Taking medication may sometimes seem like a double-edged sword.
Diabetes medicine is essential to help keep blood sugar in control. But, just as with any medication, it can come with possible risks and side effects. Thankfully, many side effects from diabetes medications can be temporary, manageable or preventable.
Why do side effects happen?
All medications come with a risk of side effects, and some are more common than others. Since not all people respond to medication the same way, it's tricky to know if you'll experience side effects. It can depend on how your body absorbs the medication. Other factors, like age, gender, allergies, additional medications and dietary supplements, can also affect your risk of side effects.
Side effects and diabetes medications
When you're prescribed a new medication, ask your health care provider what side effects to watch for. They’ll let you know what side effects are common and which symptoms warrant a need for medical attention. Do not stop taking any medication unless directed by your provider.
Insulin
All people with type 1 diabetes and some people with type 2 diabetes need to take insulin. It may be taken by an injection, either through a syringe, insulin pen or insulin pump that's connected to your body. Possible side effects include:
- A reaction at the site on your skin where you receive the injection. It's important to give insulin injections in the same general area of your body each time (for instance, the abdomen or upper arm). But, you should rotate the specific injection site (such as injecting at different spots on your abdomen). Hard lumps or extra fatty deposits can form under the skin if you administer insulin too close to the same spot too often. Not only are these problems unsightly, but they can also make insulin less effective.
- Low blood sugar. Insulin brings high blood sugar levels down, but taking too much or not balancing insulin with your diet or physical activity can cause your blood sugar levels to drop too low. This can make you irritable, jittery and sweaty. Low blood sugar is dangerous and requires prompt treatment. If you have low blood sugar, follow your treatment plan as prescribed by your health care provider.
Oral diabetes drugs
Many people with type 2 diabetes need to take oral diabetes medications to help keep blood sugar levels under control. Possible side effects may include:
| Drug class |
Drug name |
Possible side effects |
| Sulfonylureas |
Glipizide (Glucotrol), Glipizide extended release (Glucotrol XL), Glyburide (Diabeta, Glynase, Micronase), Glimepiride (Amaryl) |
Low blood sugar, weight gain, skin rash |
| Meglitinides |
Repaglinide (Prandin), Nateglinide (Starlix) |
Low blood sugar, weight gain |
| Biguanides |
Metformin (Glucophage), Metformin extended release (Glumetza, Glucophage XR, Fortamet) |
Nausea, diarrhea, upset stomach, loss of appetite |
| Thiazolidinediones |
Pioglitazone (Actos), Rosiglitazone (Avandia) |
Weight gain, swelling or fluid retention, increased risk of developing or worsening heart failure, heart attack, bone breaks |
| Alpha-glucosidase inhibitors |
Acarbose (Precose), Miglitol (Glyset) |
Stomach pain, gas, diarrhea |
| Dipeptidyl Peptidase-4 (DPP-4) inhibitors |
Sitagliptin (Januvia), Linagliptin (Tradjenta), Saxagliptin (Onglyza), Alogliptin (Nesina) |
Diarrhea, upper respiratory tract infections, sore throat |
| Bile acid sequestrants |
Colesevelam (Welchol) |
Gas, nausea, constipation |
| Dopamine-2 agonists |
Bromocriptine quick release (Cycloset) |
Nausea, weakness, constipation, dizziness |
| Sodium-glucose cotransporter-2 (SGLT2) inhibitors |
Canagliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin (Jardiance), ertugliflozin (Steglatro) |
Urinary tract and vaginal yeast infections |
| Drug class |
Sulfonylureas |
| Drug name |
Glipizide (Glucotrol), Glipizide extended release (Glucotrol XL), Glyburide (Diabeta, Glynase, Micronase), Glimepiride (Amaryl) |
| Possible side effects |
Low blood sugar, weight gain, skin rash |
| Drug class |
Meglitinides |
| Drug name |
Repaglinide (Prandin), Nateglinide (Starlix) |
