• Sulfonylureas 15
These medications help your body secrete more insulin.
Examples of medications in this class include glyburide
(DiaBeta, Glynase), glipizide (Glucotrol) and glimepiride
(Amaryl). Possible side effects include low blood sugar and
weight gain.
• Meglitinides 16
These medications work like sulfonylureas by stimulating
the pancreas to secrete more insulin, but they are faster
acting, and the duration of their effect in the body is
shorter. They also have a risk of causing low blood sugar,
but this risk is lower than with sulfonylureas.
Weight gain is a possibility with this class of medications
as well. Examples include repaglinide (Prandin) and
nateglinide (Starlix).
• Thiazolidinediones 17
Like metformin, these medications make the body’s tissues
more sensitive to insulin. This class of medications has been
linked to weight gain and other more serious side effects,
such as an increased risk of heart failure and fractures.
Because of these risks, these medications generally are not
a first-choice treatment.
Rosiglitazone (Avandia) and pioglitazone (Actos) are
examples of thiazolidinediones.
• Dipeptidyl peptidase-4 inhibitors 18
These medications help reduce blood sugar levels, but
they tend to have a modest effect. They do not cause
weight gain. Examples of these medications are sitagliptin
(Januvia), saxagliptin (Onglyza) and linagliptin (Tradjenta).
• Glucagon-like peptide-1 receptor agonists 19
These medications slow digestion and help lower blood
sugar levels, though not as much as sulfonylureas. Their
use is often associated with some weight loss. This class of
medications is not recommended for use by itself.
Exenatide (Byetta) and liraglutide (Victoza) are examples
of GLP-1 receptor agonists. Possible side effects include
nausea and an increased risk of pancreatitis.
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