Oral diabetes medications: The list

All forms of diabetes are manageable with lifestyle changes and medical support.

Type 1 diabetes often happens when your body produces little or no insulin, a hormone that helps regulate blood sugar levels.

In type 2 diabetes, your body becomes resistant to insulin or can’t make enough of it to maintain optimal blood sugar levels. 

Healthcare professionals typically manage type 1 diabetes by prescribing insulin therapy, which involves periodic injections. For type 2 diabetes, they may recommend lifestyle modifications alongside oral medications.

Diabetes medications: Oral formulations

Oral diabetes medications come in different drug classes and formulations. Here are a few of the most common:

Biguanides

Biguanide drugs effectively lower blood sugar levels by reducing glucose production in the liver and improving insulin sensitivity in muscle tissue.

Metformin (Riomet) is one of the most common biguanides healthcare professionals prescribe to manage diabetes. It starts at a low dose and gradually increases to a maintenance dose of about 500–2,000 milligrams (mg), taken two or three times per day.

Need a refill for metformin (Glucophage)? You may be able to get an online prescription through Optum Perks in as little as 15 minutes with no video or appointment needed. Learn more here.

Sulfonylureas

Sulfonylureas bind to pancreatic potassium channels, stimulating insulin release.

Common sulfonylureas may include: 

• glipizide (Glucotrol)
• glimepiride (Amaryl)
• glyburide (Glynase)

Dosage and frequency may vary but could involve:

• Glipizide (Glucotrol): 2.5–5 mg once per day 30 minutes before a meal.
• Glimepiride (Amaryl): 1–2 mg once per day with a meal or up to 30 minutes after a meal.
• Glyburide (Glynase): 2.5–5 mg once per day with the first main meal.

Meglitinides

Meglitinides have similar effects to sulfonylureas but may have different mechanisms and indications. They include:

• repaglinide (Prandin)
• nateglinide (Starlix) 

Dosage and frequency may involve:

• Repaglinide (Prandin): 0.5–4 mg before meals, up to 4 times per day.
• Nateglinide (Starlix): 120 mg three times per day before each main meal.

Thiazolidinediones (TZDs)

TZDs help lower blood sugar levels by increasing insulin sensitivity in muscle and fat cells.

Healthcare professionals often recommend TZDs alongside lifestyle modifications or other oral diabetes medications like biguanides.

Pioglitazone (Actos) is one of the most commonly prescribed TZD, with a daily dosage ranging from 15–45 mg.

Dipeptidyl peptidase-4 (DPP-4) inhibitors

DPP-4 medications increase the incretin hormone levels, which helps stimulate insulin release and lower glucose production. 

DPP-4 inhibitors may include:

• sitagliptin (Januvia)
• saxagliptin (Onglyza)
• linagliptin (Tradjenta) 

Dosage and frequency may involve:

• Sitagliptin (Januvia): 100 mg once per day. 
• Saxagliptin (Onglyza): 2.5 mg or 5 mg once per day.
• Linagliptin (Tradjenta): 5 mg once per day.

You can take DPP-4 inhibitors with or without meals, which is convenient for managing type 2 diabetes.

Sodium-Glucose Co-Transporter-2 (SGLT2) Inhibitors

SGLT2 inhibitors prevent glucose reabsorption in the kidneys, which would lead to increased urinary glucose elimination and reduced blood glucose levels.

They may include:

• canagliflozin (Invokana)
• dapagliflozin (Farxiga)
• empagliflozin (Jardiance)

Dosage and frequency may involve:

• Canagliflozin (Invokana): 100 mg once per day before the first main meal.
• Dapagliflozin (Farxiga): 5 mg once per day.
• Empagliflozin (Jardiance): 10 mg once per day. 

If you need help covering the cost of medications, the free Optum Perks Discount Card could help you save up to 80% on prescription drugs. Follow the links on drug names for savings on that medication, or search for a specific drug here.

Pros and cons of oral diabetes medications

Oral diabetes medications offer many benefits, but there may be some disadvantages depending on your needs.

Pros

• Effectiveness: Oral diabetes medications may be highly effective in managing blood glucose levels when taken as directed.
• Comfort: Unlike other diabetes treatment methods, oral diabetes medications are easy to take and don’t require needles or injections, which some people might prefer.
• Safety: Oral diabetes medications are generally well tolerated, and the chance of serious side effects is low when taken as directed.
• Speed of action: Depending on the specific medication, some medications start working within a few hours after ingestion.

Cons

• Some interactions: Like all medications, oral diabetes medications may interact with other drugs and supplements, so you need to watch when and how you take them.
• Individual variations: Some people may not respond as well to oral diabetes medications as others, and could see more progress with other types of administration forms. 
• Consistency: Although they are effective and some of them act quickly, consistency is key to experiencing the full effects. Also, how quickly they work may vary among different medications, and it may take time to properly manage blood sugar. 

Other types of diabetes medications

Apart from oral medications, injectable options such as insulin can effectively help you manage diabetes. Healthcare professionals inject insulin into the fatty tissue under the skin, typically in the abdomen or thigh.

Types of insulin include:

• Rapid-acting insulin: It starts working within 15 minutes after injection. These may include insulin aspart (Novolog) and insulin lispro (Humalog).
• Short-acting insulin: Also known as regular insulin, it starts working within 30 minutes. They include Humulin R and Novolin R.
• Intermediate-acting insulin: This type of medication starts working within 1–4 hours. Common examples include insulin isophane (Humulin N).
• Long-acting insulin: This type provides a slow, steady insulin release for up to 24 hours. Some long-acting insulins include insulin detemir (Levemir) and insulin glargine (Lantus).

Diabetes medications that aren’t insulin and also come as injections include:

• tirzepatide (Mounjaro)
• semaglutide (Ozempic)
• liraglutide (Victoza)
• dulaglutide (Trulicity)

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Summary

Managing diabetes with oral diabetes medications is a common approach.

Different classes of these medications are available that can effectively lower blood sugar levels and provide convenience in managing diabetes.

Consider discussing the best treatment plan with a healthcare professional.