Recall of metformin extended release

In May 2020, the Food and Drug Administration (FDA) recommended that some makers of metformin extended release remove some of their tablets from the U.S. market. This is because an unacceptable level of a probable carcinogen (cancer-causing agent) was found in some extended-release metformin tablets. If you currently take this drug, call your healthcare professional. They will advise whether you should continue to take your medication or if you need a new prescription.

When you have diabetes, your body has difficulty managing insulin. Insulin is a hormone your pancreas produces that helps your body use glucose (sugar) from the food you eat.

Insulin moves glucose from your bloodstream into your cells, which use it for energy. But if your body doesn’t make enough insulin or doesn’t use it properly, the glucose stays in your blood.

Having high blood glucose levels for too long can damage parts of your body.

There are two types of diabetes: type 1 and type 2. People with type 1 diabetes cannot make their own insulin. People with type 2 diabetes can make insulin, but their bodies are not able to use it properly.

The only medication used to treat type 1 diabetes is insulin, and it comes in different types.

Type 2 diabetes can be treated with a broader range of medications. Some people with type 2 diabetes may need to take more than one type of medication to treat their condition.

Read on to learn about new diabetes drug options and drugs that are currently being developed, as well as medications commonly used for both types of diabetes.

In recent years, several new diabetes drugs have been developed. These include oral and injectable drugs.

New oral drugs

Except for Steglatro, which contains only one drug, the new oral drugs used to treat type 2 diabetes are all combination drugs. They each combine two drugs used on their own to treat type 2 diabetes.

These medications are all brand-name drugs that don’t have generic forms.

Xigduo XR

Xigduo XR, which comes as a 24-hour extended-release oral tablet, was approved for use in 2014. Xigduo XR combines metformin with dapagliflozin.

Metformin helps make body tissues more sensitive to insulin.

Dapagliflozin blocks some of the glucose in your body from reentering your blood through your kidneys. This causes your body to get rid of more glucose through your urine.

Synjardy

Synjardy, which is also available as Synjardy XR and comes as an oral tablet, was approved for use in 2015. It combines the drugs metformin and empagliflozin. Empagliflozin works in a similar way to dapagliflozin.

Glyxambi

Glyxambi, which comes as an oral tablet, was approved for use in 2015. It combines the drugs linagliptin and empagliflozin.

Linagliptin blocks the breakdown of certain hormones in your body that tell your pancreas to make and release insulin. It also slows your digestion, which slows the release of glucose into your blood.

Steglujan

Steglujan, which comes as an oral tablet, was approved in late 2017. It combines ertugliflozin and sitagliptin.

Ertugliflozin works through the same mechanism as empagliflozin.

Sitagliptin blocks the breakdown of certain hormones in your body that tell your pancreas to make and release insulin. It also slows your digestion, which slows the absorption of glucose into your blood.

Segluromet

Segluromet, which comes as an oral tablet, was approved in late 2017. It combines ertugliflozin and metformin.

Steglatro

Steglatro, which comes as an oral tablet, was approved in late 2017. It’s a brand-name form of the drug ertugliflozin. It works through the same mechanism as empagliflozin.

Like the combination drugs in this list, Steglatro is used to treat type 2 diabetes.

New injectables

These new brand-name injectables are not available as generic drugs. They’re used to treat either type 2 diabetes, or both type 1 and type 2 diabetes.

These drugs contain a type of insulin, a GLP-1 agonist, or both. The different types of injected insulin act as a replacement for the insulin your body doesn’t make or can’t use properly.

Glucagon-like peptide-1 (GLP-1) receptor agonists help your pancreas release more insulin when your glucose level is high. They also slow down glucose absorption during digestion.

Tresiba

Tresiba, which was approved in 2015, is a brand-name version of the drug insulin degludec. It’s used to treat both type 1 and type 2 diabetes.

Tresiba is a long-acting insulin that lasts up to 42 hours. This is longer than commonly used insulin. It’s injected once daily.

Basaglar and Toujeo

Basaglar and Toujeo are two new forms of insulin glargine. They’re used to treat both type 1 and type 2 diabetes and are both injected once daily.

Basaglar is a long-acting insulin drug that was approved in 2015. It’s similar to another insulin glargine drug called Lantus. It lasts for 24 hours.

Toujeo is a more concentrated form of insulin glargine. It was approved for use in 2015 and lasts for 36 hours.

Xultophy

Xultophy was approved in 2016. It’s only used to treat type 2 diabetes. Xultophy is injected once per day.

Xultophy combines insulin degludec, a long-acting insulin, and liraglutide, a GLP-1 agonist.

Soliqua

Soliqua was approved in 2016. It’s only used to treat type 2 diabetes. It’s injected once per day.

