Large-print version

What I need to know about 

Diabetes Medicines

National Diabetes Information 

Clearinghouse

What I need to know about 

Diabetes Medicines

Contents

What do diabetes medicines do? ..................................... 1

What targets are recommended for 

blood glucose levels? ....................................................... 2

What happens to blood glucose levels in people 

with diabetes? ................................................................... 4

Medicines for My Diabetes ............................................... 6

Types of Diabetes Medicines ............................................ 8

What do I need to know about side effects 

of medicines? ................................................................. 13

For More Information ...................................................... 14

Acknowledgments .......................................................... 15

*Inserts are in back pocket

What do diabetes medicines do?

Over time, high levels of blood glucose, also called blood 

sugar, can cause health problems. These problems 

include heart disease, heart attacks, strokes, kidney 

disease, nerve damage, digestive problems, eye disease, 

and tooth and gum problems. You can help prevent health 

problems by keeping your blood glucose levels on target. 

Everyone with diabetes needs to choose foods wisely and 

be physically active. If you can’t reach your target blood 

glucose levels with wise food choices and physical activity, 

you may need diabetes medicines. The kind of medicine 

you take depends on your type of diabetes, your schedule, 

and your other health conditions. 

Diabetes medicines help keep your blood glucose in your 

target range. The target range is suggested by diabetes 

experts and your doctor or diabetes educator. See page 

2 for more information about target levels for good health. 

You may need diabetes 

medicines to reach your 

blood glucose targets.

1
 

 

 

 

What targets are recommended for blood 

glucose levels? 

The National Diabetes Education Program uses blood 

glucose targets set by the American Diabetes Association 

(ADA) for most people with diabetes. To learn your daily 

blood glucose numbers, you’ll check your blood glucose 

levels on your own using a blood glucose meter. 

Target blood glucose levels 

for most people with diabetes My targets 

Before meals 70 to 130 mg/dL* 

1 to 2 hours after 

the start of a meal Less than 180 mg/dL 

* Milligrams per deciliter. 

Also, you should ask your doctor for a blood test called 

the A1C at least twice a year. The A1C will give you your 

average blood glucose for the past 3 months. 

Target A1C result for 

people with diabetes My target 

Less than 7 percent 

Your personal A1C goal might be higher or lower than 

7 percent. Keeping your A1C as close to normal as 

possible—below 6 percent without having frequent low blood 

glucose—can help prevent long-term diabetes problems. 

2 
 

 

Doctors might recommend other goals for very young 

children, older people, people with other health problems, or 

those who often have low blood glucose. 

Talk with your doctor or diabetes educator about whether the 

target blood glucose levels and A1C result listed in the charts 

on page 2 are best for you. Write your own target levels in 

the charts. Both ways of checking your blood glucose levels 

are important. 

If your blood glucose levels are not on target, you might 

need a change in how you take care of your diabetes. 

The results of your A1C test and your daily blood glucose 

checks can help you and your doctor make decisions about 

l what you eat 

l when you eat 

l how much you eat 

l what kind of exercise you do 

l how much exercise you do 

l the type of diabetes medicines you take 

l the amount of diabetes medicines you take 

3 
What happens to blood glucose levels in 

people with diabetes? 

Blood glucose levels go up and down throughout the day 

and night in people with diabetes. High blood glucose 

levels over time can result in heart disease and other 

health problems. Low blood glucose levels can make you 

feel shaky or pass out. But you can learn how to make 

sure your blood glucose levels stay on target—not too high 

and not too low. 

What makes blood glucose levels go too high? 

Your blood glucose levels can go too high if 

l	 you eat more than usual 

l	 you’re not physically active 

l	 you’re not taking enough diabetes medicine 

l	 you’re sick or under stress 

l	 you exercise when your blood glucose level is 


already high
 

4 
What makes blood glucose levels go too low? 

Your blood glucose levels can go too low if 

l you eat less than usual 

l you miss a meal or snack or eat later than usual 

l you’re more active than usual 

l you drink alcoholic beverages on an empty stomach 

Some diabetes medicines can also lower your blood 

glucose too much. Ask your doctor whether your diabetes 

medicines can cause low blood glucose. See Insert N for 

information about low blood glucose. 

The results of your blood glucose checks can help you make 

decisions about your diabetes medicines, food choices, and 

physical activity. 

5 
 

 

 

Medicines for My Diabetes 

Ask your doctor what type of diabetes you have and check 

off the answer. 

I have 

q type 1 diabetes 

q type 2 diabetes 

q gestational diabetes 

q another type of diabetes: ____________________ 

Medicines for Type 1 Diabetes 

Type 1 diabetes, once called juvenile diabetes or 

insulin-dependent diabetes, is usually first found in 

children, teenagers, or young adults. If you have type 1 

diabetes, you must take insulin because your body no 

longer makes it. You also might need to take other types 

of diabetes medicines that work with insulin. 

6 
 

 

 

Medicines for Type 2 Diabetes 

Type 2 diabetes, once called adult-onset diabetes or 

noninsulin-dependent diabetes, is the most common form 

of diabetes. It can start when the body doesn’t use insulin 

as it should, a condition called insulin resistance. If the 

body can’t keep up with the need for insulin, you may need 

diabetes medicines. Many choices are available. Your 

doctor might prescribe two or more medicines. The ADA 

recommends that most people start with metformin, a kind 

of diabetes pill. 

Medicines for Gestational Diabetes 

Gestational diabetes is diabetes that occurs for the first 

time during pregnancy. The hormones of pregnancy or a 

shortage of insulin can cause gestational diabetes. Most 

women with gestational diabetes control it with meal 

planning and physical activity. But some women need 

insulin to reach their target blood glucose levels. 

