Search this site
Article Listings
Active Living
Full Listing with story descriptions
A Healthy Balance
Ankle Sprains
Active Kids, Healthy Kids
Active Kids in Winter
Athletic Skin Infections
Children, Nutrition and Exercise
Beat the Heat!
Cold Comfort
Cold Weather Workouts
Concussion in Sport
Core Stability
Cross Country Skiing
Exercise and Disabilities
Exercise and Menstrual Irregularities
Exercise in the Heat
Exercise is Medicine
Exercise Options
Exercising in Pregnancy
Exercising in Pregnancy
Female Athletes
FITT Prescription
Footwear for Running
From Surviving to Thriving
Gadgets and Gizmos
Get Moving!
Get Motivated
Golf Exercises
Golf Injury Prevention
Head Injuries
High Intensity Interval Training (HIIT)
Hockey Injuries
Home Gyms
Jump Start Weight Loss
Knee Cap Pain
Knee Ligament Injuries
Live Actively
Low Back Pain
Osteoporosis and Exercise
Osteoarthritis of the Knee
Plantar Fasciitis
Prehistoric Workout
Recreational Safety Equipment
Safe Snow Shovelling
Shin Splints
Ski Conditioning
Sore Elbow
Sore Shoulder
Spinal Cord Injuries
Staying Active
Staying Fit in the Cold
Sports Nutrition and Supplements
Strength Training
Swimming Injuries
Teen Sports Injuries
Water and Exercise
Weight Training
7 Wonders of Walking
Adolescent Health
Full Listing with story descriptions
Adolescent Behaviour Problems
Adolescent Growth and Development
Body Image
Body Piercing
Chronic Diseases in Teens
Communications Skills
Concussion in Sport
Cosmetics and Skincare
Dangers of Artificial Tanning
Depression - Causes
Drug Use
Female Physical Exam
First Period
Internet Safety
Junior High
Mentoring to Quit Smoking
Parent-Teen Communication
Parent -Teen Interaction Patterns
Personal Care
Psychological Assessment
School Problems
Self Esteem
Self Esteem and Body Image
Sexually Transmitted Diseases
Talking About Sex
Taking Chances
Teaching Respect
Teens and Smoking
Teenage Blues
Teen Bedwetting
Teen Drivers
Teen Girls
Teen Health
Teen Immunization
Teen Independence
Teen Rebellion
Teens and Divorce
Teenagers and Sexual Issues
Teens and Exercise
Water and Exercise
A Woman's Physical
Your First Job
Youth Violence
Ask the Doctor
Aspirin Every Day?
Cost of Doctor's Visit
Does My Sore Knee Require an MRI?
Do I Need a Bone Density Test?
Do I Need an Annual Physical?
My Doctor Says I Need a Test
My Doctor Diagnosed Osteoarthritis
Restore Your Core
Should I Exercise During pregnancy?
Vaccination Controversies
Full Listing with story descriptions
Advice from the Maternity Clinic
Advice from the Maternity Clinic (Part 2)
Alcohol in Pregnancy
Building a Better Baby
Birthing Etiquette
Birth Plans
Birthing Procedure Trends
Bleeding in Pregnancy
Blood Pressure
Breastfeeding Benefits
Caesarean Section by Request
Care for the New Mother
Cord Blood Banking
Delaying Motherhood
Blue after Baby or Postpartum Depression
Diabetes in Pregnancy
Eating Well for Pregnancy
Evolving Ideas about Pregnancy and Birth
Exercise in Pregnancy
Is it Safe to Exercise During Pregnancy
Fetal Alcohol
Flying During Pregnancy
Folic Acid in Pregnancy
High Blood Pressure in Pregnancy
Getting a latch on breastfeeding
Group B Streptococcus
Induction of Labour
Infections During Pregnancy
Intrauterine Growth Restriction (IUGR)
In-Vitro Fertilization
Low Birth Weight Babies
Maternity and parental leave
Medication and Pregnancy
Managing Your Own Labour
Monitoring Your Labour
Nausea and Vomiting in Pregnancy
Pain Relief in Labour
Prenatal Classes
Preterm Labour
Planning a Pregnancy
Prenatal Care Providers
Postpartum Repetitive Strain Injuries
RH Disease
Rupture of Membranes Before Labour
Sex During Pregnancy
Skin Changes in Pregnancy
Smoking and Pregnancy
Support During Labour