Soliqua combines the drug insulin glargine with lixisenatide, a GLP-1 receptor agonist.

Ozempic and Rybelsus

Ozempic was approved in late 2017. It’s only used to treat type 2 diabetes.

Ozempic and Rybelsus are a brand-name version of the GLP-1 agonist called semaglutide. It’s injected once per week.

Adlyxin

Adlyxin was approved in 2016. It’s only used to treat type 2 diabetes.

Adlyxin is a brand-name version of the GLP-1 agonist called lixisenatide. It’s injected once daily.

In addition to these new medications, several diabetes drugs are currently in development. These drugs include:

  • Oral-Lyn: This brand-name drug comes as a fast-acting oral insulin spray. It’s designed to treat both type 1 and type 2 diabetes.
  • Dance 501: This aerosol device contains a liquid insulin that is intended to be inhaled at mealtime. It’s designed to treat both type 1 and type 2 diabetes.

Now that you know about new and upcoming diabetes drugs, here’s a list of some of the diabetes drugs that are currently used most often. Some of these drugs are components of the new combination medications listed above, as well as the older combination medications listed below.

Oral medications

The following groups of drugs are commonly used to treat type 2 diabetes. All come as oral tablets. Metformin also comes as an oral solution.

Biguanides such as metformin

Metformin is often the first drug used to treat type 2 diabetes. It works by slowing glucose production in your liver. It also makes your body tissues more sensitive to insulin, which helps the tissues absorb glucose.

Metformin is also combined with other oral medications to reduce the number of tablets you need to take.

Alpha-glucosidase inhibitors

These drugs slow or block the breakdown of carbohydrates in your body. Carbohydrates are in starchy or sugary foods. This action slows the absorption of glucose into your bloodstream.

Examples of these drugs include:

Dipeptidyl peptidase-4 inhibitors (DPP-IV inhibitors)

These drugs block the breakdown of certain hormones in your body that tell your pancreas to make and release insulin. These drugs also slow your digestion, which slows the release of glucose into your blood.

Examples of these drugs include:

Meglitinides

These drugs tell your pancreas to release insulin.

Examples of these drugs include:

Sodium-glucose co-transporter 2 inhibitors (SGLT2)

These drugs block some of the glucose in your system from reentering your blood through your kidneys. They also cause your body to get rid of more glucose through your urine.

Examples of these drugs include:

Sulfonylureas

These drugs cause your pancreas to release more insulin.

Examples of these drugs include:

Thiazolidinediones

These drugs, such as pioglitazone, make your body tissues more sensitive to insulin. This helps your body use more of the glucose in your blood.

Combination medications

In addition to the new ones listed above, several combination medications have been available for a while. Older combination medications include the following:

  • Duetact is a tablet that combines pioglitazone with glimepiride.
  • Janumet is a tablet that combines sitagliptin with metformin.
  • A generic drug that comes as a tablet combines metformin with glipizide (brand-name Metaglip).
  • The drug pioglitazone is available in tablet form in combination with metformin.

Injectable medications

The following classes of drugs come in injectable forms.

Insulin

Injected insulin acts as a replacement for the insulin your body doesn’t make or can’t use properly. It can be used to treat type 1 or type 2 diabetes.

Different types of insulin are available. Some types act quickly. These types help control your blood glucose level at mealtime.

Other types act over a longer period. These types control your blood glucose level throughout the day and night.

Some types of insulin include:

  • insulin aspart (Novolog, NovoLog FlexPen, Fiasp, ReliOn NovoLog)
  • insulin degludec (Tresiba)
  • insulin glargine (Semglee)

Amylin analogue

The amylin analogue called pramlintide is taken before a meal. It helps to decrease the amount of insulin you need. It’s used to treat both type 1 and type 2 diabetes.

Glucagon-like peptide-1 receptor agonists (GLP-1 agonists)

These drugs help your pancreas release more insulin when your glucose level is high. They also slow down glucose absorption during digestion. These drugs are used to treat type 2 diabetes only.

Examples of these drugs include:

  • dulaglutide
  • exenatide
  • liraglutide
  • semaglutide

While many effective diabetes drugs have been on the market for years, new drugs may provide benefits that aren’t available with most commonly used drugs.

Keep in mind that all the side effects and interactions of new drugs may not currently be known. Also, newer drugs may cost more than older drugs or may not yet be covered by most insurance plans.

In addition, your insurance plan may prefer certain drugs over others, or they may require you to do a trial of older, less expensive medications before they cover the newer, more expensive drugs.

It’s important to talk with your doctor if you’re considering new diabetes drug options. Discuss your full medical history with your doctor, as well as all medications and supplements you take.

Together, you and your doctor can decide which new drugs, if any, may be right for you.