Is This Information Right for Me?
What is covered in this research summary?
This summary covers the research on the benefits and possible side effects of medicines to lower or control your blood sugar. It will help you talk with your doctor or other health care professional to decide which medicines are best for you.
Where does the information come from?
The information in this summary comes from a review of many studies about type 2 diabetes medicines. The review was conducted by an independent research center in 2007 and again in 2011. Read the full report at www.effectivehealthcare.ahrq.gov/diabetesmeds.cfm.
Understanding Your Condition
What is type 2 diabetes?
Why treat type 2 diabetes?
How is type 2 diabetes treated?
How do I know the amount of sugar in my blood?
There are two common tests for blood sugar. They can help you and your doctor check how well your blood sugar is under control.
One test is a finger (or forearm) stick that you can do yourself. This test is done one or more times a day. You can do it in the morning before you eat (fasting) or at other times of the day, like after a meal. This test tells what your blood sugar level is at that moment in time. The fasting number should be between 80 and 120. After a meal, the target is usually less than 180.
The other test is a blood test called hemoglobin (Hb) A1C. This test is done at your doctor’s office or at a lab a few times a year. The A1C test shows your average blood sugar level over the past 2 to 3 months. Usually the goal is for your A1C to be around 7. This means that your finger-stick blood sugar level has been in the “good” range over the past 2 to 3 months. If the A1C level is higher than this, changing your medicine might help.
Understanding Your Options
Are all diabetes medicines the same?
There are many types of diabetes medicines. Each type works in a different way to control blood sugar.
How well can medicines lower my blood sugar?
All the medicines in this summary lower blood sugar. The lab test for blood sugar level (A1C) is the best way to tell how well the medicines work.
Medicines for Type 2 Diabetes – Benefits
Medicines for Type 2 Diabetes – Possible Side Effects
Why is information about cholesterol and triglycerides listed in the chart?
Diabetes medicines are mainly for lowering blood sugar. Research shows that a few of them can also affect cholesterol and triglycerides.
What else should I know about serious side effects?
The most common side effects of type 2 diabetes medicines are weight gain and stomach problems. The chart titled "Medicines for Type 2 Diabetes – Possible Side Effects" lists other side effects that are not common but can be serious. Here is more information about some of them so that you can talk with your doctor about your concerns.
Low blood sugar
Sometimes, the medicines can lower your blood sugar too much. This is called “hypoglycemia” (high-po-gly-SEE-mee-ah). Low blood sugar can cause you to feel dizzy, cold and sweaty, confused, shaky, and weak.
Warning: If you think you may have low blood sugar, eat or drink something with sugar in it right away. If you have symptoms while driving or using a machine, pull to the side of the road or turn off the machine. You may wish to keep juice or candy with you until you are comfortable with your medicine. Ask your doctor.
Taking diabetes medicines can raise the chance of a rare condition called “lactic acidosis” (lak-tik a-suh-DOE-sis). This condition is more likely for people who take diabetes medicines and have kidney or liver problems. Each year, about 1 out of 10,000 people taking diabetes medicine will have lactic acidosis. Common signs of lactic acidosis are:
The chance of having lactic acidosis is about the same for all diabetes medicines.
Warning: If you have any signs of lactic acidosis, call your doctor or nurse right away.
Congestive heart failure, or heart failure, is when the heart cannot pump enough blood to the rest of the body. Pioglitazone (Actos®) might cause congestive heart failure or make it worse. Call your doctor or nurse if you suddenly notice these symptoms of heart failure:
Making a Decision
How much do these medicines cost?
The cost to you depends on several things, including:
Most medicines for type 2 diabetes are covered by health insurance and come in a generic form. The chart below lists the average cost to the pharmacy for each generic and brand-name medicine mentioned in this summary. The doses are similar to those used in the research studies.
Average Wholesale Prices for Diabetes Medicines
How often will I need to take these medicines?
Where can I get more information about type 2 diabetes?
For more information about diabetes, visit the Medline Plus Web site.
Ask Your Doctor
Talk with your doctor or health care provider about the information in this research summary.
The information in this summary comes from the report Oral Diabetes Medications for Adults With Type 2 Diabetes: An Update. It was produced by the Johns Hopkins University Evidence-based Practice Center through funding from the Agency for Healthcare Research and Quality (AHRQ). For a copy of the report or for more information about AHRQ and the Effective Health Care Program, go to www.effectivehealthcare.ahrq.gov/diabetesmeds.cfm.
This summary was prepared by the John M. Eisenberg Center for Clinical Decisions and Communications Science at Baylor College of Medicine, Houston, TX.