Medicines for Other Types of Diabetes 

If you have one of the rare forms of diabetes, such as 

diabetes caused by other medicines or monogenic 

diabetes, talk with your doctor about what kind of diabetes 

medicine would be best for you. 

7 
 

 

 

 

 

 

 

Types of Diabetes Medicines 

Diabetes medicines come in several forms. 

Insulin 

If your body no longer makes enough insulin, you’ll need to 

take it. Insulin is used for all types of diabetes. Your doctor 

can help you decide which way of taking insulin is best for 

you. 

l	 Taking injections. You’ll give yourself shots using a 

needle and syringe. The syringe is a hollow tube with 

a plunger. You will put your dose of insulin into the 

tube. Some people use an insulin pen, which looks 

like a pen but has a needle for its point. 

l	 Using an insulin pump. An insulin pump is a small 

machine about the size of a cell phone, worn outside 

of your body on a belt or in a pocket or pouch. The 

pump connects to a small plastic tube and a very 

small needle. The needle is inserted under the skin 

and stays in for several days. Insulin is pumped from 

the machine through the tube into your body. 

8 
 

 

l	 Using an insulin jet injector. The jet injector, which 

looks like a large pen, sends a fine spray of insulin 

through the skin with high-pressure air instead of a 

needle. 

l	 Using an insulin infuser. A small tube is inserted 

just beneath the skin and remains in place for several 

days. Insulin is injected into the end of the tube 

instead of through the skin. 

If your body no longer makes enough insulin, you’ll 

need to take it. 

9 
 

 

 

 

What does insulin do? 

Insulin helps keep blood glucose levels on target by 

moving glucose from the blood into your body’s cells. Your 

cells then use glucose for energy. In people who don’t 

have diabetes, the body makes the right amount of insulin 

on its own. But when you have diabetes, you and your 

doctor must decide how much insulin you need throughout 

the day and night. 

What are the possible side effects of insulin? 

Possible side effects include 

l low blood glucose (for more information, see Insert N) 

l weight gain 

How and when should I take my insulin? 

Your plan for taking insulin will depend on your daily 

routine and your type of insulin. Some people with 

diabetes who use insulin need to take it two, three, or four 

times a day to reach their blood glucose targets. Others 

can take a single shot. Your doctor or diabetes educator 

will help you learn how and when to give yourself insulin. 

10 
 

 

 

Types of Insulin 

Each type of insulin works at a different speed. For 

example, rapid-acting insulin starts to work right after you 

take it. Long-acting insulin works for many hours. Most 

people need two or more types of insulin to reach their 

blood glucose targets. 

Look at the list of types of insulin on Insert C in the pocket 

of this booklet. Check off the names of the kinds of insulin 

you take. Then write the names of your insulins under 

My Insulins in the chart on Insert A. 

Diabetes Pills 

Along with meal planning and physical activity, diabetes 

pills help people with type 2 diabetes or gestational 

diabetes keep their blood glucose levels on target. Several 

kinds of pills are available. Each works in a different way. 

Many people take two or three kinds of pills. Some people 

take combination pills. Combination pills contain two kinds 

of diabetes medicine in one tablet. Some people take pills 

and insulin. 

Diabetes pills help people with 

type 2 diabetes or gestational 

diabetes keep their blood 

glucose levels on target. 

11 
 

 

 

 

 

Your doctor may ask you to try one kind of pill. If it doesn’t 

help you reach your blood glucose targets, your doctor 

may ask you to 

l take more of the same pill 

l add another kind of pill 

l change to another type of pill 

l start taking insulin 

l start taking another injected medicine 

If your doctor suggests that you take insulin or another 

injected medicine, it doesn’t mean your diabetes is getting 

worse. Instead, it means you need insulin or another type 

of medicine to reach your blood glucose targets. Everyone 

is different. What works best for you depends on your 

usual daily routine, eating habits, and activities, and your 

other health conditions. 

For information about the different kinds of pills and what 

they do, see the cards in the pocket of this booklet. You’ll 

see the brand name and the generic name—the scientific 

name—for each medicine. Find your diabetes pills and 

check off the names. Then write the names of your 

diabetes pills under My Pills and Injected Medicines in 

the chart on Insert A. 

12 
Injections Other Than Insulin

In addition to insulin, two other types of injected medicines 

are now available. Both work with insulin—either the 

body’s own or injected—to help keep your blood glucose 

from going too high after you eat. Neither is a substitute 

for insulin. 

See the cards in the pocket of this booklet for more 

information about these injected medicines. Check off 

the kinds you take. Then write the names of your injected 

medicines under My Pills and Injected Medicines in the 

chart on Insert A.

Talk with your doctor if you have questions about your 

diabetes medicines. Do not stop taking your diabetes 

medicines without checking with your doctor first. See 

Insert B for a list of questions to ask your doctor about 

your medicines.

What do I need to know about side effects 

of medicines?

A side effect is an unwanted problem caused by a 

medicine. For example, some diabetes medicines 

can cause nausea or an upset stomach when you first 

start taking them. Before you start a new medicine, ask 

your doctor about possible side effects and how you can 

avoid them. If the side effects of your medicine bother you, 

tell your doctor. 

13
For More Information

To find diabetes educators—nurses, dietitians, 

and other health professionals—near you, call 

the American Association of Diabetes Educators 

toll-free at 1–800–TEAMUP4 (1–800–832–6874). Or 

go to www.diabeteseducator.org and see the “Find a 

Diabetes Educator” section.

