1. Metformin
Metformin is a medication commonly used to treat type 2 diabetes by improving insulin sensitivity and reducing glucose production in the liver. It belongs to the biguanide class of drugs and is often prescribed as a first-line treatment for diabetes management. Medicines Related to Diabetes..
How Metformin Works
- Reduces liver glucose production (gluconeogenesis).
- Improves insulin sensitivity in muscles and fat tissues.
- Decreases intestinal glucose absorption.
Uses
- Primarily for type 2 diabetes management.
- Sometimes used for polycystic ovary syndrome (PCOS) to help with insulin resistance.
- Investigated for potential benefits in weight loss, anti-aging, and cancer prevention (though not officially approved for these).
Common Side Effects
- Nausea, diarrhea, stomach upset (usually temporary).
- Loss of appetite.
- Metallic taste.
- Rare but serious: Lactic acidosis (a dangerous buildup of lactic acid in the blood, more common in kidney or liver disease).
Who Should Be Cautious?
- People with kidney or liver disease.
- Those with severe heart failure or alcohol use disorder.
- Patients undergoing contrast dye imaging (may require temporary discontinuation).
2. Glimipride
Glimepiride is an oral medication used to treat type 2 diabetes. It belongs to the sulfonylurea class and works by stimulating the pancreas to release more insulin, thereby lowering blood sugar levels.
How Glimepiride Works
- Stimulates beta cells in the pancreas to produce insulin.
- Increases insulin sensitivity in peripheral tissues (muscles and fat).
- Reduces hepatic glucose production to some extent.
Uses
- Type 2 diabetes management, often in combination with metformin or insulin.
- Not for type 1 diabetes or diabetic ketoacidosis (DKA).
Common Side Effects
- Hypoglycemia (low blood sugar) – dizziness, sweating, hunger, confusion.
- Weight gain (common with sulfonylureas).
- Nausea or mild stomach upset.
- Skin reactions (rash, itching).
Precautions & Warnings
- Risk of severe hypoglycemia, especially in elderly patients or with excessive alcohol intake.
- Not recommended for people with severe kidney or liver disease.
- Avoid alcohol, as it can worsen blood sugar fluctuations.
3. Pioglitazone
Pioglitazone is an oral medication used to treat type 2 diabetes. It belongs to the thiazolidinedione (TZD) class and works by improving insulin sensitivity in the body.
How Pioglitazone Works
- Increases insulin sensitivity in muscle and fat cells.
- Reduces glucose production in the liver.
- Does NOT stimulate insulin release, so it has a lower risk of hypoglycemia compared to sulfonylureas (like glimepiride).
Uses
- Type 2 diabetes management (alone or in combination with metformin, sulfonylureas, or insulin).
- Investigated for potential benefits in non-alcoholic fatty liver disease (NAFLD) and polycystic ovary syndrome (PCOS).
Common Side Effects
- Weight gain (due to fluid retention).
- Edema (swelling in the legs and ankles).
- Increased risk of fractures, especially in women.
- Possible heart failure risk (due to fluid retention)
Warnings & Precautions
- Not recommended for heart failure patients (can worsen fluid retention).
- May increase the risk of bladder cancer (long-term use at high doses).
- Can cause liver enzyme elevations (liver function should be monitored).
4. Gliclazide
Gliclazide is an oral medication used to treat type 2 diabetes. It belongs to the sulfonylurea class and works by stimulating the pancreas to release more insulin, helping lower blood sugar levels.
How Gliclazide Works
- Increases insulin secretion from pancreatic beta cells.
- Reduces post-meal blood sugar spikes.
- Has mild anti-inflammatory and blood vessel-protective effects, which may reduce diabetes-related complications.
Uses
- Type 2 diabetes management, often combined with metformin or other antidiabetic drugs.
- Not for type 1 diabetes or diabetic ketoacidosis (DKA).
Common Side Effects
- Hypoglycemia (low blood sugar) – sweating, dizziness, hunger, confusion.
- Weight gain (common with sulfonylureas).
- Nausea or mild stomach discomfort.
Precautions & Warnings
- Risk of severe hypoglycemia, especially in elderly patients or those skipping meals.
- Not recommended for severe kidney or liver disease.
