Usually, people with Type 1 diabetes don't use oral medications. These medications work best in people with Type 2 diabetes who have had high blood sugar for less than ten years and who have normal weight or obesity. It's not uncommon for oral medication to control blood sugar well for years and then stop working. Some people who begin treatment with oral medications eventually need to take insulin. The following information explains common diabetes oral medication including how they work, how often they are taken and common side effects.

• Alpha-glucosidase inhibitors
• Biguanides
• Meglitinides
• Sulfonylureas
• Thiazolidinediones

Sulfonylureas

How they work
Until 1994, sulfonylureas were the only oral medications for diabetes available in the US . These medications act to force your pancreas to make more insulin, which then lowers your blood sugar.
For this medication to work, your pancreas has to make some insulin. If your pancreas makes no insulin at all, you aren't a good candidate for this class of drugs. Also, if you have an allergy to sulfa drugs you should probably avoid sulfonylureas.

How often to take
Some sulfonylureas work all day, so you take them only once. Others are taken twice each day. Your doctor will tell you how many times a day you should be taking yours.

When to take
The correct time to take these medications varies. If you take the medication once a day, you will probably take it just before breakfast. If you take it twice each day, you will probably take the first pill before breakfast and the second one just before supper. Take the medications at the same times each day. Your doctor can tell you when to take your medication, depending on the type of sulfonylureas prescribed.

Side Effects

• low blood sugar
• an upset stomach
• skin rash or itching
• weight gain

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Biguanides

How they work
The generic (non-brand) name of this drug is metformin. It helps lower blood sugar by making sure your liver doesn't make too much sugar. Metformin also lowers the amount of insulin in your body. You may lose a few pounds when you start to take metformin. This weight loss can help you control your blood glucose. Metformin can also improve blood fat and cholesterol levels, mainly affecting triglyerides and HDL levels favorably, which are often high if you have Type 2 diabetes.

How often, when to take
Two to three times each day with a meal. Your doctor will tell you which meals to take it with.

Side Effects

• Metformin can make you sick if you drink more than about two to four alcoholic drinks a week. If you drink more than that, you need to tell your doctor. You probably shouldn't take this medication.
• If you already have a kidney problem, metformin may build up in your body. Make sure that your doctor knows your kidneys work well before you are placed on this medication.
• If you are vomiting, have diarrhea, and can't drink enough fluids, you may need to stop taking this medication for a few days.
• Occasionally, people on this medication can become weak, tired or dizzy and have trouble breathing. If you ever have any of these symptoms, call your doctor or get medical attention immediately.
• You may have nausea, diarrhea and other stomach problems when you first start taking metformin. These usually go away, but you should check with your doctor if you are experiencing these symptoms.
• You may notice the taste of metal in your mouth.
• If you are having surgery, tell the surgeon you are taking metformin. You should be told to stop taking this medication on the day of surgery. Then you shouldn't take it again until you are eating and your kidneys are working normally.
• If you have a medical test using dye, tell the doctor you are taking metformin. You may be told to stop taking metformin the day of the test and not to take the medication again for 48 hours.
• The UKPDS showed enormous benefit with medformin.

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Alpha-glucosidase inhibitors

How they work
There are now two alpha-glucosidase inhibitors, acarbose and miglitol. Both medications block the enzymes that digest the starches you eat. This action causes a slower and lower rise of blood sugar through the day, but mainly right after meals.

How often, when to take
Acarbose and Miglitol are taken three times daily, at meals, although your doctor might ask you to take the medication less often at first. It should be taken with the first bite of a meal.

Side Effects
Taking this medication may cause stomach problems such as gas, bloating and diarrhea that most often go away after you take the medication for awhile.

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Thiazolidinediones

How they work
The generic names for this medication is pioglitazone and Rosiglitazone. The medication works by helping make your cells more sensitive to insulin. The insulin can then move glucose from your blood into your cells for energy.

How often, when to take
Pioglitazone or Rosiglitazone is usually taken once a day at the same time, with or without a meal.

Side Effects

• If you take pioglitazone or Rosiglitazone, it is important for your health care provider to check your liver enzyme levels regularly. Call your doctor right away if you have any signs of liver disease, which include nausea, vomiting, stomach pain, lack of appetite, tiredness, yellowing of the skin or whites of the eyes, or dark-colored urine.
• Medications in this group don't cause blood sugar to drop too low. But if you take other diabetes medications along with pioglitazone or Rosiglitazone, your blood sugar might drop too low.
• If you take birth control pills, medications in this group might make your birth control pills less effective in preventing pregnancy.
• Weight gain.
• You may be at risk for developing anemia which will make you feel tired. Anemia causes your blood to carry less oxygen than normal.
• Swelling in the legs or ankles.

Combinations and thiazolidinediones
Your doctor may ask you to take another diabetes medication along with a thiazolidinedione. Or you may take it as your only medication.

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Meglitinides

How they work
This is a new type of diabetes medication. Prandin and Starlix (brand names) Repaglinide is a generic (non-brand) name for one of the meglitinides. As glucose levels rise, this medication helps your pancreas make more insulin, which lowers glucose levels. Your doctor might prescribe repaglinide by itself or with metformin if one medication alone doesn't control your blood sugar. A good thing about repaglinide is that it works fast and your body uses it quickly. This fast action means you can vary the times you eat and the number of meals you eat more easily than you can with other diabetes medications. These work like short acting sulfonylureas.

How often, when to take
Your doctor will tell you to take repaglinide before you eat a meal. If you skip a meal, you shouldn't take the dose. Repaglinide is taken from 30 minutes before to just before a meal. It lowers blood sugar the most one hour after it's taken, and it is out of the bloodstream in three to four hours.

Side Effects

• weight gain
• low blood sugar

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