| Possible side effects |
Low blood sugar, weight gain |
| Drug class |
Biguanides |
| Drug name |
Metformin (Glucophage), Metformin extended release (Glumetza, Glucophage XR, Fortamet) |
| Possible side effects |
Nausea, diarrhea, upset stomach, loss of appetite |
| Drug class |
Thiazolidinediones |
| Drug name |
Pioglitazone (Actos), Rosiglitazone (Avandia) |
| Possible side effects |
Weight gain, swelling or fluid retention, increased risk of developing or worsening heart failure, heart attack, bone breaks |
| Drug class |
Alpha-glucosidase inhibitors |
| Drug name |
Acarbose (Precose), Miglitol (Glyset) |
| Possible side effects |
Stomach pain, gas, diarrhea |
| Drug class |
Dipeptidyl Peptidase-4 (DPP-4) inhibitors |
| Drug name |
Sitagliptin (Januvia), Linagliptin (Tradjenta), Saxagliptin (Onglyza), Alogliptin (Nesina) |
| Possible side effects |
Diarrhea, upper respiratory tract infections, sore throat |
| Drug class |
Bile acid sequestrants |
| Drug name |
Colesevelam (Welchol) |
| Possible side effects |
Gas, nausea, constipation |
| Drug class |
Dopamine-2 agonists |
| Drug name |
Bromocriptine quick release (Cycloset) |
| Possible side effects |
Nausea, weakness, constipation, dizziness |
| Drug class |
Sodium-glucose cotransporter-2 (SGLT2) inhibitors |
| Drug name |
Canagliflozin (Invokana), Dapagliflozin (Farxiga), Empagliflozin (Jardiance), ertugliflozin (Steglatro) |
| Possible side effects |
Urinary tract and vaginal yeast infections |
Other injectable medicines
Some people with type 1 or type 2 diabetes need to take injectable drugs other than insulin to help control blood sugar. Side effects include:
| Drug class |
Drug name |
Possible side effects |
| Amylin analog |
Pramlintide (Symlin) |
Low blood sugar, nausea, vomiting, headache, stomach pain |
| Glucagon-like peptide (GLP-1) receptor agonists |
Abiglutide( Tanzeum), Dulaglutide (Trulicity), Exenatide (Byetta), Exenatide extended release (Bydureon), Liraglutide (Victoza), Lixisenatide (Adlyxin), semaglutide (Ozempic, Rybelsus) |
Nausea, vomiting, headache, dizziness, increased risk of pancreatitis |
| Drug class |
Amylin analog |
| Drug name |
Pramlintide (Symlin) |
| Possible side effects |
Low blood sugar, nausea, vomiting, headache, stomach pain |
| Drug class |
Glucagon-like peptide (GLP-1) receptor agonists |
| Drug name |
Abiglutide( Tanzeum), Dulaglutide (Trulicity), Exenatide (Byetta), Exenatide extended release (Bydureon), Liraglutide (Victoza), Lixisenatide (Adlyxin), semaglutide (Ozempic, Rybelsus) |
| Possible side effects |
Nausea, vomiting, headache, dizziness, increased risk of pancreatitis |
Coping with minor side effects
Be sure to talk to your health care provider if you have unexpected or bothersome symptoms. They can help you determine if your symptoms are side effects of your medicine or are caused by something else. Your provider or pharmacist can offer suggestions to manage the side effects. Or, your provider may decide to lower your dose, switch you to another medication or suggest changes to your diet or lifestyle to help you feel better.
Taking medications exactly as directed may lessen or eliminate some side effects. For example, some medications need to be taken with food or else they may upset your stomach. If your medicine causes modest weight gain, following the other parts of your treatment plan, like eating a healthy diet and exercising regularly, can help you maintain your weight. Using the correct dose of insulin can help reduce the risk of low blood sugar, and rotating the injection site can help lower the risk of skin reactions at the injection site.
A word on serious side effects
Though rare, dangerous side effects can occur from taking a medication. Keep in mind that your health care provider prescribes medicine when they feel the benefit of taking a drug outweighs the risk of not taking it. If you're taking a medication where a serious side effect is a risk, let you provider know if you have any unusual symptoms. If your symptoms are concerning, seek medical help right away.
Clinically reviewed March 18, 2021
Sources:
