Choosing a Type 2 Diabetes Drug

Why generic metformin is often the best choice

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Diabetes makes your blood sugar get too high. Type 2 diabetes is the most common kind of diabetes.

If you have type 2 diabetes, you may think that you need drugs to control it. But not everyone needs a drug. Eating less, exercising more, and losing weight may lower your blood sugar enough. See the blue section on the right for more information.

If you need a drug, metformin is usually best.

For most patients, the best choice for managing type 2 diabetes is metformin. It has been used for almost 20 years and is often better than the newer drugs you see advertised. Metformin is the generic name. The brand-name is Glucophage.

Generic metformin works better for most people compared to the newer brand-name drugs Actos, Avandia, Glyset, Januvia, and Onglyza. Metformin is also the better drug compared to Precose and Starlix, which come as generic acarbose and nateglinide.

Why metformin works better than newer drugs.

  • Metformin lowers blood sugar more than the newer drugs.
  • Metformin can lower bad cholesterol. High cholesterol can clog your arteries and lead to heart disease. The newer drugs do not help lower cholesterol.
  • Metformin does not cause weight gain like some newer drugs do. And it may even help some people lose weight.

Metformin is generally safer than the newer drugs.

Metformin can cause minor side-effects, such as bloating, gas, nausea, and diarrhea.

  • Some of the newer drugs can make your blood sugar drop too low. This can cause sweating, shaking, dizziness, hunger, and, in rare cases, death.
  • Some of the newer drugs are linked to other serious problems. Avandia and Actos may cause heart failure. Avandia may also increase the risk of heart attack and stroke.

Metformin costs less than the newer drugs.

  • You can buy generic metformin through discount generic-drug programs. It can cost only $4 for a one-month supply and $10 for a three-month supply. You can find these programs at chain stores such as Kroger’s, Sam’s Club, Target, and Walmart. You can buy generic metformin for about $14 for a one-month supply at other stores.
  • The newer, brand-name drugs can cost several hundred dollars for a one-month supply. For example, Actos can cost from $230 to $370 a month. Januvia can cost $265 a month.

When is a newer drug a good choice?

  • Some patients should not take metformin. This includes people who have kidney disease or heart failure, or who drink a lot of alcohol. In these cases, metformin can make lactic acid build up in your body. Symptoms of too much lactic acid include abdominal pain, nausea or vomiting, confusion, and even coma.
  • Some people need to take a newer drug along with metformin. You may need to do this if you cannot lower your blood sugar enough by taking metformin, changing your diet, and exercising.

Advice from Consumer Reports

This report is for you to use when talking with your healthcare provider. It is not a substitute for medical advice and treatment. Use of this report is at your own risk.
© 2012 Consumer Reports. Developed in cooperation with the American College of Physicians. To learn more about the sources used in this report and terms and conditions of use, visit ConsumerHealthChoices.org/about-us/.