1st Edition August 2005
By : Cindy Canter
*Sulfonylureas:
Stimulates the pancreas to release more insulin.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Chlorpropamide (Diabinese):
The only first generation sulfonylurea still
prescribed. Possible benefits are: Helps in
regulating blood sugar in non-insulin-dependent
diabetics along with diet, exercise, and weight
control.
Its possible risks are: Prolonged and severe
hypoglycemia, allergic skin reactions (some
severe), water retention, and liver damage or
blood cell and bone marrorw disorders (rare). It
is not as widely used as it once was.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Glipizide (Glucotrol and Glucotrol XL):
Second-generation sulfonylureas. Possible
benefits are: Tighter control of blood sugar,
decreased risk of heart and kidney disease by
keeping tighter control of blood sugar, once a
day dosing, Combining with metformin achieves
tighter control with less risk of low blood sugar.
Possible risks are: Hypoglycemia (low blood
sugar), allergic skin reactions (some severe),
blood cell and bone marrow disorders, possible
increased risk of heart (cardiovascular) mortality.
Possible side effects: (natural, expected, and
unavoidable drug action)
If too much of the drug is used, or if meals are
missed or inadequate, abnormally low blood
sugar (hypoglycemia) is possible.
Possible Adverse effects are:
Allergic reactions: skin rash, hives, itching.
headache, drowsiness, dizziness, fatigue,
sweating-rare to infrequent indigestion, nausea,
vomiting, diarrhea-rare to infrequent, increased
liver enzymes-case reports (question as to
cause)
Possible serious adverse effects:
Allergic reactions: severe skin reactions-case
reports
Anemia
Bone marrow depression with fatigue,
weakness, fever, sore throat, and
abnormal bleeding-case reports
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Glyburide (Micronase, Glynase, and Diabeta):
Second-generation sulfonylureas. Possible
benefits are: Helps regulate blood sugar, and
when combined with metformin in the
Glucovance form, it gives even tighter control.
Possible risks are: Severe, prolonged
hypoglycemia, lactic acidosis (rare with
Glucovance form), possible anemia, liver
damage, blood cell and bone marrow disorders,
allergic skin reactions.
Possible side effects: (natural, expected, and
unavoidable drug reactions)
If too much drug is used, or if meals are missed
or inadequate, abnormally low blood sugar
(hypoglycemia) is possible.
Possible adverse effects are:
Allergic reactions: skin rash, hives, itching
Headache, drowsiness, dizziness,
fatigue-possible
Indigestion, heartburn, nausea-rare
Possible Serious adverse effects:
Allergic reactions: hepatitis with jaundice,
severe skin reactions
Anemia, liver toxicity-case reports
Blood clotting problems-rare
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Glimepiride (Amaryl):
Second-generation sulfonylurea Possible
benefits are: Tighter control of blood sugar,
decreased risk of heart and kidney disease,
once a day dosing, decreased risk of higher
insulin levels, decreased risk of hypoglycemia,
may be combined with metformin or insulin if
needed, possibly decreases risk of abnormal
blood clots.
Possible risks are: Allergic skin reactions,
possible increased risk of heart mortality.
Possible side effects: (Natural, expected, and
unavoidable reactions)
Hypoglycemia will occur with excessive dose or
if meals are skipped or inadequate. This risk is
increased if this medicine is combined with
insulin.
Possible adverse effects are:
Allergic reactions: skin rash, hives, itching (may
subside over time)
Headache, dizziness, or blurred vision-rare
Nausea-rare Increased liver enzymes-infrequent
Possible Serious adverse effects:
Allergic reactions
Lowering of sodium-case reports
Low blood sugar-possible
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Meglitinides: Also stimulates the pancreas to
release more insulin
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Repaglinide (Prandin):
Possible side effects are:
Most common: High or low blood sugar,
headache, and respiratory infection
Common: sinus irritation, runny nose,
bronchitis, nausea, diarrhea, and back or joint
pain
Less common: constipation, vomiting, upset
stomach, tingling in the hands and feet, chest
pain, urinary infection, and tooth problems
Rare: allergy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Nateglinide (Starlix):
Possible benefits are: Helps to control blood
sugar, may be combined with metformin,
absorbed well and is cleared from the blood
quickly.
Possible risks are: Hypoglycemia, possible
increased risk of heart problems
Possible side effects: (natural, expected, and
unavoidable drug actions)
Hypoglycemia is possible if too much drug is
taken or meals are skipped or inadequate.