For additional information about diabetes, contact

American Diabetes Association

National Service Center

1701 North Beauregard Street

Alexandria, VA 22311–1742

Phone: 1–800–DIABETES (1–800–342–2383)

Fax: 703–549–6995

Email: AskADA@diabetes.org

Internet: www.diabetes.org

Juvenile Diabetes Research Foundation International

26 Broadway, 14th Floor

New York, NY 10004

Phone: 1–800–533–CURE (1–800–533–2873) 

Fax: 212–785–9595

Email: info@jdrf.org

Internet: www.jdrf.org 

14
National Diabetes Education Program

1 Diabetes Way

Bethesda, MD 20814–9692

Phone: 1–888–693–NDEP (1–888–693–6337) 

TTY: 1–866–569–1162

Fax: 703–738–4929

Email: ndep@mail.nih.gov

Internet: www.ndep.nih.gov

Acknowledgments

Publications produced by the Clearinghouse are carefully 

reviewed by both NIDDK scientists and outside experts. 

This booklet was reviewed by Stuart T. Haines, Pharm.D., 

University of Maryland School of Pharmacy, Baltimore.

The U.S. Government does not endorse or favor any specifi c commercial 

product or company. Trade, proprietary, or company names appearing 

in this document are used only because they are considered necessary 

in the context of the information provided. If a product is not mentioned, 

the omission does not mean or imply that the product is unsatisfactory.

15
National Diabetes 

Information Clearinghouse

1 Information Way

Bethesda, MD 20892–3560

Phone: 1–800–860–8747

TTY: 1–866–569–1162

Fax: 703–738–4929

Email: ndic@info.niddk.nih.gov

Internet: www.diabetes.niddk.nih.gov

The National Diabetes Information Clearinghouse (NDIC) is a service 

of the National Institute of Diabetes and Digestive and Kidney Diseases 

(NIDDK). The NIDDK is part of the National Institutes of Health of the 

U.S. Department of Health and Human Services. Established in 1978, the 

Clearinghouse provides information about diabetes to people with diabetes 

and to their families, health care professionals, and the public. The NDIC 

answers inquiries, develops and distributes publications, and works closely 

with professional and patient organizations and Government agencies to 

coordinate resources about diabetes.

This publication is not copyrighted. The Clearinghouse encourages users 

of this publication to duplicate and distribute as many copies as desired.

This publication is available at www.diabetes.niddk.nih.gov.

This publication may contain information about medications. When 

prepared, this publication included the most current information available. 

For updates or for questions about any medications, contact the U.S. Food 

and Drug Administration toll-free at 1–888–INFO–FDA (1–888–463–6332) 

or visit www.fda.gov. Consult your doctor for more information.
What I need to know about Diabetes Medicines

Inserts

My Diabetes Medicines ............................................. Insert A

Questions to Ask about Your Diabetes Medicines.... Insert B

Types of Insulin ......................................................... Insert C

Glyset and Precose (Alpha-Glucosidase 

Inhibitors).................................................................... Insert D

Glucophage, Glucophage XR, and Riomet 

(Biguanides) .............................................................. Insert E

Starlix (D-Phenylalanine Derivative).......................... Insert F

Januvia (DPP-4 Inhibitor) .......................................... Insert G

Prandin (Meglitinide) ................................................. Insert H

Amaryl, DiaBeta, Diabinese, Glucotrol, 

Glucotrol XL, Glynase PresTab, Micronase, 

tolazamide, and tolbutamide (Sulfonylureas)............ Insert I

Actos and Avandia (Thiazolidinediones)................... Insert J

Actoplus Met, Actoplus Met XR, Avandamet, 

Avandaryl, Duetact, Glucovance, Janumet, 

and Metaglip (Combination Diabetes Pills) ............... Insert K

Symlin (Amylin Mimetic)............................................ Insert L

Byetta (Incretin Mimetic)............................................ Insert M

About Low Blood Glucose......................................... Insert N

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm
What I need to know about Diabetes Medicines Insert A
 

My Diabetes Medicines 

Write the names of your diabetes medicines here. 

My Insulins 

Brand Name Generic Name Type of Insulin 

My Pills and Injected Medicines
 

Brand Name Generic Name 

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm 
What I need to know about Diabetes Medicines 

 

 

Insert B
 

Questions to Ask about Your Diabetes 

Medicines 

Ask your doctor these questions when you get a prescription 

for a medicine. Make copies of this card and use one card for 

each of your medicines. 

What are the names of my medicine? 

Brand name: Generic name: 

What does my medicine do? 

When should I start this medicine? 

This medicine is prescribed by: 

How long will it take this medicine to work? 

What is the strength (for example, how many milligrams, 

written as mg)? 

How much should I take for each dose? 

How many times a day should I take my medicine? 

At what times should I take my medicine? 

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm 
What I need to know about Diabetes Medicines Insert B
 

Should I take it before, with, or after a meal? 

Should I avoid any foods or medicines when I take it? 

Should I avoid alcoholic beverages when I take it? 

Are there any times when I should change the amount of 

medicine I take? 

What should I do if I forget to take it? 

If I’m sick and can’t keep food down, should I still take my 

medicine? 

Can my diabetes medicine cause low blood glucose? 

What should I do if my blood glucose is too low? 

What side effects can this medicine cause? 

What should I do if I have side effects? 

How should I store this medicine? 
What I need to know about Diabetes Medicines 

 

 

 

 

 

Insert C
 

Types of Insulin 

Each type of insulin has an onset, a peak, and a duration 

time. 

The onset is how soon the insulin starts to lower your blood 

glucose after you take it. 

The peak is the time the insulin is working the hardest to 

lower your blood glucose. 

The duration is how long the insulin lasts—the length of 

time it keeps lowering your blood glucose. 

The times shown in the chart are estimates. Your onset, 

peak, and duration times may be different. You’ll work with 

your health care team to come up with an insulin plan that 

works best for you. 

