Diabetes Medicines

Brand Names: Prandase™, Glucobay™

​This medicine is from the Alpha-glucosidase inhibitors class. This medicine helps your body to break down sugar and starch in the food you eat. By helping this process, Acarbose lowers the amount of sugar that enters your blood and cells.

Acarbose lowers your A1c level. It is expected to lower your A1c by 0.6 percent (%).

Side Effects and Your Role

Every medicine has side effects. People tend to react in different ways to the same medicine.

The common side effects of Acarbose are:

• upset stomach
• nausea
• diarrhea
• gas
• bloating

If you take other medicines along with Acarbose, it can cause low blood sugar levels.

Your Role

• Take Acarbose with the first bite of your meal to allow the medicine work while you eat the rest of your meal.
• Do not take Acarbose if you do not eat. Without food, there won’t be sugar and starch to break down.
• Do not take Acarbose if you have an intestinal disease (such as inflammatory bowel disease). Taking this medicine could make intestinal disease worse. Tell your doctor about all health conditions that you have.
• Talk to your doctor if you have questions about your medicine.

Brand Names: NovoRapid™, Novolog™

​This medicine is part of the Insulin class. Aspart is a “rapid-acting” form of insulin meaning it works quickly to give you insulin. Aspart will take effect in 15 to 30 minutes and is most effective between 30 minutes and 2.5 hours. Its effect lasts up to 3 to 5 hours.

Aspart provides extra insulin to your body when your pancreas cannot make enough. Aspart helps lower your blood sugar by, 1) lowering the amount of sugar released from your liver, and 2) helping your body store sugar from your blood.

Aspart is expected to lower your A1c by 0.9 to 1.1 percent (%).

Side Effects and Your Roles

​Every medicine has side effects. People have different side effects from the same medicine.

The most common side effects of Aspart are:

• low blood sugar (hypoglycemia)
• weight gain
• low potassium (a mineral)

When you start using insulin you might get temporary symptoms (symptoms that don’t last). These include:

• swollen legs
• problems with your eyes (visual disturbances)
• changes at the injection site (where the medicine went in) such as redness, pain, bruising, and itching

If these symptoms don’t go away, call your doctor right away.

Your Role

• Avoid low blood sugar by:
  • checking your blood sugar often.
  • checking your blood sugar before you drive.
  • checking your blood sugar before and after you exercise.
  • always carrying a fast-acting carbohydrate with you (such as sugar tablets, juice, or pop). Fast-acting carbohydrates raise your blood sugar quickly. Eat a fast-acting carbohydrate if your blood sugar is low.
• Follow the instructions on storing insulin:
  • Store all insulins in the fridge.
  • Store insulins with the outer carton to protect them from the light.
• Rotate the site of injection. You may get complications with your skin and skin tissues if you always inject the same site of your body. These complications include damage to your fat tissues and a condition called skin amyloidosis, which may impair insulin absorption.
• If you have diseases in the kidneys, liver, thyroid, pituitary gland, or adrenal gland, may require changes to your insulin doses.
• Talk to your doctor before you stop taking insulin or if your insulin needs to be increased. Not having enough insulin can lead to a complication called “ketoacidosis”. The symptoms of ketoacidosis develop slowly over hours or days. These symptoms include thirst, peeing more often, nausea, drowsiness, dry skin or mouth, and a sweet (acetone) smell on your breath. You can die from ketoacidosis. Contact your doctor if you experience any of these symptoms. 
• Skipping a meal or doing unplanned, hard exercise can lead to low blood sugar. Consider this if you use insulin.
• Talk to your doctor if you are also taking pioglitazone, especially if you start gaining weight or retaining fluids.
• Talk to your doctor if you have questions about your medicine.

Brand Names: NovoMix 30™

​This medicine is part of the Insulin class. There are many types of insulins and they vary based on how quickly they start working and for how long they work. Biphasic Insulin Aspart is a “premixed” form of insulin. Premixed means this medicine works fast and slow at the same time.

Biphasic Insulin Aspart has two forms of insulin: rapid and slow. The ¨rapid insulin” will start working within 15 minutes after injection, peak in 2 hours, and last up to 4 hours afterwards. The “slow insulin” will last up to 24 hours. 

When taken, Biphasic Insulin Aspart provides extra insulin to your body. Extra insulin is needed when your pancreas cannot make enough. Biphasic Insulin Aspart helps lower sugar released from your liver. This medicine also helps your body store sugar from your blood. As a result, Biphasic Insulin Aspart helps lower your blood sugar.