Possible adverse effects:
Allergic reactions: skin rash, hives, itching
Headache, drowsiness, dizziness,
fatigue-possible
Nausea, vomiting, diarrhea, heartburn-infrequent
Possible serious adverse effects:
Allergic reactions
Hypoglycemia
Cardiovascular mortality-possible increased risk
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Biguanide: Decreases amount of glucose
produced by the liver
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Metformin (Glucophage):
Possible benefits: Can prevent diabetes in some
high risk patients, combined with Avandia may
slow progression of diabetes and may prevent
long term complications of diabetes, gives
effective glucose control without insulin, does
not lead to weight gain, usually avoids
excessive lowering of blood sugar, favorable
effects on lipids
Possible risks: Lactic acidosis, possible anemia
Possible side effects: (natural, expected, and
unavoidable effects)
is possible if too much drug is taken or meals
are skipped or inadequate
Possible adverse effects:
Allergic reaction, rare rash
Metallic taste-infrequent and usually resolves
Nausea, vomiting, diarrhea-often subsides
Headache, nervousness, dizziness, or
tiredness-infrequent
Possible serious adverse effects:
Allergic reactions-rare
Liver toxicity-rare
Lactic acidosis-very rare
Lowered vitamin B levels resulting in
anemia-rare
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Thiazolidinediones:
Help insulin work better in muscle and fat and
reduces glucose production in the liver.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Avandia:
Possible benefits: Combining with metformin
may slow progression of diabetes and help
avoid long-term complications of diabetes,
decreases insulin resistance, effective control of
blood sugar,
Possible risks: Fluid retention, and worsening of
existing heart failure because of fluid retention,
low blood sugar.
Possible side effects:
Low blood sugar if meals are skipped or
inadequate
Possible adverse effects:
Allergic reactions: rare
Headache-infrequent
Hypoglycemia-possible
Weight gain-possible
Muscle aches-infrequent
Fluid retention (edema)-infrequent
Increased liver enzymes-very rare
Diarrhea-rare
Possible serious adverse effects:
Allergic reactions
Congestive heart failure or worsening of
existing heart failure-possible due to increased
fluid retention
Anemia-possible
Liver toxicity-very rare
Stimulates the pancreas to release more insulin.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Chlorpropamide (Diabinese):
The only first generation sulfonylurea still
prescribed. Possible benefits are: Helps in
regulating blood sugar in non-insulin-dependent
diabetics along with diet, exercise, and weight
control.
Its possible risks are: Prolonged and severe
hypoglycemia, allergic skin reactions (some
severe), water retention, and liver damage or
blood cell and bone marrorw disorders (rare). It
is not as widely used as it once was.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Glipizide (Glucotrol and Glucotrol XL):
Second-generation sulfonylureas. Possible
benefits are: Tighter control of blood sugar,
decreased risk of heart and kidney disease by
keeping tighter control of blood sugar, once a
day dosing, Combining with metformin achieves
tighter control with less risk of low blood sugar.
Possible risks are: Hypoglycemia (low blood
sugar), allergic skin reactions (some severe),
blood cell and bone marrow disorders, possible
increased risk of heart (cardiovascular) mortality.
Possible side effects: (natural, expected, and
unavoidable drug action)
If too much of the drug is used, or if meals are
missed or inadequate, abnormally low blood
sugar (hypoglycemia) is possible.
Possible Adverse effects are:
Allergic reactions: skin rash, hives, itching.
headache, drowsiness, dizziness, fatigue,
sweating-rare to infrequent indigestion, nausea,
vomiting, diarrhea-rare to infrequent, increased
liver enzymes-case reports (question as to
cause)
Possible serious adverse effects:
Allergic reactions: severe skin reactions-case
reports
Anemia
Bone marrow depression with fatigue,
weakness, fever, sore throat, and
abnormal bleeding-case reports
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Glyburide (Micronase, Glynase, and Diabeta):
Second-generation sulfonylureas. Possible
benefits are: Helps regulate blood sugar, and
when combined with metformin in the
Glucovance form, it gives even tighter control.
Possible risks are: Severe, prolonged
hypoglycemia, lactic acidosis (rare with
Glucovance form), possible anemia, liver
damage, blood cell and bone marrow disorders,
allergic skin reactions.
Possible side effects: (natural, expected, and
unavoidable drug reactions)
If too much drug is used, or if meals are missed
or inadequate, abnormally low blood sugar
(hypoglycemia) is possible.