- Caution with alcohol, as it can cause unpredictable blood sugar drops.
5. Vildagliptin
Vildagliptin is an oral antidiabetic medication used to treat type 2 diabetes. It belongs to the DPP-4 (dipeptidyl peptidase-4) inhibitor class and works by increasing insulin secretion and reducing glucose production in a glucose-dependent manner, which lowers the risk of hypoglycemia.
How Vildagliptin Works
- Inhibits the DPP-4 enzyme, which normally breaks down incretin hormones (GLP-1 and GIP).
- Increases insulin release from the pancreas when blood sugar is high.
- Reduces glucagon secretion, lowering liver glucose production.
- Works only when blood sugar is high, so it has a low risk of hypoglycemia.
Uses
- Type 2 diabetes management, either alone or in combination with metformin, sulfonylureas, or pioglitazone.
- Often prescribed as Vildagliptin + Metformin (Galvus Met) for better blood sugar control.
Common Side Effects
- Generally well tolerated, but some may experience:
- Headache
- Dizziness
- Mild gastrointestinal issues (nausea, constipation)
- Upper respiratory infections
Precautions & Warnings
- Not for type 1 diabetes or diabetic ketoacidosis (DKA).
- Liver monitoring required – can cause elevated liver enzymes.
- Rare but serious: Risk of pancreatitis (severe abdominal pain, nausea, vomiting).
- Not recommended for severe kidney or liver disease.
6. Sitagliptin
- Sitagliptin is an oral antidiabetic medication used to treat type 2 diabetes. It belongs to the DPP-4 (dipeptidyl peptidase-4) inhibitor class and works by increasing insulin release and reducing glucagon levels, leading to better blood sugar control.
How Sitagliptin Works
- Inhibits DPP-4 enzyme, which slows down the breakdown of incretin hormones (GLP-1 and GIP).
- Increases insulin secretion when blood sugar levels are high.
- Reduces glucagon secretion, preventing excess liver glucose production.
- Works in a glucose-dependent manner, so it has a low risk of hypoglycemia.
Uses
- Type 2 diabetes management, alone or in combination with metformin, sulfonylureas, or insulin.
- Available as a combination pill with metformin (Sitagliptin + Metformin = Janumet).
Common Side Effects
- Generally well tolerated, but possible:
- Headache
- Nausea
- Mild stomach discomfort
- Upper respiratory infections
Precautions & Warnings
- Not for type 1 diabetes or diabetic ketoacidosis (DKA).
- Rare risk of pancreatitis (watch for severe abdominal pain).
- May require dose adjustment in kidney disease.
- Liver monitoring recommended in some cases.
7.Teneligliptin
- Teneligliptin is an oral antidiabetic medication used for type 2 diabetes. It belongs to the DPP-4 (dipeptidyl peptidase-4) inhibitor class and helps control blood sugar levels by increasing insulin release and reducing glucose production.
How Teneligliptin Works
- Inhibits the DPP-4 enzyme, which normally breaks down incretin hormones (GLP-1 and GIP).
- Increases insulin release from the pancreas when blood sugar is high.
- Reduces glucagon secretion, lowering liver glucose production.
- Works only when blood sugar is high, so it has a low risk of hypoglycemia.
Uses
- Type 2 diabetes management, alone or in combination with metformin, sulfonylureas, or pioglitazone.
- Available in some countries as Teneligliptin + Metformin combination therapy.
Common Side Effects
- Usually well tolerated, but possible:
- Headache
- Dizziness
- Nausea
- Mild stomach discomfort
- Upper respiratory infections
Precautions & Warnings
- Not for type 1 diabetes or diabetic ketoacidosis (DKA).
- Risk of pancreatitis (watch for severe abdominal pain).
- May require dose adjustment in kidney disease.
- Liver monitoring is recommended in some cases.
8. Linagliptin
- Linagliptin is an oral antidiabetic medication used for type 2 diabetes. It belongs to the DPP-4 (dipeptidyl peptidase-4) inhibitor class and helps control blood sugar levels by increasing insulin release and reducing glucagon levels.
How Linagliptin Works
- Type 2 diabetes management, alone or in combination with metformin, sulfonylureas, or insulin.