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm 
 

 

 

 

 

 

 

 

 

 

 

What I need to know about Diabetes Medicines Insert C What I need to know about Diabetes Medicines Insert C
 

Type of Insulin Brand Name Generic Name Onset Peak Duration 

Rapid-acting q	 NovoLog q Insulin aspart 15 minutes 30 to 90 minutes 3 to 5 hours 

q	 Apidra q Insulin glulisine 15 minutes 30 to 90 minutes 3 to 5 hours 

q	 Humalog q Insulin lispro 15 minutes 30 to 90 minutes 3 to 5 hours 

Short-acting q Humulin R 

q Novolin R 

q Regular (R) 30 to 60 minutes 2 to 4 hours 5 to 8 hours 

Intermediate-acting q Humulin N 

q Novolin N 

q NPH (N) 1 to 3 hours 8 hours 12 to 16 hours 

Long-acting q Levemir 

q Lantus 

q

q

Insulin detemir 

Insulin glargine 

1 hour Peakless 20 to 26 hours 

Pre-mixed NPH 

(intermediate-acting) 

and regular 

(short-acting) 

q Humulin 70/30 

q Novolin 70/30 

q 70% NPH and 

30% regular 

30 to 60 minutes Varies 10 to 16 hours 

q Humulin 50/50 q 50% NPH and 

50% regular 

30 to 60 minutes Varies 10 to 16 hours 

Pre-mixed insulin lispro q Humalog Mix q 75% insulin lispro 10 to 15 minutes Varies 10 to 16 hours 

protamine suspension 75/25 protamine and 

(intermediate-acting) 25% insulin lispro 

and insulin lispro 

(rapid-acting) q Humalog Mix 

50/50 

q 50% insulin lispro 

protamine and 

50% insulin lispro 

10 to 15 minutes Varies 10 to 16 hours 

Pre-mixed insulin aspart q NovoLog Mix q 70% insulin aspart 5 to 15 minutes Varies 10 to 16 hours 

protamine suspension 70/30 protamine and 

(intermediate-acting) 30% insulin aspart 

and insulin aspart 

(rapid-acting)
What I need to know about Diabetes Medicines	 

 

 

Insert D
 

Alpha-Glucosidase (AL-fuh-gloo-KOH-sih-dayss) 

Inhibitor (in-HIB-ih-tur) 

Brand Name Generic Name 

q	 Glyset (GLY-set) 

q	 Precose (PREE-kohss) 

q	 miglitol (MIG-lih-tol) 

q	 acarbose (A-kahr-bohss) 

What does this type of pill do? 

This type of pill helps keep your blood glucose from going 

too high after you eat, a common problem in people with 

diabetes. It works by slowing down the digestion of foods 

high in carbohydrate, such as rice, potatoes, bread, milk, 

and fruit. 

Who should not take Glyset or Precose? 

Talk with your doctor about whether to take this type of pill if 

l	 you have bowel disease or other intestinal conditions 

l	 you have advanced kidney or liver disease 

l	 you are pregnant, planning to get pregnant, or 


breastfeeding
 

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm 
 

 

 

What I need to know about Diabetes Medicines Insert D
 

What are the possible side effects? 

This type of pill doesn’t cause low blood glucose by itself. 

But your risk of having low blood glucose goes up if you also 

take 

l diabetes pills that cause low blood glucose 

l insulin 

Your doctor may ask you to take a lower dose of your other 

diabetes medicines while you take this type of pill. 

Taking Glyset or Precose may cause stomach pain, gas, 

bloating, or diarrhea. These symptoms usually go away after 

you have taken these pills for a while. 

If you take Glyset or Precose: What you need to know 

about low blood glucose 

If you take Glyset or Precose, only glucose tablets or 

glucose gel will bring your blood glucose level back to 

normal quickly. Other quick-fix foods and drinks won’t 

raise your blood glucose as quickly because Glyset and 

Precose slow the digestion of other quick-fix foods and 

drinks. 
What I need to know about Diabetes Medicines Insert E

Biguanide (by-GWAH-nyd)

Brand Name Generic Name

q Glucophage (GLOO-coh-fahj)

q Glucophage XR 

q Riomet (RY-oh-met)

q metformin (met-FOR-min) 

q metformin—long-acting

q metformin—liquid

The American Diabetes Association recommends metformin 

(Glucophage, Glucophage XR, Riomet) as the first choice 

of diabetes medicine for most people with type 2 diabetes. 

Metformin can be taken alone or with other diabetes 

medicines. See Insert K for information about combination 

pills that contain both metformin and another diabetes 

medicine.

What does this type of medicine do?

This type of medicine, which comes in pill or liquid form, 

lowers the amount of glucose made by your liver. Then your 

blood glucose levels don’t go too high. This type of medicine 

also helps treat insulin resistance. With insulin resistance, 

your body doesn’t use insulin the way it should. When your 

insulin works properly, your blood glucose levels stay on 

target and your cells get the energy they need. This type of 

medicine improves your cholesterol levels. It also may help 

you lose weight.

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm
What I need to know about Diabetes Medicines Insert E

Who should not take Glucophage, Glucophage XR, 

or Riomet?

Talk with your doctor about whether to take this type of 

medicine if

l you have advanced kidney or liver disease

l you drink excessive amounts of alcoholic beverages

l you are pregnant, planning to get pregnant, or 

breastfeeding

What are the possible side effects?

This type of pill doesn’t cause low blood glucose by itself. 

But your risk of having low blood glucose goes up if you also 

take

l diabetes pills that cause low blood glucose

l insulin

Your doctor may ask you to take a lower dose of your other 

diabetes medicines while you take this type of pill.