Travelling While Pregnant
Ultrasound for Fun and Photos
Natural Remedies in Pregnancy
Pregnancy Weight Gain
Vaccinations During Pregnancy
Vacuum and Forceps for Delivery
Vaginal Birth After Caesarean
When Baby Comes Home
Full Listing with story descriptions
Asthma in Children
Attention Deficit Disorder
Bedtime Battles
Bed Wetting
Childcare Options
Children's Headaches
Childhood Obesity
Choosing A Babysitter
Colds and Flu
Common Childhood Skin Infections
Developmental Milestones
Diaper Rash
Daytime Wetting
Developmental Co-ordination Disorder
Feeding Your Baby
Feeding Your Toddler
Head Lice
How Children Grow
Hearing Loss
Hearing Issues in Newborns
Heart Murmers
Hip Clicks
Is it an Emergency?
Children and Sports Injuries
Lazy Eye (Amblyopia)
Learning Disabilities
Leg Problems
Preparing for Lab Tests
Red Rashes
RSV-Childhood Respiratory Virus
Safe Summer Fun
Sick Toddler
Sleep Struggles
Sniffles, Fevers, Rashes and Coughs
Introducing Solid Foods
Sore Throats
Speech Problems
Strep Throat
Toddler Safety
Tooth Injuries
Travelling with Children
Urinary Tract Infections
Vaccination and Autism
When to go to the Doctor
Whooping Cough
Worried Sick
Yeast Infections in Children
Chronic Pain
Full Listing with story descriptions
Managing Your Pain
Movement Matters
Moving Forward
Pain Medications
Returning to Work
Understanding and Goal Setting
When Pain Doesn't End
Dental Health
Full Listing with story descriptions
Antibiotics and Dental Surgery
Baby Bottle Tooth Decay
Baby Teeth
Bad Breath (Halitosis)
Children's Dental Injuries
Choosing a Dentist
Cosmetic Dentistry
Mouth Guards
Dental Exam
Dental Care Devices
Dental Caries
Dental Implants
Dental X-Rays
Dentures and Healthy Jaw
Esthetic Dentistry
Fluoride Findings
First Dental Visit
A Healthy Mouth
Healthy Mouth, Healthy Body
Jaw Joint and Muscle Problems
Keeping it Clean
Laser Use in Dentistry
Oral Cancer Screening
Oral health and long term care
Oral Health Care Products
Orthodontist First Visit
Painless Dentistry
Periodontal Disease
Removable Dentures
Root Canal
Seniors Oral Care
Sensitive Teeth
Sore Mouth, Aching Jaw
Snoring and Sleep Apnea
Teeth for Life
Temporomandibular Disorders (TMD)
Tobacco Risks to Oral Health
Tongue Piercing
Tooth Whitening
Travel Dentistry
Water Fluoridation
Wisdom Teeth
Your Healthy Smile
Full Listing with story descriptions
10,000 Steps
A1C Test
A Diabetes Success Story
ABCs of Diabetes Management
Alternate Site Testing
Artery Health
ASA Therapy
Benefits of Insulin
Benefits of Breakfast
Blood Glucose Medications
Blood Glucose Myths
Blood Glucose Testing
Blood Sugar Lows
Blood Glucose Monitors
C-Peptide Testing
Canada Food Guide Revisited
Carbohydrate Counting
Catastrophic Drug Plan
CDA Guidelines for Diabetes
Celiac Disease and Diabetes
Celebrating Health
Childhood Diagnosis of Diabetes
Children and Type 2 Diabetes
Cholesterol-lowering Medications
Colds and Diabetes
Continuous Blood Glucose Monitoring
Cutting Edge
Dangers of Uncontrolled High Blood Pressure
Driving and Diabetes
Diabetes and Menopause
Diabetes Care Team
Diabetes and Depression
Diabetes Distress
Diabetes Eating on a Shoestring Budget
Diabetes Etiquette
Diabetes and Oral Health
Diabetes and Thyroid Disease
Diabetes and Your Mouth
Diabetes and Your Eyes
Diabetes in Cats
Diabetes in Dogs
Diabetes Management ABCs
Diabetes Meter Technicians
Diabetes Myths
Diabetic Ketoacidosis
Diabetic Retinopathy
Diet Tips for South Asians
Dining Out with Diabetes
Drinking and Diabetes
Eating Disorders
Easing the Strain of Stress
Eating Mindfully
Eating to Protect Your Kidneys
Eating Well During Shift Work
Eggs in a Diabetic Diet
Emotional Eating
Emotions of Diabetes Diagnosis
