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Tablets

In Australia, there are six classes, or groups of tablets used to lower blood glucose levels for people with type 2 diabetes. These tablets can be taken either by themselves or together with a tablet from another group of tablets. You can read more about the different groups of tablets below.

Your doctor will talk to you about:

  • which tablets are right for you
  • when to take your tablets
  • how much to take, and
  • possible side effects.

You should talk to your doctor or pharmacist if you experience any problems with your medication.

Read more in our fact sheet Medications for type 2 diabetes.

Biguanides

Chemical name:

  • Metformin

Points to remember about biguanides:

  • This group of tablets helps lower blood glucose levels by reducing the amount of glucose released by the liver and helps your own insulin work better.
  • These tablets need to be started at a low dose and increased gradually.
  • Metformin is often prescribed as the first diabetes tablet for people with type 2 diabetes. It generally does not lead to weight gain. It may even help to manage weight.
  • Type 2 diabetes is progressive, and your doctor may need to increase the dose over time.
  • Metformin may need to be used together with other groups of diabetes tablets, and/or insulin to better manage your diabetes.
  • Metformin by itself does not cause hypoglycaemia (low blood glucose, or a ‘hypo’), but it may contribute to hypoglycaemia when used together with tablets from the sulphonylurea group or insulin.

Sulphonylureas

Chemical names include:

  • Glibenclamide
  • Gliclazide
  • Glimepiride
  • Glipizide

Points to remember about sulphonylureas:

  • This group of diabetes tablets lower blood glucose levels by stimulating the pancreas to release more insulin.
  • They can cause hypoglycaemia. Be sure to discuss this with your health professional and refer to our fact sheet Managing hypoglycaemia.
  • Type 2 diabetes is progressive and your doctor may need to increase the dose over time.
  • Sulphonylureas may need to be used together with metformin and other groups of diabetes tablets and/or insulin to better manage your diabetes.
  • They should not be taken by women who are pregnant or breastfeeding.

Thiazolidinediones (glitazones)

Chemical names:

  • Pioglitazone
  • Rosiglitazone

Points to remember about glitazones:

  • They help to lower blood glucose levels by reducing the amount of glucose released by the liver and increasing the effect of your own insulin, especially on muscle and fat cells, i.e. they improve insulin resistance.
  • Their effect is slow, taking days or even weeks to begin working and one to two months to take full effect.
  • They work well together with some of the other groups of diabetes tablets.
  • Taken on their own they do not cause hypoglycaemia (low blood glucose, or a hypo), but hypos can occur when they are taken with a sulphonylurea.
  • They should be used with careful monitoring and regular blood tests in people who have liver disease.
  • They should not be taken by women who are pregnant or breastfeeding.

Alpha-glucosidase inhibitors

Chemical name:

  • Acarbose

Points to remember about alpha-glucosidase inhibitors:

  • They help to slow down the digestion and absorption of certain dietary carbohydrates in the stomach (intestine).
  • Does not cause hypoglycaemia when used on their own
  • They can be taken together with other groups of diabetes tablets and/or insulin to better manage your diabetes.
  • They should not be taken by women who are pregnant or breastfeeding.

Dipeptidyl peptidase-4 inhibitors (DPP-4 inhibitors or gliptins)

Chemical name:

  • Alogliptin
  • Linagliptin
  • Saxagliptin
  • Sitagliptin
  • Vildagliptin

Points to remember about DPP-4 inhibitors:

  • They work by inhibiting the enzyme DPP-4. This enhances the levels of active incretin hormones, which act to lower blood glucose levels by increasing insulin secretion and decreasing glucagon secretion (a hormone that has the opposite effect of insulin by increasing blood glucose levels).
  • By themselves, they are unlikely to cause hypoglycaemia.
  • They should not be used by people who are under 18 years of age, pregnant or intending to become pregnant, and breastfeeding or planning to breastfeed.
  • If you have kidney or liver problems, your doctor may prescribe lower doses.

Sodium-glucose co-transporter 2 inhibitors (SGLT2 inhibitors)

Chemical names:

  • Dapagliflozin
  • Empagliflozin
  • Ertugliflozin

Points to remember about SGLT2 inhibitors:

  • They work by reducing the amount of glucose reabsorbed in the kidney and increase how much is excreted in the urine.
  • They have a low risk of causing hypoglycaemia (low blood glucose, or a ‘hypo’) when used on their own, but it may contribute to hypoglycaemia when used in conjunction with tablets from the sulphonylurea group or insulin.
  • They should not be taken by women who are pregnant or breastfeeding.

Combinations

At some stage, your doctor may decide to add a second or even a third type of diabetes tablet to maintain your blood glucose levels in your target range. For example, metformin plus a tablet from the sulphonylurea is a common combination.

As an alternative to taking two separate tablets, there are now many products that combine two medications into a single tablet.

How are you going with your diabetes health checks?

Regular checks can help prevent serious diabetes complications like problems with your feet, eyes, heart and kidneys. Individual members of your health care team will let you know how often you need checks, so you can schedule them into your calendar.

Your medications should be reviewed every year as part of your diabetes health check, or more often if blood glucose levels are not in your target range.