You may have nausea, diarrhea, or an upset stomach when 

you first start taking this type of medicine. These side effects 

are likely to go away after a while.
What I need to know about Diabetes Medicines Insert E

Rarely, a serious condition called lactic acidosis occurs as 

a side effect of taking this medicine. Call your doctor right 

away if you

l become weak and tired

l become dizzy

l feel very cold

l have trouble breathing

l have unusual muscle pain and stomach problems

l have a sudden change in the speed or steadiness of 

your heartbeat

Sometimes you’ll need to stop taking this type of medicine 

for a short time so you can avoid developing lactic acidosis. 

If you have severe vomiting, diarrhea, or a fever, or if you 

can’t keep fluids down, call your doctor right away. You 

should also talk with your doctor well ahead of time about 

stopping this type of medicine if

l you’ll be having special x rays that require an injection of 

dye

l you’ll be having surgery

Your doctor will tell you when it’s safe to start taking your 

medicine again.
What I need to know about Diabetes Medicines	 

 

 

 

Insert F
 

D-Phenylalanine (dee-FEN-il-AL-uh-neen) 

Derivative (duh-RIV-uh-tiv) 

Brand Name Generic Name 

q Starlix (STAR-liks) q nateglinide 

(nuh-TEG-lih-nyd) 

What does this type of pill do? 

This type of pill helps your body make more insulin for a 

short period of time right after meals. The insulin helps 

keep your blood glucose from going too high after you eat, a 

common problem in people with diabetes. 

Who should not take Starlix? 

Talk with your doctor about whether to take this type of pill if 

l	 you are pregnant, planning to get pregnant, or 


breastfeeding
 

l	 you have liver disease 

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm 
What I need to know about Diabetes Medicines Insert F
 

What are the possible side effects? 

Possible side effects are 

l low blood glucose, also called hypoglycemia 

(HY-poh-gly-SEE-mee-uh)—for more information, see 

Insert N
 

l weight gain
 

l dizziness
 
What I need to know about Diabetes Medicines	 

 

 

Insert G
 

DPP-4 Inhibitor 

Dipeptidyl (dy-PEP-tih-dil) Peptidase-4 

(PEP-tih-dayss-FOR) Inhibitor (in-HIB-ih-tur) 

Brand Name Generic Name 

o Januvia (juh-NOO-vee-uh) o sitagliptin (sih-tuh-GLIP-tin) 

phosphate (FOSS-fayt) 

What does this type of pill do? 

This type of pill lowers your blood glucose by helping your 

body make more insulin when it’s needed, especially right 

after meals. It also helps keep your liver from putting stored 

glucose into your blood. 

Who should not take Januvia? 

Talk with your doctor about whether to take this type of pill if 

l	 you are pregnant, planning to get pregnant, or 


breastfeeding
 

l	 you have kidney disease 

l	 you have type 1 diabetes and if you have a condition 

called diabetic ketoacidosis 

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm 
 

What I need to know about Diabetes Medicines Insert G
 

What are the possible side effects? 

This type of pill doesn’t cause low blood glucose by itself. 

But your risk of having low blood glucose goes up if you 

also take 

l diabetes pills that cause low blood glucose 

l insulin 

Your doctor may ask you to take a lower dose of your other 

diabetes medicines while you take this type of pill. 

Possible side effects are 

l a cold 

l runny nose 

l sore throat 

l headache 

If you take Januvia and have kidney problems, your health 

care provider might order blood tests to see how well your 

kidneys are working.
What I need to know about Diabetes Medicines	 

 

 

 

Insert H
 

Meglitinide (meh-GLIH-tih-nyde)
 

Brand Name Generic Name 

q Prandin (PRAN-din) q repaglinide 

(ruh-PAG-luh-nyd) 

What does this type of pill do? 

This type of pill helps your body make more insulin for a 

short period of time right after meals. The insulin helps 

keep your blood glucose from going too high after you eat, a 

common problem in people with diabetes. 

Who should not take Prandin? 

Talk with your doctor about whether to take this type of pill if 

l	 you are pregnant, planning to get pregnant, or 


breastfeeding
 

l	 you have liver disease 

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm 
What I need to know about Diabetes Medicines Insert H
 

What are the possible side effects? 

Prandin can cause 

l low blood glucose, also called hypoglycemia 

(HY-poh-gly-SEE-mee-uh)—for more information, see 

Insert N
 

l weight gain 


l upset stomach
 

l back pain or a headache
 
What I need to know about Diabetes Medicines 

 

 

 

 

 

Insert I
 

Sulfonylurea (SUHL-foh-nil-yoo-REE-uh)
 

Brand Name Generic Name 

q Amaryl (AM-uh-ril) q glimepiride (gly-MEP-ih-ryd) 

q DiaBeta (dy-uh-BAY-tuh) q glyburide (GLY-buh-ryd) 

q Diabinese (dy-AB-ih-neez) q chlorpropamide 

(klor-PROH-puh-myd) 

q Glucotrol (GLOO-kuh-trohl) q glipizide (GLIP-ih-zyd) 

q Glucotrol XL 

(GLOO-kuh-trohl)(EKS-EL) 

q glipizide (GLIP-ih-zyd) 

(long-acting) 

q Glynase (GLY-nayz) 

PresTab 

q glyburide (GLY-buh-ryd) 

q Micronase (MY-kroh-nayz) q glyburide (GLY-buh-ryd) 

Available only in generic form: 

q tolazamide (tahl-AZ-uh-myd) 

q tolbutamide 

(tahl-BYOO-tuh-myd) 

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm 
 

 

What I need to know about Diabetes Medicines Insert I
 

What does this type of pill do? 

This type of pill helps your body make more insulin. The 

insulin helps lower your blood glucose. 

Who should not take sulfonylureas? 

Talk with your doctor about whether to take this type of pill if 

l you are allergic to sulfa drugs 

l you are pregnant, planning to get pregnant, or 

breastfeeding 

What are the possible side effects? 

