Diabetes Drugs

There are a number of different types of diabetes drugs – with some having similar ways of acting. Drugs which act similarly to each other are put into the same class of drugs.

Below is a list of the most common diabetes drug classes, an A-Z of all diabetes drugs, how they work, who they are for and which medications fall into these drug classes.

Jump to the treatment you’re interested in:

• Insulin
• Biguanides / Metformin
• Sulphonylureas
• Meglitinides / Prandial glucose regulator / Glinides
• Alpha-glucosidase inhibitors
• Thiazolidinedione / Glitazones
• DPP-4 inhibitors / Gliptins
• Incretin mimetics / GLP-1 analogues
• Amylin analogues
• A to Z of diabetes drugs

Insulin

Insulin is a hormone which helps to regulate blood sugar. A number of different types of insulin are available as medication, with some insulins acting for as long as a day and others acting for only a few hours.

However, insulin is prescribed for people with type 1 diabetes and for people with type 2 diabetes who have not responded so well on oral medication (tablets).

• Read more on insulin

Biguanides / Metformin

The only available diabetes medication in the biguanides class of drugs is metformin.

Biguanides prevent the liver from producing glucose and helps to improve the body’s sensitivity towards insulin. Metformin is commonly used as a first line treatment for type 2 diabetes and may occasionally be prescribed, in combination with insulin, for people with type 1 diabetes.

• Read more on metformin

Sulphonylureas

Sulphonylureas are the class of antidiabetic drug for type 2 diabetes that tends to include those drugs which end in ‘ide’.

The following drugs are all in the sulphonylureas class (branded names in brackets):

• Glibenclamide –also known as Glyburide (Daonil)
• Glipizide (Glucotrol)
• Gliquidone (Glurenorm)
• Glyclopyramide (Deamelin-S)
• Glimepiride (Amaryl)
• Gliclazide (Diamicron)

Sulphonylureas work by increasing the amount of insulin the pancreas produces and increasing the working effectiveness of insulin. The mode of action of sulphonylureas means that hypoglycemia and weight gain can be relatively common side effects.

• Read more on sulphonylureas

Meglitinides / Prandial glucose regulator / Glinides

The glinides are a class of drug which have a similar response as sulphonylureas but act for a shorter time. Meglitinides are prescribed to be taken by people with type 2 diabetes within half an hour before eating. As the drugs act for a shorter period than sulphonylureas, the side effects of hypoglycemia and weight gain have a smaller likelihood.

Examples of prandial glucose regulators are (brand names in brackets):

• Repaglinide (Prandin)
• Nateglinide (Starlix)

Alpha-glucosidase inhibitors

Alpha-glucosidase inhibitors, such as acarbose (marketed as Precose or Glucobay) or miglitol (branded as Glyset) are drugs for type 2 diabetes which slow down the digestion of carbohydrates in the small intestine and therefore can help to reduce after meal blood sugar levels.

Thiazolidinedione / Glitazones

Thiazolidinediones, also known as glitazones, are a medication for type 2 diabetes which help to improve insulin sensitivity and have been found to help decrease triglyceride levels.

However, these have recently been in public spotlight as questions over their long term safety.

In September 2010, the most popularly prescribed drug in this class rosiglitazone ( Avandia ) was banned for use by the European medicines Agency over heart attack concerns.

Pioglitazone (Actos) has also made the news in connection with instances of bladder cancer, however, the danger has not been deemed sufficient to need to ban the drug in the UK.

DPP-4 inhibitors / Gliptins

DPP-4 inhibitors, also known as gliptins, are a class of drug which help to stimulate the production of insulin and reduce the production of glucagon, particularly during digestion.

DPP-4 inhibitors are usually prescribed for people with type 2 diabetes who have not responded well to drugs such as metformin and sulphonylureas.

This drug class includes following medications (trade names in brackets):

• Linagliptin (Tradjenta)
• Saxagliptin (Onglyza)
• Sitagliptin (Januvia)
• Vildagliptin (Galvus)

Incretin mimetics / GLP-1 analogues

Incretin mimetics, also known as GLP-1 analogues, are an injectable treatment for type 2 diabetes.
Incretin mimetics look to mimic the effect of a group of hormones called incretins which increase the production of insulin and decrease the release of glucagon in a relatively similar way DPP-4 inhibitors.

This is not a coincidence as the way DPP-4 inhibitors work is to prevent the protein dipeptidyl peptidase-4 from destroying the incretin hormones.

GLP-1 analogues have been found to be particularly effective in helping to improve blood glucose levels and helping with weight loss.

The following GLP-1 analogues are prescribed in the UK (branded names in brackets):

• Dulaglutide (Trulicity)
• Exenatide (Byetta)
• Liraglutide (Victoza)
• Lixisenatide (Lyxumia)

Amylin analogues

Amylin is a hormone produced by the pancreas and released at the same time as insulin, but in much smaller quantities (about 1% compared with insulin). Amylin helps to suppress glucagon release and therefore reduce post meal blood glucose levels.

Pramlintide acetate (marketed as Symlin) is available in the US as an injectable drug for the treatment of both type 1 and type 2 diabetes

The use of amylin with insulin can carry an increased chance of hypoglycemia.

A-Z of diabetes drugs

Explore the 50+ diabetes drugs available in the UK and worldwide (including those discontinued in the UK):