Diabetes Medicines

What I need to know about

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 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. 

1

You may need diabetes medicines 

to reach your blood glucose 

targets.
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 

Before meals 70 to 130 mg/dL* 

My targets 

1 to 2 hours after Less than 180 

the start of a meal 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 

2 
blood glucose—can help prevent long-term diabetes 

problems. 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
15

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 specific 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.
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.
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
Insert A 

What I need to know about Diabetes Medicines 

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 
Insert B 

What I need to know about Diabetes Medicines 

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? 
Insert C 

What I need to know about Diabetes Medicines 

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 Insulin detemir 

q 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 75/25 q 75% insulin lispro protamine 10 to 15 minutes Varies 10 to 16 hours 

protamine suspension and 25% insulin lispro 

(intermediate-acting) 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 70/30 q 70% insulin aspart protamine 5 to 15 minutes Varies 10 to 16 hours 

protamine suspension and 30% insulin aspart 

(intermediate-acting) and 

insulin aspart (rapid-acting) 
Insert D 

What I need to know about Diabetes Medicines 

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.

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
What I need to know about Diabetes Medicines Insert E

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.
Insert F 

What I need to know about Diabetes Medicines 

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 

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 

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

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

What I need to know about Diabetes Medicines 

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. 
Insert H 

What I need to know about Diabetes Medicines 

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 

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
 

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

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

What I need to know about Diabetes Medicines 

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.

This type of pill can cause heart failure or make it worse.

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.

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

signs include

l having swelling in your legs or ankles

l gaining a lot of weight in a short time

l having trouble breathing

l having a cough

l being very tired

People being treated for bladder cancer should not take Actos or 

combination pills containing pioglitazone.
What I need to know about Diabetes Medicines Insert J

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

your doctor.

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

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.
What I need to know about Diabetes Medicines Insert J

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

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. 

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 J for more information about the thiazolidinedione 

medicines.

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

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

Brand Name Generic Name

q Actoplus Met (AK-toh- q pioglitazone (py-oh-GLIH-tuhpluhss)(met) zohn) + metformin (met-FORq Actoplus Met XR min)

q Avandamet (uh-VAN-duhmet)

q rosiglitazone (rohss-ih-GLIHtuh-zohn) + metformin (metFOR-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

l Insert J for information about pioglitazone and rosiglitazone

(thiazolidinediones)

l Insert E for information about metformin (a biguanide)

 

 

 
What I need to know about Diabetes Medicines Insert K

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

l Insert J for information about pioglitazone and rosiglitazone

(thiazolidinediones)

l Insert I for information about glimepiride (a sulfonylurea)

Brand Name Generic Name

q Glucovance (GLOO-koh-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

l Insert I for information about glyburide (a sulfonylurea)

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

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

l Insert G for information about sitagliptin (a DPP-4 inhibitor)

l Insert E for information about metformin (a biguanide)

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

l Insert I for information about glipizide (a sulfonylurea)

l Insert E for information about metformin (a biguanide)
Insert L 

What I need to know about Diabetes Medicines 

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 

l	 you have recently had severe 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 L 

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 

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

● you are pregnant, planning to get pregnant, or breastfeeding 

● you have type 1 diabetes

Byetta has not been studied for use in children.

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

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.

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.
Insert N 

What I need to know about Diabetes Medicines 

About Low Blood Glucose 

What is low blood glucose? 

Low blood glucose, also called hypoglycemia (HY-poh-gly-SEE-mee-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. 

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. 

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

www.diabetes.niddk.nih.gov/dm/pubs/medicines_ez/index.htm 
How will I feel if I have low blood glucose?

Low blood glucose can make you feel

l hungry

l dizzy

l nervous

l shaky

l sweaty

l sleepy

l confused

l anxious

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 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. 

What I need to know about Diabetes Medicines Insert N
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 quickfix 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 No. 14–4222

December 2013

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