Possible side effects include 

l low blood glucose, also called hypoglycemia 

(HY-poh-gly-SEE-mee-uh)—for more information, see 

Insert N
 

l upset stomach 


l skin rash 


l weight gain
 
What I need to know about Diabetes Medicines Insert J

Thiazolidinedione (THY-uh-ZOHL-ih-deen-DY-ohn)

Brand Name Generic Name

q Actos (AK-tohss) q pioglitazone 

(py-oh-GLIH-tuh-zohn)

q Avandia (uh-VAN-dee-uh) q rosiglitazone 

(rohss-ih-GLIH-tuh-zohn)

If you are currently taking the thiazolidinedione medicine 

pioglitazone (Actos) or a combination diabetes pill containing 

pioglitazone: See the U.S. Food and Drug Administration 

(FDA) announcement on the next page about this pill. 

Discuss treatment options with your doctor before stopping 

your diabetes medicines. Stopping your diabetes medicines 

without talking with your doctor can cause serious short-term 

health problems and could increase the risk of long-term 

diabetes-related complications. 

See Insert K for more information about combination 

diabetes pills that contain pioglitazone or rosiglitazone.

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm
What I need to know about Diabetes Medicines Insert J

In June 2011, the FDA warned that use of Actos for 

more than 1 year may be associated with an increased 

risk of bladder cancer. The FDA recommended that 

people receiving treatment for bladder cancer should 

not take Actos, and Actos should be used with caution 

in people with a history of bladder cancer. This 

warning also applies to the combination diabetes pills 

containing pioglitazone—Actoplus Met, Actoplus Met 

XR, and Duetact; see Insert K.

Visit www.fda.gov/Drugs/DrugSafety/ucm259150 or call 

the FDA at 1–888–INFO–FDA (1–888–463–6332) for more 

information about the FDA’s warning on the use of Actos.
What I need to know about Diabetes Medicines Insert J

What does this type of pill do?

This type of pill helps treat insulin resistance. With insulin 

resistance, your body doesn’t use insulin the way it should. 

Thiazolidinediones help your insulin work properly. Then 

your blood glucose levels stay on target and your cells get 

the energy they need.

Who should not take this type of pill?

People with heart failure, also called congestive heart failure, 

should not take this type of pill.

Heart failure is a condition in which your heart no longer 

pumps properly. Then your body keeps too much fluid in 

your legs, ankles, and lungs.

This type of pill can cause heart failure or make it 

worse.
What I need to know about Diabetes Medicines Insert J

Call your doctor right away if you have signs of heart failure. 

Warning signs include

l having swelling in your legs or ankles

l

l

l

l

People being treated for bladder cancer should not take 

Actos or combination pills containing pioglitazone.

gaining a lot of weight in a short time

having trouble breathing

having a cough

being very tired

If you have a history of bladder cancer and are taking Actos, 

talk with your doctor.
What I need to know about Diabetes Medicines Insert J

You should also talk with your doctor about whether to take 

this type of pill if

l you are pregnant, planning to get pregnant, or 

breastfeeding

l you have liver disease

What are the possible side effects?

Heart failure is a serious side effect. 

Bladder cancer may be more likely to occur in people who 

take Actos for more than 1 year. Call your doctor right away 

if you have symptoms of bladder cancer while taking Actos: 

l pink, red, or cola-colored urine, indicating the presence 

of blood

l an urgent need to urinate or pain while urinating

l pain in your back or lower abdomen
What I need to know about Diabetes Medicines Insert J

This type of pill doesn’t cause low blood glucose by itself. 

But your risk of having low blood glucose goes up if you also 

take

l diabetes pills that cause low blood glucose

l insulin

Your doctor may ask you to take a lower dose of your other 

diabetes medicines while you take this type of pill.

Other possible side effects are

l anemia (uh-NEE-mee-uh), a condition that can make 

you feel very tired

l an increased risk of getting pregnant even if you’re 

taking birth control pills
What I need to know about Diabetes Medicines Insert J

Women who take Actos, Avandia, or combination diabetes 

pills containing pioglitazone or rosiglitazone may have an 

increased risk of bone fractures.

If you take Actos or Avandia, your health care provider 

should make sure your liver is working properly. Call your 

doctor right away if you have any signs of liver disease: 

nausea, vomiting, stomach pain, tiredness, dark-colored 

urine, or loss of appetite.
What I need to know about Diabetes Medicines Insert K

Combination Diabetes Pills

Many people with diabetes need more than one medicine 

to control their diabetes. If you need more than one type 

of diabetes pill, your health care provider may prescribe a 

combination pill. Combination pills contain two different types 

of diabetes medicines, so you can take one pill instead of two 

separate pills. 

Combination pills available include the following: 

See warning below;

these medicines contain 

pioglitazone (Actos):

l Actoplus Met

l Actoplus Met XR

l Duetact

l Avandamet

l Avandaryl

l Glucovance 

l Janumet 

l Metaglip

If you are currently taking a combination diabetes pill containing 

the thiazolidinedione medicine pioglitazone (Actos): See the 

U.S. Food and Drug Administration (FDA) announcement on 

the next page about this pill. 

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm
What I need to know about Diabetes Medicines Insert K

Discuss treatment options with your doctor before stopping your 

diabetes medicines. Stopping your diabetes medicines without 

talking with your doctor can cause serious short-term health 

problems and could increase the risk of long-term diabetesrelated complications. 

See Insert J for more information about the thiazolidinedione 

medicines.

In June 2011, the FDA warned that use of Actos for 

more than 1 year may be associated with an increased 

risk of bladder cancer. The FDA recommended that 

people receiving treatment for bladder cancer should 

not take Actos, and Actos should be used with caution 

in people with a history of bladder cancer. This warning 

also applies to combination diabetes pills containing 

pioglitazone—Actoplus Met, Actoplus Met XR, and 

Duetact.