Erectile Dysfunction
Exercise Excuses
Why Fad Diets Fail
Fill Your Day with Energy
Diabetic Retinopathy
Food Temptation
Foot Care
Foot Health
Footwear and Foot Health
Fruits and Veggies
Gestational Diabetes
Get Active
Get Physical
Gift Ideas
Glucose Meters
Glycemic Index and Glycemic Loads
The Glycemic Index
Going Green in the Kitchen
Going Home from the Hospital
Grocery Shopping Tips
Holiday Party Survival Guide
Health Information on the 'Net
Healthy Happy Holidays
Healthy Beverage Choices
Health Benefits of Soy
Healthy Restaurant Meals
High Blood Pressure and Diabetes
High Blood Pressure
HbA1c Test
Healthy Eating for Active People
High Blood Lipids
Home from the Hospital
Home Alone and Sick
Hypoglycemic Unawareness
Impaired Glucose Tolerance
Immunization and Diabetes
Incretins-a Hormone Treatment
Injecting Insulin
Insulin Discovery-The Story
Insulin Handling
Insulin - the Key to Energy Management
Insulin Pumps
Insulin Pen Needles
Insulin Pump Infusion Sets
Insulin Pump Therapy
Immunization and Diabetes
Internet Health Sites
Islet Cell Transplantation
Kidney Disease - Reducing the Risk
Living Powerfully with Diabetes
Low Blood Glucose
Managing Diabetes
Managing Blood Glucose
Mental Health and Diabetes
Nutrition Food Labels
Meal Planning
Your Medication Expert
Medication Research Studies
Metabolic Syndrome
New Diabetes Technologies
Natural Medicines and Diabetes
No Need for Insulin?
Not Snoozing
Oral Health and Diabetes
Osteoporosis and Diabetes
Diabetes and OTC Medications
Pedicure Precautions
Pain of Walking - Peripheral Arterial Disease
Pet Diabetes
Planning for Pregnancy
Prebiotics and Probiotics
Preparing for Activity
Putting off Insulin
Reducing Stress of Surgery
Safe and Successful Travel
Schizophrenia and Diabetes
Setting Health Goals
Setting Goals for Physical Activity
Sharps Disposal
Shorter Insulin Needles
Sleep - a Missing Link
Smart Snacking
Smart Summer Nutrition
Snack Bars
Snacking with Diabetes
Social Media and Diabetes
Stress and Diabetes
Success in School
Supporting Spouse with Diabetes
Sugar, Carbs and Blood Glucose Control
Think Positive with Diabetes
Tiny Bites Equal Big Calories
Travelling with Diabetes
Tips for a Better You
Tobacco Use and Diabetes
Top 10 Reasons to Exercise
Treating Low Blood Glucose
Treating Hypoglycemia - Role of Glucagon
Tune up Your Diet
Type 1.5 Diabetes
Type 2 Diabetes
Understanding Diabetes
Understanding Diabetes Medications
Urinary Incontinence
Vacationing with Diabetes
Vegetarian Eating for Diabetes
Vitamin D
Wonderful Water
World Diabetes Day
Your Medicine Cupboard
Zimbabwe Hand Jive
Family Medicine
Full Listing with story descriptions
ADHD in Children
Allergic Rhinitis
Antibiotic Use
Aspirin Every Day?
Back Pain
Back Pain Myths
Back Pain - Lower
Birth Control
Bladder Problems
Blood Transfusions
Breaast and Prostate Cancer Screening
Carpal Tunnel Syndrome
Colon Cancer Screening
Contact Lenses
Diabetes Management
Diagnostic Tests
Doctor Visit
Driving Vision
Dealing with Dry Eyes
Electronic Medical Records
Eye Exam
Family Doctor
Floaters and Flashes
Food Poisoning
5 Ways to Stay Healthy
Get Active!
Healthcare Teams
Heart Health
Hepatitis C
Human Papilloma Virus
High Blood Pressure
How to Talk to Your Doctor
Irritable Bowel Syndrome
Joint Replacement Surgery
Kidney Disease
Lazy Eye Blindness (Amblyopia)
Medical Digital Technology
Multiple Sclerosis
Multiple Myeloma
Opioid Myths
Primary Healthcare Reform
Prostate Problems
Quitting Smoking
Red Eyes
Respiratory Tract Infections
Screening Tests
Special Diagnostic Tests
Sports Eye Injuries
Stopping Stroke
Urine Tests
Win by Losing
Urinary Incontinence
Urinary Tract Infections
Vision Flickers
First Aid
