From the Guidelines
Diabetes medications can be categorized into several classes, including biguanides, sulfonylureas, meglitinides, thiazolidinediones, DPP-4 inhibitors, SGLT2 inhibitors, GLP-1 receptor agonists, alpha-glucosidase inhibitors, and insulin therapy, with the choice of medication depending on the type of diabetes, glucose control needs, comorbidities, and patient preferences, as outlined in the 2025 standards of care in diabetes 1.
Medication Classes
- Biguanides: metformin (Glucophage) reduces glucose production in the liver and improves insulin sensitivity, with a high glucose-lowering efficacy and neutral effect on weight, as noted in the 2025 standards of care in diabetes 1.
- Sulfonylureas: glipizide (Glucotrol), glyburide (DiaBeta, Glynase), and glimepiride (Amaryl) stimulate insulin secretion, with a high glucose-lowering efficacy but increased risk of hypoglycemia and weight gain 1.
- DPP-4 inhibitors: sitagliptin (Januvia), saxagliptin (Onglyza), and linagliptin (Tradjenta) prevent the breakdown of incretin hormones, with an intermediate glucose-lowering efficacy and neutral effect on weight 1.
- SGLT2 inhibitors: empagliflozin (Jardiance), dapagliflozin (Farxiga), and canagliflozin (Invokana) reduce glucose reabsorption in the kidneys, with an intermediate to high glucose-lowering efficacy and potential benefits for cardiovascular and kidney outcomes 1.
- GLP-1 receptor agonists: semaglutide (Ozempic, Rybelsus), dulaglutide (Trulicity), and liraglutide (Victoza) stimulate insulin secretion and reduce glucagon, with a high to very high glucose-lowering efficacy and potential benefits for weight loss and cardiovascular outcomes 1.
- Insulin therapy: includes rapid-acting, short-acting, intermediate-acting, and long-acting formulations, with a high to very high glucose-lowering efficacy but increased risk of hypoglycemia and weight gain 1.
Key Considerations
- The choice of medication should be individualized based on the patient's specific needs and comorbidities, as outlined in the 2025 standards of care in diabetes 1.
- Medications with potential benefits for cardiovascular and kidney outcomes, such as SGLT2 inhibitors and GLP-1 receptor agonists, should be considered for patients with these comorbidities 1.
- Medications with a high risk of hypoglycemia, such as sulfonylureas and insulin, should be used with caution in patients at risk for hypoglycemia 1.
From the FDA Drug Label
Oral Antidiabetic Agents Metformin (1000 mg) Pioglitazone (45 mg) Sitagliptin (100 mg) Glimepiride (4 mg) Voglibose (0.2 mg three times daily)
The different classes of medications for diabetes mentioned in the drug label are:
- Biguanides: metformin
- Thiazolidinediones: pioglitazone
- Dipeptidyl peptidase-4 (DPP-4) inhibitors: sitagliptin, saxagliptin
- Sulfonylureas: glimepiride
- Alpha-glucosidase inhibitors: voglibose
- Sodium-glucose cotransporter 2 (SGLT2) inhibitors: dapagliflozin
Some commonly used examples, their generic and trade names are:
- Metformin (Glucophage)
- Pioglitazone (Actos)
- Sitagliptin (Januvia)
- Saxagliptin (Onglyza)
- Glimepiride (Amaryl)
- Dapagliflozin (Farxiga)
- Voglibose (Volix) 2, 2, 3
From the Research
Classes of Medications for Diabetes
The classes of medications for diabetes include:
- Biguanides, such as metformin 4
- Sulfonylureas 5
- Meglitinides 5
- Alpha-glucosidase inhibitors 5
- Thiazolidinediones 5
- DPP-4 inhibitors 6, 7
- GLP-1 receptor agonists 4, 6, 7
- SGLT-2 inhibitors 4, 6, 7
Examples of Medications for Diabetes
Some examples of medications for diabetes, along with their generic and trade names, are:
- Metformin (Glucophage) 4
- Sulfonylureas, such as glimepiride (Amaryl) and glyburide (DiaBeta) 5
- Meglitinides, such as repaglinide (Prandin) 5
- Alpha-glucosidase inhibitors, such as acarbose (Precose) 5
- Thiazolidinediones, such as pioglitazone (Actos) 5
- DPP-4 inhibitors, such as sitagliptin (Januvia) 6, 7
- GLP-1 receptor agonists, such as liraglutide (Victoza) and semaglutide (Ozempic) 6, 7
- SGLT-2 inhibitors, such as canagliflozin (Invokana) and empagliflozin (Jardiance) 6, 7
Insulin and Insulin Analogs
In addition to oral medications, insulin and insulin analogs are also used to treat diabetes, including: