Diabetes pills work in one of three ways. They either stimulate the pancreas to release more insulin, increase the body's sensitivity to the insulin that is already present, or slow the breakdown of foods (especially starches) into glucose. There are six categories of diabetes pills: sulfonylureas, meglitinides, nateglinides, biguanides, thiazolidinediones, and alpha-glucose inhibitors.
Pills that help the body use insulin better may be taken in addition to insulin.
Sulfonylureas (sulfa-based pills) stimulate the pancreas to release more insulin. Sulfonylureas include glyburide (DiaBeta®, Micronase® or Glynase®), glipizide (Glucotrol®), glipizide extended release (Glucotrol XL™) and glimepiride (Amaryl®).
Biguanides decrease the release of glucose by the liver and make liver cells more sensitive to insulin. Biguanides include metformin (Glucophage®) and metformin extended release (Glucophage®XR).
Thiazolidinediones make muscle and fat cells more sensitive to insulin and decrease the release of glucose by the liver. Thiazolidinediones include pioglitazone (Actos®) and rosiglitazone (Avandia®).
Meglitinides cause the pancreas to release insulin over a shorte period of time (after meals). Meglitinides include repaglinide (Prandin®).
D-phenylalanine Derivatives cause the pancreas to release insulin over a shorte period of time (after meals). D-phenylalanine Derivatives include nateglinide (Starlix®).
Alpha Glucosidase Inhibitors slow the body's absorption of carbohydrate. Alpha Glucosidase Inhibitors include acarbose (Precose®) and miglitol (Glyset®).
Combination pills are two or more medications with complementary actions combined in one pill. Combination pills include: glyburide/metformin (Glucovance®), glipizide/metformin (Metaglip®) and rosiglitazone/metformin (Avandamet®).