Full Listing with story descriptions
Bites and Stings
Cuts and Scrapes
Emergency Care Guidelines
Eye Injuries
Fainting and Convulsions
First Aid Travel Kit
Hypothermia and Frostbite
Poisoning - Household
Growing Older
Full Listing with story descriptions
Advance Care Plans
Age-Related Macular Degeneration
Alzheimer Disease
Avoiding Memory Loss
Building Strength
Caring for the Caregiver
Can I see Well Enough to Drive?
Congestive Heart Failure
Coping with Dementia
Controlling Medications
Diagnosing Dementia
Dementia and Agitation
Dizziness (Vertigo)
Eating Well
Elder Abuse
Exercise Benefits
Erectile Dysfunction
Eye Care
Eyesight and Driving
Fungal Nail Infections
Get Active!
Have Health, Will Travel
Health Tips for Seniors
Joint Replacement
Lab Tests
Living Longer With Diabetes
Macular Degeneration
Male Menopause (Andropause)
Maintaining Quality of Life as You Age
Memory Loss
New Corneal Treatments
Nutrition for Seniors
Parkinson Disease
Problem Gambling
Prostate Health
Seniors and Medications
Senior Sexuality
Sexually Transmitted Infections
Screening Tests
Seniors and Driving
Skin Structure
Skin Protection
Skin Over 50
Solving Sleep Issues
Staying Healthy
Stroke Prevention
Travel Tips for Snowbirds
Wills and Personal Directives
Modern Living
Full Listing with story descriptions
Adult ADHD
Aging and Memory
Alcohol and Your Health
Anger Management
Barbecue Basics
Bathtub Safety
Binge Drinking
Bisphenol A
Canada's New Blood System
Caring for a Loved One Dying at Home
Carpal Tunnel Syndrome
Computer Stress
Coping With Change
Cosmetic Surgery
Cosmetic Pesticides
Diabetes Epidemic
Diseases from Pets
Dying at Home
Erectile Dysfunction New Treatments
Exotic Travel
Fertility Issues
Fetal Alcohol Spectrum Disorder
Foodborne Illness
Flu Pandemic
Healing Through Music
Healthy Computing
Ice Safety
Indoor Air Quality
Mature Student
Melamine in Food
Middle Age Health
Mind-Body Connection
Mom Time
Money Matters
Outdoor Workers and Sun Safety
Patient Safety in the Hospital
Pets and Health Benefits
Pet Therapy
Physiotherapy Visit
Planning for End of LIfe
Reproductive Freedom
Safe Drinking Water
Smokeless Tobacco
Sexually Transmitted Diseases
Stigma of Mental Illness
Street Drugs
Stressed or Depressed?
Stress in the Workplace
Stress Leave
Swim to Survive
Time Management
Travel Health Protection
Travel Comfort Tips
Travel Immunization
Understanding Change
Wind Chill Index
Workplace Drug Testing
Workplace Health
Full Listing with story descriptions
5 Myths about Nutrition and Diabetes
5 Tips to Manage Weight
10 Ways to Cut Down on Fat
Battle the Bulge
Boost Your Bone Strength
Body Image
Breakfast is Important
Bowel Health
Building Your Bones
Celiac Disease
Challenging the Milk Myth
Diet Reality Check
Drink Up!
Eating Smarter and Cheaper
Energy Drinks
Food Allergies
Food for Active Kids
Fast Food
Food Labels
Giving Up Gluten
Healthy Diet, Healthy Smile
Healthy Eating for Boomers and Zoomers
Healthy Eating for Seniors
Healthy Eating on Business Travel
Healthy Ethnic Meals
Fad Diets
Fruits and Veggies - 5-10 a Day
Fat Phobias
Fats and Cholesterol
Feeding Your Kids
Food Chemistry 101
Food and Mood
Getting Kids to MOVE
Healthy Eating for Teens
Healthy Habits
Herbal Medicine and Nutrition
New Ingredients for Your Shopping Cart
Kid's Food
Liquid Candy
Meal Planning with Planned Overs
Meal Planning for Busy Families
Mercury Levels in Fish
Night Snacking
Night Shift Eating
Nutrition on the Net
Nutrition Myths Busted
Nutrition Questions Top 5
Nutrition for Menopause
Essential Omega-3
Preventing Cancer Through Nutrition
Picky Eaters
Power of Fruits and Veggies
Portion Control
Power Lunch
PMS and Nutrition
Preparing for Surgery
