The Main Diabetes Tablets, Explained
Reviewed by CDE Mehandi Sharma · Updated
There are several families of diabetes medicine, and they do genuinely different jobs. Knowing which one you are on tells you a lot — including whether you need to worry about going low.
| Group | What it does | Can cause lows? |
|---|---|---|
| Metformin | Liver releases less glucose; body uses insulin better | Not usually |
| Sulfonylureas | Push the pancreas to release more insulin | Yes — main risk |
| Meglitinides | Push the pancreas to release insulin around meals | Possible |
| DPP-4 inhibitors | Help your own gut hormones work longer | Not usually |
| SGLT2 inhibitors | Kidneys pass extra glucose out in urine | Not usually |
| GLP-1 receptor agonists | Mimic gut hormones; reduce appetite and weight | Not usually |
| Pioglitazone (TZD) | Helps insulin work better in muscle and fat | Low risk |
A few practical notes. Sulfonylureas are effective and inexpensive, which is why they are widely used in India — but they are the group most likely to cause low blood sugar, especially if you skip a meal. SGLT2 inhibitors make you pass more glucose in urine, so genital yeast infections are more common and fluids matter. Pioglitazone can cause fluid retention and is avoided in heart failure.
If you do not know which group your tablet belongs to, ask. It changes what you should watch for.