There are several types of diabetes medications available in Canada. These include both pills and injections. Insulin is used to treat type 1 diabetes. Type 2 diabetes is managed with healthy eating, exercise, and medications – including oral, insulin and other injectable drugs. Below is a list of the main classes of diabetes medications.
Oral diabetes medications (taken by mouth)
This is a common medication used for type 2 diabetes and is often the first one that is prescribed. It decreases glucose production from the liver and therefore lowers blood sugar.
Thiazolidinediones (e.g. pioglitazone, rosiglitazone)
These medications decrease insulin resistance, the inability of cells in the body to respond appropriately to insulin by removing glucose from the blood.
Sulfonylureas (e.g. glyburide, gliclazide, glimepiride)
Sulfonylureas continuously stimulate the release of insulin from the pancreas.
DPP-4 Inhibitors (e.g. sitagliptin, saxogliptin, linagliptin, alogliptin)
Inhibiting the enzyme DPP-4 increase the level of a hormone named GLP-1. GLP-1 stimulates insulin production and decreases production of glucagon when glucose levels are too high.
SGLT-2 Inhibitors (e.g. canagliflozin, dapagliflozin, empagliflozin, ertugliflozin)
This class of medication lowers blood sugar by causing the kidneys to remove excess glucose through the urine. SGLT2-inhibitors work independently of insulin.
There are several combination oral medications available in Canada. Usually, they include metformin plus a medication from another drug class, but they may also be a combination of a DPP-4 inhibitor and an SGLT-2 inhibitor. The combination medications are generally more effective and potentially reduce side effects compared to taking multiple drugs separately. Combination medications are also more convenient as they reduce the number of times a medication is needed.
Insulin and other injectables
Insulin (rapid-acting, short-acting, intermediate-acting, long-acting)
Insulin is a hormone produced by the pancreas that stimulates cells in the body to remove glucose from the blood for storage or usage. Insulin is normally released by the body following a meal to bring high sugar levels back into the normal range.
GLP-1 Agonists (e.g. liraglutide, exenatide, dulaglutide, lixisenatide)
These medications, also known as incretin mimetics, work by copying the functions of the natural incretin hormones in your body that help lower post-meal blood glucose levels. These functions include stimulating insulin secretion, inhibiting the release of glucagon and slowing glucose absorption into the bloodstream.
Combination insulin products
Basal insulin has been combined with GLP-1 agonists in a single injection and have similar advantages as oral combination medications – reduced side effects, simplified regimens, improved efficacy. Currently there are two products available in Canada