Reducing High Blood Pressure
Replacement Meals
Sensible Snacking
Sodium and Blood Pressure
Sports-Minded Nutrition
Sugar Substitutes
Survive and Thrive
Teen Nutrition
Tips for a SuperDiet
Understanding Food Biotechnology
Vacation Eating
Vitamins D
Vitamins and Minerals
Vegetarian Diet
Weight Loss Wisdom
Weight Loss
Weight Wise Tips
Pharmacy Care
Full Listing with story descriptions
After a Heart Attack
Adverse Drug Reactions
Adult Vaccinations
Allergy Attack
Antibiotic Overuse
New Anticoagulant Medications
Inhaled Asthma medications
Arthritis Medications
Biological Response Modifiers
Blood Pressure Monitoring
Blood Thinners
Calcium and Iron Supplements
Changing Role of the Pharmacist
Children's Cold Remedies
Child's Fever
Choosing Sunscreens
Cold Relief
Cold Sores
Constipation and Haemorrhoids
Diuretics and Potassium Supplements
Drug Recalls and Withdrawals
Drug Interactions
Emergency Contraception
Erectile Dysfunction
Expanding Role of Pharmacies
Eye Protection - Sunglasses
Feminine Hygiene
Generic or Name Brand?
Heart Health
Kids and Cold Medications
Medication Questions?
Metabolic Syndrome
Natural Medicines
New Blood Thinners
Non-Steroidal Anti-Inflammatory Drugs
Obesity Medication
Over-the-Counter Drugs
Over-the-Counter Pain Relievers
Over-the-Counter Drugs and Pregnancy
OTC Pain Relief
Packing Medications for Travel
Pharmaceutical Studies
Preventing Summer Hazards
Research Studies
Quit Smoking
Skin and Cosmeceuticals
Sports and Nutrition Supplements
Taking Medication
Take as Directed
Using Antibiotics Wisely
Vitamin D
Yeast Infections
Your Best Shot
Your Medicine Cupboard
Full Listing with story descriptions
Accident Prevention
Antibiotic Resistance
Backpack Pain
Bacteria Fight Back
Disaster Planning
Diseases from Pets
Cell Phones and Driving
Childhood Obesity
Cancer Prevention Tips
Chronic Disease Prevention
Cold and Flu Season
Disaster Planning
Diseases from Pets
Distracted Driving
Farm Safety for City Kids
Foodborne Illness
Flu Pandemic
The Flu and You
Heading Home for a Visit
Health Tips for Snowbirds
Hearing Loss and Music Players
H1N1 Virus - Plan Ahead
Household Mould
Infection Control
Injury Prevention
Live Actively!
Insect Repellant
Keys to Preventing Cancer
Kids' Mental Health
Live Actively!
Low Birth Weight
Are Pesticides Safe?
Preventing Burns and Scalds
Preventing Cancer through Nutrition
Quit Smoking 101
Respiratory Infections
Seniors and STIs
Should You Immunize?
Sun Safety
Surviving Disaster
Sushi Preparation
Teens, Drugs and Driving
Travel Health Considerations
Travel Medicine 101
Travel Tips
Type 2 Diabetes Prevention
Water Smarts
Vision Damage
Water Wisdom
West Nile Disease
Whooping Cough
Workplace Alcohol Abuse
Women's Health
Full Listing with story descriptions
15 Great Reasons to Breastfeed
Approaching Menopause
Birth Control
Breast Cancer Screening
Breast Cancer - Genetic Risks
Breast Cancer Self-Exam
Breast Cancer Screening Guidelines Changes
Breast Health
Breastfeeding Myths
Cervical Cancer Screening
Contraception for Mature Women
Cosmetic Procedures
Estrogen's Effect on the Brain
Fear of Fracture
Heart Attack
Hirsutism - Unwanted Hair
Hormone Replacement Therapy
Menopause - What Men Should Know
Menopause and Your Moods
Menstrual Bleeding - Abnormal
Menstrual Bleeding - Heavy
Menstruation Myths
Menstrual Pain
Third Generation Birth Control Pills
Ovarian Cancer
Ovarian Cysts
Oral Contraction (The Pill)
Pap Test
Premenstrual Syndrome
Sexually Transmitted Infections
Urinary Incontinence
Varicose Veins
Viagra for Women
Yeast Infections
Your Pelvic Floor
Family Health Online / Pharmacy at Safeway
spacer   spacer pharmacy image pharmacy
Managing Diabetes Magazine - diabetes