- Often prescribed as Linagliptin + Metformin (Jentadueto) for better blood sugar control.
Key Advantages of Linagliptin
✔ No dose adjustment required in kidney disease (unlike sitagliptin, vildagliptin, and teneligliptin).
✔ Once-daily dosing for convenience.
✔ Low risk of hypoglycemia when used alone.
Common Side Effects
- Generally well tolerated, but possible:
- Headache
- Nasopharyngitis (cold-like symptoms)
- Mild stomach discomfort
Precautions & Warnings
- Not for type 1 diabetes or diabetic ketoacidosis (DKA).
- Rare risk of pancreatitis (watch for severe abdominal pain).
- Use with caution in liver disease.
9. Empagliflozin
Empagliflozin is an oral antidiabetic medication used for type 2 diabetes. It belongs to the SGLT-2 (sodium-glucose co-transporter-2) inhibitor class and works by increasing glucose excretion through urine, helping lower blood sugar levels.
How Empagliflozin Works
- Blocks SGLT-2 in the kidneys, reducing glucose reabsorption.
- Increases glucose excretion through urine, lowering blood sugar.
- Promotes weight loss due to calorie loss from glucose excretion.
- Reduces blood pressure by promoting mild diuresis (fluid loss).
Uses
- Type 2 diabetes management, alone or in combination with metformin, DPP-4 inhibitors, or insulin.
- Heart failure treatment (reduces hospitalization risk).
- Chronic kidney disease (CKD) protection (slows kidney damage).
Key Benefits of Empagliflozin
✔ Reduces risk of heart-related death in diabetic patients.
✔ Promotes weight loss (unlike sulfonylureas and insulin).
✔ Lowers blood pressure naturally.
✔ Protects kidney function in diabetes patients.
Common Side Effects
Increased urination (due to glucose excretion).
Urinary tract infections (UTIs) and genital infections (due to sugar in urine).
Dehydration & dizziness (due to mild fluid loss).
Ketoacidosis (rare but serious) – can occur even with normal blood sugar.
Precautions & Warnings
- Not for type 1 diabetes or diabetic ketoacidosis (DKA).
- Increased risk of genital infections (especially in women).
- Caution in elderly patients – risk of dehydration and low blood pressure.
- May cause rare Fournier’s gangrene (serious genital infection).
- Not recommended in severe kidney disease (low eGFR < 30 mL/min).
10. Dapagliflozin
Dapagliflozin is an oral antidiabetic medication used for type 2 diabetes, heart failure, and chronic kidney disease (CKD). It belongs to the SGLT-2 (sodium-glucose co-transporter-2) inhibitor class and works by increasing glucose excretion through urine, helping to lower blood sugar.
How Dapagliflozin Works
- Blocks SGLT-2 in the kidneys, reducing glucose reabsorption.
- Increases glucose excretion through urine, lowering blood sugar levels.
- Promotes weight loss due to calorie loss from glucose excretion.
- Reduces blood pressure by promoting mild diuresis (fluid loss).
- Protects the heart and kidneys by reducing strain on these organs.
Uses
- Type 2 diabetes management, alone or in combination with metformin, DPP-4 inhibitors, or insulin.
- Heart failure treatment (reduces risk of hospitalization and death).
- Chronic kidney disease (CKD) protection (slows kidney damage progression).
Key Benefits of Dapagliflozin
✔ Reduces risk of heart failure (even in non-diabetic patients).
✔ Promotes weight loss (unlike sulfonylureas and insulin).
✔ Lowers blood pressure naturally.
✔ Protects kidney function in diabetes and CKD patients.
Common Side Effects
- Increased urination (due to glucose excretion).
- Urinary tract infections (UTIs) and genital infections (due to sugar in urine).
- Dehydration & dizziness (due to mild fluid loss).
- Ketoacidosis (rare but serious) – can occur even with normal blood sugar.
Precautions & Warnings
- Not for type 1 diabetes or diabetic ketoacidosis (DKA).
- Increased risk of genital infections (especially in women).
- Caution in elderly patients – risk of dehydration and low blood pressure.
- May cause rare Fournier’s gangrene (serious genital infection).
- Not recommended in severe kidney disease (low eGFR < 25 mL/min)
