personal injury suffered directly or indirectly from reliance on such information.