Blood Glucose Medications
Drugs can help manage blood glucose

Marie was diagnosed with Type 2 diabetes five years ago. Her doctor told her if she could change what she was eating and go for a walk each day, she might not have to take pills to keep her glucose levels under control. These changes worked for a while. Eventually, she needed to begin taking the medication metformin, and then glyburide six months later. These medications worked for her until about a year ago. Now, Marie wonders what the next step will be.

Type 2 diabetes is a progressive disease. Once we believed that changes in nutrition and an increase in physical activity would be enough to permanently keep blood glucose levels under control. Newer research is showing that Type 2 diabetes becomes harder to control over time. Although better nutrition and more physical activity are healthy choices at any time in life, as diabetes progresses it becomes more likely you will need medication to help reduce blood glucose levels. Insulin may also be needed for a short time during an illness or when pills can no longer keep blood glucose at acceptable levels. When people with diabetes need another medication or start insulin, it is not their fault. Type 2 diabetes worsens with time, but there are now more medications available than ever to keep blood glucose levels down.

The current medications to treat Type 2 diabetes work in three different areas.

Insulin resistance: This is the most important problem in Type 2 diabetes. Insulin is a hormone made by the pancreas, which allows glucose to reach your cells where it is used as energy. Insulin resistance prevents your body from using insulin effectively. Less glucose reaches the cells of the body and instead stays in the blood, causing high blood glucose.

Decreased insulin production: In diabetes the cells in the pancreas that make insulin don’t work properly and don’t put out insulin appropriately. This worsens with time. The longer you have diabetes, the less insulin is released from the pancreas. Less available insulin increases the amount of glucose in the blood, as insulin is required for glucose to leave the blood and reach the cells of the body.

Release of glucose stored in the liver: Your body stores extra glucose in the liver for times when you are not eating. It is released into the blood when your body senses your cells are not receiving enough glucose. With insulin resistance, your blood glucose levels are high, but glucose is not reaching your cells. This causes the release of glucose from liver stores, pushing blood glucose levels even higher.

