Nutrition Tip  
  December 2011
Updated Diabetes Medicines  

ORAL AND INJECTABLE AGENTS FOR DIABETES- Updated 11/2011
CLASS: Sulfonylureas
Mode of Action: Stimulate pancreas to make more insulin
                            Must be making insulin to start
                            Has potential to cause hypoglycemia

GENERIC NAME                             BRAND NAME
acetohexamide                                      generic only
chloropropamide                                  Diabinase
glimepiride                                            Amaryl             Peak 2-3 hours
glipizide                                                Glucotrol                      Peak 1-3 hours
glipizide- long acting                              Glucotrol XL                Peak 6-12 hours
glyburide                                              DiaBeta, Micronase      Peak 4 hours- best on empty stomach
glyburide micronized                             Glynase PresTab          Peak 2 hours- best on empty stomach
tolazamide                                            Tolinase
tolbutamide                                           Orinase


CLASS:  Meglitinides
Mode of Action: Stimulate pancreas make more insulin around mealtime.
Must be taking insulin to start.
Has potential to cause hypoglycemia
Kicks in faster than sulfonylureas. Take 15 minutes before meals.

GENERIC NAME                             BRAND NAME
repaglinide                                            Prandin
nateglinide                                            Starlix


CLASS: Biguanides
Mode of Action:  Inhibit glucose output by liver. Rarely causes hypoglycemia
unless used in combination with sulfonylureas, meglitinides or insulin.

GENERIC NAME                             BRAND NAME
metformin                                             Glucophage 
metformin                                             Fortamet
metformin                                             Glumetza
meformin                                              Riomet
metformin- long acting               Glucophage XR
CLASS: Alpha-glucosidase Inhibitors
 Mode of Action:  Inhibit glucose uptake from gut. Rarely causes hypoglycemia unless used in combination with sulfonylureas, meglitinides or insulin. Can be gassy.      Take with first bite of food.
GENERIC NAME                             BRAND NAME
Miglitol                                     Glyset
Acarbose                                             Precose 


 CLASS: Thiazolidinediones (TZD’s)
Mode of Action:  Promote glucose uptake by muscle and fat.  Rarely causes hypoglycemia unless used in combination with sulfonylureas, meglitinides or insulin.
GENERIC NAME                             BRAND NAME
Pioglitazone                                          Actos
Rosiglitazone                                        Avandia


 CLASS: DPP-4 Inhibitors
Mode of Action: Increases insulin when blood sugar is high.
Reduces the amount of sugar made by your liver after you eat
Only for use in Diabetes type 2

GENERIC NAME                             BRAND NAME
Linagliptin                                             Tradjenta
Sitagliptin                                              Januvia
Saxagliptin                                            Onglyza 


 CLASS: Combination Drugs
Mode of Action: See above for each drug in the combination above.
GENERIC NAME                             BRAND NAME
metformin + glyburide               Glucovance
metformin + rosaglitazone                     Avandamet
metformin + glipizide                             Metaglip
metformin + actos                                 Actos Plus
metformin + januvia                              Janumet
metformin + Prandin                             Prandimet
glimepiride + actos                                Duetact
glimepiride + avandia                            Avandaryl 
 CLASS: Incretin Mimetics- INJECTED
Mode of Action: combination of all the above
GENERIC NAME                             BRAND NAME
exenatide                                              Byetta                          used with type 2
pramlintide                                            Symlin                          used with type 1 & 2 who use insulin
can cause severe hypoglycemia
liraglutide                                              Victoza                         only use with type 2(GLP-1 analogs)
can cause severe hypoglycemia
and pancreatitis


INSULIN                                ONSET                       PEAK              EFFECTIVE DURATION
RAPID ACTING                     15-30 min                    ½ - 1 hr            3-4 hours
lispro-humalog 
aspart-novolog
glulisine apidra
INSULIN POWDER               10-20 min                    2 hours             6 hours
exhubera                                 
SHORT ACTING                    ½ - 1 hour                    2-3 hours         3-6 hours
regular                                     
INTERMEDIATE                    2-4 hours                     6-10 hours       10-16 hours
NPH   
LONG ACTING                     1-2 hours                     peakless           24 hours
glargine-lantus
detemir-levemir

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