Visit www.fda.gov/Drugs/DrugSafety/ucm259150 or call 

the FDA at 1–888–INFO–FDA (1–888–463–6332) for more 

information about the FDA’s warning on the use of Actos.
What I need to know about Diabetes Medicines Insert K

l

l

Brand Name Generic Name

q Actoplus Met (AK-tohpluhss)(met) 

q Actoplus Met XR 

q Avandamet (uh-VANduh-met)

q pioglitazone (py-oh-GLIH-tuh-zohn) 

+ metformin (met-FOR-min)

q rosiglitazone (rohss-ih-GLIH-tuhzohn) + metformin (met-FOR-min)

What does this type of pill do?

Actoplus Met, Actoplus Met XR, and Avandamet are a 

combination of two types of pills. One type lowers the amount 

of glucose made by your liver. Both types help your insulin 

work the way it should. Actoplus Met XR contains an extended 

release form of metformin along with pioglitazone.

To learn more about the types of pills in Actoplus Met, Actoplus 

Met XR, and Avandamet, see

Insert J for information about pioglitazone and 

rosiglitazone (thiazolidinediones)

Insert E for information about metformin (a biguanide)
What I need to know about Diabetes Medicines Insert K

l

l

Brand Name Generic Name

q Avandaryl (uh-VANduh-ril)

q Duetact (DOO-uh-tak)

q rosiglitazone (rohss-ih-GLIH-tuhzohn) + glimepiride (gly-MEP-ih-ryd)

q pioglitazone (py-oh-GLIH-tuh-zohn) 

+ glimepiride (gly-MEP-ih-ryd)

What does this type of pill do?

Avandaryl and Duetact are a combination of two types of pills. 

One type helps your insulin work the way it should. The other 

type helps your body make more insulin.

To learn more about the types of pills in Avandaryl and Duetact, 

see

Insert J for information about pioglitazone and 

rosiglitazone (thiazolidinediones)

Insert I for information about glimepiride (a sulfonylurea)
What I need to know about Diabetes Medicines Insert K

l

l

Brand Name Generic Name

q Glucovance (GLOOkoh-vanss)

q glyburide (GLY-buh-ryd) + metformin 

(met-FOR-min)

What does this type of pill do?

Glucovance is a combination of two types of pills. One type 

helps your body make more insulin. The other type lowers the 

amount of glucose made by your liver and helps your insulin 

work the way it should.

To learn more about the types of pills in Glucovance, see

Insert I for information about glyburide (a sulfonylurea)

Insert E for information about metformin (a biguanide)
What I need to know about Diabetes Medicines Insert K

l

l

Brand Name Generic Name

q Janumet (JAN-yoo-met) q sitagliptin (sih-tuh-GLIP-tin) + 

metformin (met-FOR-min)

What does this type of pill do?

Janumet is a combination of two types of pills. One type helps 

your body make more insulin when it’s needed, especially right 

after meals. It also helps keep your liver from putting stored 

glucose into your blood. The other type lowers the amount of 

glucose made by your liver and helps your insulin work the way 

it should.

To learn more about the types of pills in Janumet, see

Insert G for information about sitagliptin (a DPP-4 

inhibitor)

Insert E for information about metformin (a biguanide)
What I need to know about Diabetes Medicines Insert K

l

l

Brand Name Generic Name

q Metaglip (MET-uh-glip) q glipizide (GLIP-ih-zyd) + metformin 

(met-FOR-min)

What does this type of pill do?

Metaglip is a combination of two types of pills. One type 

helps your body make more insulin. The other type lowers the 

amount of glucose made by your liver and helps your insulin 

work the way it should.

To learn more about the types of pills in Metaglip, see

Insert I for information about glipizide (a sulfonylurea)

Insert E for information about metformin (a biguanide)
What I need to know about Diabetes Medicines	 

 

 

 

 

 

Insert L
 

Amylin (AM-ih-lin) Mimetic (mih-MET-ik)
 

Brand Name Generic Name 

o Symlin (SIM-lin) o pramlintide (PRAM-lin-tyd) 

acetate (ASS-ih-tayt) 

What does this medicine do? 

Symlin helps keep your blood glucose from going too high 

after you eat, a common problem in people with diabetes. 

It works by helping food move more slowly through your 

stomach. Symlin helps keep your liver from putting stored 

glucose into your blood. It also may prevent hunger, helping 

you eat less and maybe lose weight. 

Symlin is for people who already take insulin. However, 

you should always use a separate syringe to inject Symlin. 

Symlin is not used in place of insulin. But taking Symlin may 

change the amount of insulin you take. 

Who should not take Symlin? 

Talk with your doctor about whether you should take this type 

of medicine if 

l	 you can’t tell when you are having low blood glucose, a 

condition called hypoglycemia unawareness 

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm
 

 

What I need to know about Diabetes Medicines	 Insert L
 

l	 you have recently had severe low blood glucose 

l	 you have stomach problems caused by diabetes-related 

nerve damage 

l	 you are pregnant, planning to get pregnant, or 


breastfeeding 


Symlin has not been studied for use in children. 

There may be times when you should not take your usual 

dose of Symlin. If you’re having surgery or you’re sick and 

can’t eat, you should not take your Symlin. Ask your doctor 

about other times to not take it. 

What are the possible side effects? 