We can divide medications used to lower blood glucose in Type 2 diabetes into three groups. Medications are grouped based on how they affect one of the three different areas. The groups of medications are insulin sensitizers, sugar/starch blockers, and insulin stimulators.

Insulin Sensitizers

Insulin resistance occurs many years before Type 2 diabetes is diagnosed. Any decrease in insulin resistance will improve blood glucose levels. By decreasing insulin resistance, insulin sensitizers increase the effect of insulin on the cells of the body. More glucose can enter the cells to be used as energy and glucose is taken out of the blood. Insulin sensitizers can be used as a first medication with Type 2 diabetes.

Biguanides reduce the release of glucose from liver stores and increase the effect of insulin on the cells. Metformin (Glucophage™) is the only drug of this type. It is often the first medication used with Type 2 diabetes. It does not cause weight gain and may help with weight loss. Since 80 per cent of people with Type 2 diabetes are overweight, this can be helpful. Excess body weight can be linked to developing diabetes, and even a small loss of weight can decrease high blood glucose, blood pressure and cholesterol levels. Metformin does not cause low blood glucose levels when taken alone. Low blood glucose reactions can be dangerous for some people. Metformin would be a good choice if you have Type 2 diabetes and experience low blood glucose.

All medications can cause side effects. When first starting metformin, about one in five people get diarrhea, stomach upset or both. These effects are usually mild and only last a short period of time. Taking metformin with food and starting with a low dose can usually reduce these side effects. Metformin is also associated with a lowering of vitamin B12 levels when taken for two to three years. Ask your doctor to test your vitamin B12 levels if you have been on metformin this long.

Thiazolidinediones also make the body’s cells more sensitive to insulin’s effect. It may take two to three months before these drugs reach their full effectiveness. If a thiazolidinedione is added to another glucose-lowering drug, the dosage of that drug may need to be decreased as the thiazolidinedione reaches its full effect. If a drug that can cause low blood glucose is being taken, the possibility of a low blood glucose reaction increases as the thiazolidinedione starts to work.

Thiazolidinediones do not cause low blood glucose reactions alone. Rosiglitazone (Avandia™) and pioglitazone (Actos™) are examples of this type of insulin sensitizer. Your doctor will check your levels of liver enzymes every two months for the first year you are taking a thiazolidinedione. Side effects may include weight gain and fluid retention. People with heart disease should not take thiazolidinediones as fluid retention can worsen their condition. Report excessive weight gain or swelling of your legs to your doctor promptly.

Sugar/Starch Blockers

Type 2 diabetes reduces the body’s ability to release enough insulin at the correct time to keep blood glucose levels under control. A healthy pancreas releases an appropriate amount of insulin after sugar (glucose) is absorbed from your food. With diabetes, less insulin is released. This causes your blood glucose levels to rise higher after eating. Sugar/starch blockers slow down the absorption of glucose from your food. Your pancreas then has more time to produce and release the insulin needed to deal with the food.

Sugar/starch blockers, also known as alpha-glucosidase inhibitors, lessen the rise in blood glucose after meals. They can be used as the first drug for treatment of Type 2 diabetes. Acarbose (Prandase™) is the only drug of this type available in Canada. Acarbose should be taken with the first bite of a meal to be most effective.

Acarbose should be started at a low dose and slowly increased to reduce the chance of gas, diarrhea and abdominal pain. Your body adjusts to the action of acarbose, so these side effects decrease with time. Acarbose does not cause low blood glucose when used by itself. If acarbose is taken with a drug that can cause low blood glucose and this occurs, it should be treated with dextrose tablets. Skim milk may also be used. When you are taking acarbose, low blood glucose will not improve with the type of sugar found in pop, juice or candy.

Insulin Stimulators

In Type 2 diabetes the cells in the pancreas that would normally make insulin do not work as well as they should, resulting in too little insulin being produced. Insulin stimulators cause these cells to release more insulin. More insulin allows the body’s cells to take up more glucose from the blood and decreases blood glucose levels.