Possible adverse effects are:
Allergic reactions: skin rash, hives, itching
Headache, drowsiness, dizziness,
fatigue-possible
Indigestion, heartburn, nausea-rare
Possible Serious adverse effects:
Allergic reactions: hepatitis with jaundice,
severe skin reactions
Anemia, liver toxicity-case reports
Blood clotting problems-rare
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Glimepiride (Amaryl):
Second-generation sulfonylurea Possible
benefits are: Tighter control of blood sugar,
decreased risk of heart and kidney disease,
once a day dosing, decreased risk of higher
insulin levels, decreased risk of hypoglycemia,
may be combined with metformin or insulin if
needed, possibly decreases risk of abnormal
blood clots.
Possible risks are: Allergic skin reactions,
possible increased risk of heart mortality.
Possible side effects: (Natural, expected, and
unavoidable reactions)
Hypoglycemia will occur with excessive dose or
if meals are skipped or inadequate. This risk is
increased if this medicine is combined with
insulin.
Possible adverse effects are:
Allergic reactions: skin rash, hives, itching (may
subside over time)
Headache, dizziness, or blurred vision-rare
Nausea-rare Increased liver enzymes-infrequent
Possible Serious adverse effects:
Allergic reactions
Lowering of sodium-case reports
Low blood sugar-possible
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Meglitinides: Also stimulates the pancreas to
release more insulin
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Repaglinide (Prandin):
Possible side effects are:
Most common: High or low blood sugar,
headache, and respiratory infection
Common: sinus irritation, runny nose,
bronchitis, nausea, diarrhea, and back or joint
pain
Less common: constipation, vomiting, upset
stomach, tingling in the hands and feet, chest
pain, urinary infection, and tooth problems
Rare: allergy
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Nateglinide (Starlix):
Possible benefits are: Helps to control blood
sugar, may be combined with metformin,
absorbed well and is cleared from the blood
quickly.
Possible risks are: Hypoglycemia, possible
increased risk of heart problems
Possible side effects: (natural, expected, and
unavoidable drug actions)
Hypoglycemia is possible if too much drug is
taken or meals are skipped or inadequate.
Possible adverse effects:
Allergic reactions: skin rash, hives, itching
Headache, drowsiness, dizziness,
fatigue-possible
Nausea, vomiting, diarrhea, heartburn-infrequent
Possible serious adverse effects:
Allergic reactions
Hypoglycemia
Cardiovascular mortality-possible increased risk
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Biguanide: Decreases amount of glucose
produced by the liver
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Metformin (Glucophage):
Possible benefits: Can prevent diabetes in some
high risk patients, combined with Avandia may
slow progression of diabetes and may prevent
long term complications of diabetes, gives
effective glucose control without insulin, does
not lead to weight gain, usually avoids
excessive lowering of blood sugar, favorable
effects on lipids
Possible risks: Lactic acidosis, possible anemia
Possible side effects: (natural, expected, and
unavoidable effects)
is possible if too much drug is taken or meals
are skipped or inadequate
Possible adverse effects:
Allergic reaction, rare rash
Metallic taste-infrequent and usually resolves
Nausea, vomiting, diarrhea-often subsides
Headache, nervousness, dizziness, or
tiredness-infrequent
Possible serious adverse effects:
Allergic reactions-rare
Liver toxicity-rare
Lactic acidosis-very rare
Lowered vitamin B levels resulting in
anemia-rare
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Thiazolidinediones:
Help insulin work better in muscle and fat and
reduces glucose production in the liver.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
*Avandia:
Possible benefits: Combining with metformin
may slow progression of diabetes and help
avoid long-term complications of diabetes,
decreases insulin resistance, effective control of
blood sugar,
Possible risks: Fluid retention, and worsening of
existing heart failure because of fluid retention,
low blood sugar.
Possible side effects:
Low blood sugar if meals are skipped or
inadequate
Possible adverse effects:
Allergic reactions: rare
Headache-infrequent
Hypoglycemia-possible
Weight gain-possible
Muscle aches-infrequent
Fluid retention (edema)-infrequent
Increased liver enzymes-very rare
Diarrhea-rare
Possible serious adverse effects:
Allergic reactions
Congestive heart failure or worsening of
existing heart failure-possible due to increased
fluid retention
Anemia-possible
Liver toxicity-very rare
Medications Used to Treat Diabetes
.
.
With benefits, risks, and possible side effects of each medicine