Symlin can cause 

l nausea and vomiting—most often when you first start 

taking Symlin 

l swelling, redness, or itching of the skin where Symlin is 

injected 


l headache
 

l decreased appetite
 
What I need to know about Diabetes Medicines Insert L
 

l stomach pain and indigestion 

l tiredness 

l dizziness 

This type of medicine doesn’t cause low blood glucose by 

itself. But your risk of having low blood glucose is higher 

because Symlin is always taken along with insulin.
What I need to know about Diabetes Medicines Insert M

Incretin (in-KREE-tin) Mimetic (mih-MET-ik)

Brand Name Generic Name

❏ Byetta (by-YAY-tuh) ❏ exenatide (eks-EN-uh-tyd)

What does this medicine do?

Byetta helps your body make more insulin when it’s needed. 

It helps keep your blood glucose from going too high after 

you eat, a common problem in people with diabetes. It works 

by helping food move more slowly through your stomach. 

Byetta helps keep your liver from putting stored glucose into 

your blood. It also may prevent hunger, helping you eat less 

and maybe lose weight. 

Byetta is not used in place of insulin. 

Who should not take Byetta?

Talk with your doctor about whether you should take this type 

of medicine if

● you have severe stomach or digestive problems

● you have any symptoms of kidney disease or are on 

dialysis

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm
What I need to know about Diabetes Medicines Insert M

● you are pregnant, planning to get pregnant, or 

breastfeeding 

● you have type 1 diabetes

Byetta has not been studied for use in children.

What are the possible side effects?

Byetta can cause

● nausea and vomiting—most often when you first start 

taking Byetta

● headache

● diarrhea

● dizziness

Byetta also can cause an acid stomach or make you feel 

nervous.
What I need to know about Diabetes Medicines Insert M

If you take Byetta: What you need to know about 

problems with your kidneys

Talk with your doctor right away if you notice any of the 

following:

● changes in the color of your urine, how often you 

urinate, or the amount you urinate

● swelling of your hands or feet

● tiredness 

● changes in your appetite or digestion 

● a dull ache in your mid to lower back

This type of medicine doesn’t cause low blood glucose by 

itself. But your risk of having low blood glucose goes up if 

you also take

● diabetes pills that cause low blood glucose 

● insulin 

Your doctor may ask you to take a lower dose of your other 

diabetes medicines while you take this type of medicine.
What I need to know about Diabetes Medicines 

 

 

 

 

Insert N
 

About Low Blood Glucose 

What is low blood glucose? 

Low blood glucose, also called hypoglycemia (HY-poh-gly-SEEmee-uh), is when your blood glucose is lower than normal. 

Blood glucose is too low when it’s below 70 mg/dL. If you 

don’t eat or drink something to bring your blood glucose level 

back to normal, you could pass out. Then you might need 

emergency treatment at a hospital. If you have low blood 

glucose several times a week, tell your doctor or diabetes 

educator. You might need a change in your diabetes 

medicines, meal plan, or activity routine. 

What can cause low blood glucose? 

Diabetes Medicines 

Some diabetes medicines can cause low blood glucose if 

there isn’t a balance between your medicines, food, and 

activity. Ask your doctor whether your diabetes medicines 

can cause low blood glucose. 

Other diabetes medicines do not cause low blood glucose 

on their own. But when they are taken with certain other 

diabetes medicines, they can increase the risk of low blood 

glucose. 

National Diabetes Information Clearinghouse • 1–800–860–8747

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm
 

What I need to know about Diabetes Medicines Insert N
 

Other Causes of Low Blood Glucose 

Low blood glucose can happen if you skip or delay a meal, 

eat too little at a meal, get more exercise than usual, or drink 

alcoholic beverages on an empty stomach. 

How will I feel if I have low blood glucose? 

Low blood glucose can make you feel 

l hungry l

dizzy 

nervous 

shaky l

sweaty 

sleepy 

confused 

l l l anxious 

l l l weak 

Low blood glucose can also happen while you sleep. You 

might cry out or have nightmares, sweat a lot, feel tired or 

confused when you wake up, or have a headache when you 

wake up. 
 

 

 

 

 

 

 

 

 

 

What I need to know about Diabetes Medicines	 Insert N
 

What should I do if I have low blood glucose? 

Follow these steps: 

1. If you feel like your blood glucose is low, check your 

blood glucose level with your blood glucose meter. 

2. If your blood glucose is below 70 mg/dL, have a serving 

of a “quick fix” food or drink right away. See the list of 

Quick-fix Foods and Drinks for Low Blood Glucose 

on the next page. If you can’t check your blood glucose 

but you feel like your blood glucose level is low, have 

something from the quick-fix list. 

3. After 15 minutes, check your blood glucose again. If it’s 

still below 70 mg/dL, have another serving of a quick-fix 

food or drink. 

4. Check your blood glucose again 15 minutes later.	 If it’s 

70 mg/dL or above, you’ll feel better soon. If your blood 

glucose is still low, have another serving of a quick-fix 

food or drink. Keep doing so until your blood glucose is 

70 mg/dL or above.

5. When your blood glucose has reached 70 mg/dL or 

above, think about when your next meal will be. If it will 

be more than an hour before your next meal, have a 

snack. 
 

 

What I need to know about Diabetes Medicines Insert N
 

Quick-fix Foods and Drinks for Low Blood 

Glucose 

l 3 or 4 glucose tablets
 

l 1 serving of glucose gel—the amount equal to 

15 grams of carbohydrate

l 1/2 cup (4 ounces) of any fruit juice

l 1/2 cup (4 ounces) of a regular—not diet—soft drink

l 1 cup (8 ounces) of milk

l 5 or 6 pieces of hard candy

l 1 tablespoon of sugar or honey

Always carry a quick-fix food or drink. You also can keep 

quick-fix foods in your car, at work, or wherever you go. 

Then you’ll be ready to take care of yourself if your blood 

glucose dips too low. 
NIH Publication 14–4222L

December 2013

The NIDDK prints on recycled paper with bio-based ink.