Sulfonylureas cause the pancreas to produce more insulin. Glyburide (Diabeta™) and gliclazide (Diamicron™) are the most commonly used drugs of the sulfonylureas. Tolbutamide and chlorpropamide are now rarely used. Glimepiride (Amaryl™) is the newest sulfonylurea available. These drugs are often used in combination with insulin sensitizers. Since both types of drugs reduce blood glucose levels in different ways, using them together can lower blood glucose levels further.

Sulfonylureas can cause low blood glucose levels alone or in combination with other drugs. Learn the symptoms of a low blood glucose reaction and how to treat one. When you take sulfonylureas, you must not skip meals or stop eating on sick days. If you cannot eat solid foods, juice or pop can provide sugar to prevent low blood glucose reactions. Develop a sick day plan with the help of your doctor or diabetes educator. Sulfonylureas may also cause stomach upset or weight gain. Taking them with food can decrease stomach upset. If you are allergic to sulpha drugs, you may not be able to take sulfonylureas.

Meglitinides also increase the production of insulin by cells in the pancreas. Nateglinide (Starlix™) and repaglinide (GlucoNorm™) are the meglitinides currently available. These drugs reduce the blood glucose levels after meals more quickly than sulfonylureas. Take them before each meal. If you skip a meal, you should skip the pill you would take before that meal. Meglitinides are an option for people who cannot take sulfonylureas.

Repaglinide can cause low blood glucose reactions, but reactions are much less likely with nateglinide. Headache, chest infections, and joint pain can occur with either medication. Chest pain can occur with repaglinide, and should be reported to your doctor.


As Type 2 diabetes progresses, medications you take by mouth may become less effective in lowering high blood glucose levels. Treatment of your Type 2 diabetes may have begun by changing your nutrition and physical activity. You may have started with a single pill and had more added over time. If medications taken by mouth are no longer effective for you, your diabetes has progressed and insulin needs to be added. This doesn’t happen because you haven’t cared for yourself properly.

Over time, everyone’s diabetes may get worse. Insulin can very quickly bring your blood glucose levels down to an acceptable level. It can be added to drugs you are already taking or used alone. With proper training, using insulin can be as easy as taking a pill. When blood glucose levels are reduced, studies show that long-term complications from diabetes are reduced and people with diabetes live longer, healthier lives. Insulin is also the only choice for a woman with Type 2 diabetes who becomes pregnant. Pills to reduce blood glucose cannot be taken during pregnancy.

It is important to continue to be physically active, eat well, and take your medications regularly. With more medications becoming available to treat Type 2 diabetes, blood glucose levels can now be controlled more easily. You and your doctor have more choices of medications to treat your diabetes. Medications can also be chosen based on your stage of diabetes. Each new study brings us more understanding about the nature of diabetes and how to treat it. Ask your pharmacist for more information about your medications and the new drugs available for Type 2 diabetes. Discuss medication selection with your doctor, and get involved in monitoring how your medications are working for you.

Medications to Lower Blood Glucose in Type 2 Diabetes

Insulin Sensitizers Decrease insulin resistance Glucophage™ (metformin), Avandia™ (rosiglitazone), Actos™ (pioglitazone)
Sugar/Starch Blockers Slow absorption
of sugar
Prandase™ (acarbose)
Insulin stimulators Increase insulin production Diabeta™ (glyburide), Diamicron™ (gliclazide), GlucoNorm™ (repaglinide), Starlix™ (nateglinide)
FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
FAMILY HEALTH is written with the assistance of
Alberta College of Family Physicians
While effort is made to reflect accepted medical knowledge and practice, articles in Family Health Online should not be relied upon for the treatment or management of any specified medical problem or concern and Family Health accepts no liability for reliance on the articles. For proper diagnosis and care, you should always consult your family physician promptly. © Copyright 2018, Family Health Magazine, a special publication of the Edmonton Journal, a division of Postmedia Network Inc., 10006 - 101 Street, Edmonton, AB T5J 0S1    [DI_MDab15]
Safeway Med Advisor / Safeway Pharmacy logos
Safeway Med Advisor / Safeway Pharmacy logos