Tablets

There are five classes of tablets currently used in Australia for lowering blood glucose levels for people with type 2 diabetes. These tablets can be taken alone or with a tablet from another group. Further information about medications for people with type 2 diabetes, including some brand names, can be found in the Publications and Resources section.

Your doctor will talk to you about which tablets are right for you, when to take your tablets and how much to take. Your doctor can also tell you about any possible side effects. You should speak to your doctor or pharmacist if you experience any problems.

Biguanides

Chemical name:

  • Metformin

Points to remember about biguanides

  • This group of insulin tablets help lower blood glucose levels by reducing the amount of stored glucose released by the liver, slowing the absorption of glucose from the intestine, and helping the body to become more sensitive to insulin so that your own insulin works better.
  • They need to be started at a low dose and increased slowly.
  • Metformin is often prescribed as the first diabetes tablet for people with type 2 diabetes who are overweight. It generally doesn’t lead to weight gain and may 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 combined with the sulphonylurea or other classes of tablets and/or insulin.
  • Metformin by itself does not cause hypoglycaemia (low blood glucose or ‘hypo’) but may contribute to hypoglycaemia when used in conjunction with a sulphonylurea tablet or insulin.

Sulphonylureas

Chemical name:

  • Gliclazide
  • Glibenclamide
  • Glipizide
  • Glimepiride

Points to remember about sulphonylureas

  • Sulphonylureas lower blood glucose levels by stimulating the pancreas to release more insulin.
  • They can cause hypoglycaemia. Be sure to discuss this with your doctor or health professional and refer to the Hypoglycaemia and Diabetes information sheet.
  • Type 2 diabetes is progressive and your doctor may need to increase the dose over time.
  • Sulphonylureas may need to be combined with metformin and other classes of tablets and/or insulin.

Thiazolidinediones (glitazones)

Chemical name:

  • Rosiglitazone
  • Pioglitazone

Points to remember about thiazolidinediones (glitazones)

  • They help to lower blood glucose levels by 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 to weeks to begin working and one to two months for their full effect.
  • They work well together with some of the other diabetes tablets.
  • Taken on their own, they do not cause hypoglycaemia, but this can occur when they are taken with a sulphonylurea.
  • They should not be taken by people who have liver disease.
  • They should not be taken by women who are pregnant or breast-feeding.

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). Taken on their own, they don’t cause hypoglycaemia.
  • They can be taken together with other classes of medication including insulin.
  • They should not be taken by women who are pregnant or breast-feeding.

DPP-4 Inhibitors

Chemical name:

  • 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 because they do not work when blood glucose levels are low.
  • They should not be used if you are under 18 years of age, are pregnant or intend to become pregnant, while breastfeeding or if planning to breastfeed, or for the management of type 1 diabetes or diabetic ketoacidosis. If you have kidney or liver problems, your doctor may prescribe lower doses.

Combinations

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

As an alternative to taking two separate tablets there are currently three products that combine two medications into a single tablet:

Chemical name:

  • Metformin/glibenclamide
  • Metformin/Rosiglitazone
  • Metformin/Sitagliptin
  • Metformin/Vildagliptin
Back to TOP