This document discusses oral diabetic medications for treating type 2 diabetes. It explains that oral medications can supplement insulin production in type 2 diabetics but not treat type 1 diabetics who cannot produce insulin. The document provides a history of oral medications including sulfonylureas discovered in 1942 and reviews classes of oral medications like biguanides, thiazolidinediones, alpha-glucosidase inhibitors and more. Each class is described with examples of medications and their normal dosages.

1. ORAL DIABETIC MEDICATIONS
By Tawnee Kight

2. ARE ORAL MEDICATIONS EFFECTIVE IN
TREATMENT OF ALL DIABETICS?
• No, Not all forms of diabetes are treatable with oral medication.
• Patients with Type 2 diabetes are able to produce some insulin. Therefore they are
able to utilize oral diabetic medications to supplement their body’s own insulin
production, to satisfy the demand.
• Patients with Type 1 diabetes are unable to produce insulin. Therefore the
supplemental oral medication is not enough to effectively manage the condition.

3. HISTORY OF ORAL DIABETIC
MEDICATIONS
• The first oral diabetic medication discovered were Sulfonylureas. They were found to
induce hypoglycemia in animals by chemist Marcel Janbon in 1942, while studying
sulfonamide antibiotics.
• Guanidine compounds were found in Galega (French Lilac) extracts, during the
1920’s. These compounds were found to induce hypoglycemia in animals. Some
derivatives were used to treat diabetes until the discovery of insulin. Biguanides
were brought back to treat Type 2 diabetes in the1950s.
In 2005 a new drug to treat Type 2 diabetes, Exenatide,
was found to maintain normal glucose levels in the
participants of a 3 year study. Exenatide is derived from
the saliva of the Gila Monster.

4. ORAL DIABETIC MEDICATIONS AND HOW THEY
WORK IN THE BODY
• Sulfonylureas
• Glipizide (Glucotrol, Glucotrol XL)
• Normal dosage range for this medication is 5-10 mg.
• Glimepride (Amaryl)
• Normal dosage range for this medication is 1-4 mg.
• Glyburide (DiaBeta®, Glynase PresTab®, Micronase®)
• Normal dosage for this medication is 1.25-6 mg.
• These medications lower blood glucose by stimulating the pancreas to release more
insulin.

5. • Biguanides
• Metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet)
• Normal dosage range for this medication is 500-1000 mg.
• These medications reduce how much glucose is stored and produced in the liver,
and improves how insulin works in the body by slowing the conversion of
carbohydrates into sugars.

6. • Thiazolidinediones
• Pioglitozone (Actos®)
• Normal dosage range for this medication is 15-45 mg.
• Rosiglitozone (Avandia®)
• Normal dosage range for this medication is 2-8 mg.
• These medications allow glucose to be stored in muscles, fat, and the liver,
enhancing the storage of insulin and the way insulin works.

7. • Alpha-glucosidase inhibitors
• Acarbose (Precose)
• Normal dosage for this drug is 25-100 mg.
• Miglitol (Glyset)
• Normal dosage for this drug is 25-100 mg.
• These medications breakdown carbohydrates in order to lower the blood glucose.
This medication also slows down digestion of starches by blocking certain enzymes.

8. • DPP-4 inhibitors
• Sitagliptin (Januvia)
• Normal dosage range for this medication is 25-100 mg.
• Saxagliptin (Onglyza)
• Normal dosage range for this medication is 2.5-5 mg.
• linagliptin (Tradjenta)
• Normal dosage range for this medication is 5 mg.
• Alogliptin (Nesina)
• Normal dosage range for this medication is 6.25-25 mg.
• These medications lower the amount of glucose produced by the liver and pancreas after
meals.

9. • SGLT2 inhibitors
• Canagliflozin (Invokana)
• Normal dosage range for this medication is 100 mg.
• Dapagliflozin (Farxiga)
• Normal dosage range for this medication is 5-10 mg.
• Empagliflozin (Jardiance)
• Normal dosage range for this medication is 10-25 mg.
• These medications work on the kidneys to remove excess sugars from the body.

10. • Bile acid sequestrant
• Colesevelam (Welchol)
• Normal dosage range for this medication is 625 mg-3.25 g.
• Bile acid sequestrant medications lower cholesterol and blood sugar levels.

11. • Dopamine agonist
• Bromocriptine (Cyclocet)
• Normal dosage range for this medication is 0.8-5 mg.
• This medication lowers the amount of glucose released by the liver.

12. SOURCES
• http://my.clevelandclinic.org/health/diseases_conditions/hic_Diabetes_Basics/hic_Or
al_Diabetes_Medications
• https://nfb.org/images/nfb/publications/vod/vod_22_4/vodfal0712.htm
• https://en.wikipedia.org/wiki/History_of_diabetes