Diabetes Medication: Types and Side Effects

1. Metformin (e.g. Glucophage)

Generally, metformin is the first medication used to treat type 2 diabetes. Metformin reduces the amount of sugar your liver makes.

2. Sulphonylureas

Sulphonylureas help your body secrete more insulin. Examples of medication in this class include:

• Glipizide
• Gliclazide
• Gliclazide MR (Diamicron MR)
• Glimepiride (Amaryl)

3. SGLT2 inhibitors

Their use is often associated with weight loss and blood pressure reduction. Examples of SGLT2 inhibitors are: 

• Canagliflozin (lnvokana)
• Dapagliflozin (Forxiga)
• Empagliflozin (Jardiance)

4. DPP-4 inhibitors

DPP4-inhibitors (dipeptidyl peptidase-4 inhibitors) increase levels of a group of gastrointestinal hormones called incretins, which increase insulin secretion and inhibit glucagon release.

They reduce blood glucose levels without causing hypoglycaemia. Examples of DPP-4 inhibitors are:

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

They can cause flu-like symptoms such as a runny nose, sore throat and headache.

5. Acarbose (e.g. Glucobay)

Acarbose works by slowing down the gutenzyme that turns carbohydrates into sugar. This results in a smaller rise in blood glucose levels following a meal.

6. Thiazolidinediones (TZD)

Thiazolidinediones (TZD) make your body's tissues more sensitive to insulin.

Pioglitazone (Actos) is an example of thiazolidinedione.

Thiazolidinediones (TZD) have been linked to weight gain and more serious side effects such as an increased risk of heart failure and fractures.

Because of these risks, these medications are generally not a first choice treatment.

7.GLP-1 receptoragonists

The use of GLP-1 receptor agonists is often associated with some weight loss. Examples of these medications include:

• Liraglutide (Victoza)
• Dulaglutide (Trul icity)

Possible side effects include nausea, vomiting and diarrhoea.

8. Insulin

Some people who have type 2 diabetes need insulin therapy.

Insulin cannot be taken orally and must be administered by subcutaneous injections.

Insulin injections involve using an insulin syringe or an insulin pen injector - a device that looks similar to an ink pen, except the cartridge is filled with insulin.

There are many types of insulin, and they each work in a different way.

Side effects include hypoglycaemia and weight gain.

9. Fixed ratio combination of insulin and GLP-1 receptor agonist

This formulation contains basal insulin and GLP-1 receptor agonist.

This allows administration of two medications in one injection, in a fixed ratio combination.

Nausea and vomiting, this is in relation to the presence of Lixisenatide.

Slow up-titration of this combination should attenuate these side effects.