Biphasic Insulin Aspart lowers your A1c level. This medicine is expected to lower your A1c by 0.9 to 1.1 percent (%).

Side Effects and Your Role

​Every medicine has side effects. People have different side effects from the same medicine.

The most common side effects of Biphasic Insulin Aspart are:

• low blood sugar (hypoglycemia)
• weight gain
• low potassium (a mineral in your body)

When you start using insulin you might get temporary symptoms (symptoms that don’t last). These include:

• swollen legs
• problems with your eyes (visual disturbances)
• changes at the injection site (where the medicine went in) such as redness, pain, bruising, and itching

If these symptoms don’t go away, call your doctor right away.

Your Role

• Avoid low blood sugar by:
  • checking your blood sugar often
  • checking your blood sugar before you drive
  • checking your blood sugar before and after you exercise
  • always carrying a fast acting carbohydrate with you (such as sugar tablets, juice, or pop). Fastaacting carbohydrates raise your blood sugar quickly. Eat a fast-acting carbohydrate if your blood sugar is low.
• Follow the instructions on storing insulin
  • Store all insulins in the fridge
  • Check the expiry date of your medicine
    • Novo Mix can be used for 2 years if it is not opened. It can be used for 4 weeks if it is opened.
  • Store insulins with the outer carton to protect them from the light.
    • Do not use if you notice the liquid is not uniformly white.
• Rotate the site of injection. You may get complications with your skin and skin tissues if you always inject the same site of your body. These complications include damage to your fat tissues and a condition called skin amyloidosis, which may impair insulin absorption.
• If you have diseases in the kidneys, liver, thyroid, pituitary gland, or adrenal gland, may require changes to your insulin doses.
• Talk to your doctor before you stop taking insulin or if your insulin needs to be increased. Not having enough insulin can lead to a complication called “ketoacidosis”. The symptoms of ketoacidosis develop slowly over hours or days. These symptoms include thirst, peeing more often, nausea, drowsiness, dry skin or mouth, and a sweet (acetone) smelling breath. You can die from ketoacidosis. Contact your doctor if you experience any of these symptoms. 
• Skipping a meal or doing unplanned, hard exercise can lead to low blood sugar. Consider this if you use insulin.
• Talk to your doctor if you have questions about your medicine.​

Brand Names: Invokana™

​This medicine is part of the SGLT-2 Inhibitor (Gliflozins) class. This class of medicine tells your kidneys to release more sugar in your urine (pee). As a result, Canagliflozin lowers your blood sugar levels.

Canagliflozin is expected to lower your A1c by 0.5 to 1 percent (%).

Side Effects and Your Role

Every medicine has side effects. People have different side effects from the same medicine.

The most common side effects of Canagliflozin are:

• urinating (peeing) more often
• dehydration (your body does not have enough water)
• low blood pressure
• infection on your groin
• risk of breaking bones (fractures)
• higher LDL (bad) cholesterol levels
• urinary or genital infections
• constipation (hard to poo)
• thirst
• nausea

Your Role

• Talk to your doctor if you have kidney problems.
• Stop this medicine if you are ill (with a cold or infection) to prevent a very serious health problem (ketoacidosis).
• Tell your doctor if you take insulin. If you use this medicine along with insulin, you may require less insulin.
• Take this medicine with or without food. It is best to take it before the first meal of the day.
• Tell your doctor if you start feeling fatigued, dizzy, or lightheaded. You may get dehydrated while taking this medicine and will need to start taking your blood pressure.
• Tell your doctor if you ever had diabetic ketoacidosis. If you did, Canagliflozin might not be the right medicine for you. If you start feeling increased thirst, pee more often, nausea, drowsiness, dry skin or mouth, or a sweet (acetone) smell on your breath, go to the Emergency Department right away.
• Talk to your doctor right way if you start feeling pain, tenderness, redness, or swelling in your genital area (vagina or scrotum) or perineal area (the space between your genitals and your anus), along with a fever or a feeling of discomfort.
• Ask your doctor on how to have proper foot care. 
• Talk to your doctor if you are lactose intolerant or if you have hereditary galactose problems because the tablets contain lactose.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Forxiga™

​This medicine is part of the SGLT-2 Inhibitor (Gliflozins) class. This class of medicine tells your kidneys to release more sugar in your urine (pee). As a result, Dapagliflozin lowers your blood sugar levels.

Dapagliflozin lowers your A1c level by 0.5 to 1 percent (%). If you are living with cardiovascular disease or heart failure, this medicine can improve the long-term outcome of your condition (your prognosis).

Side Effects and Your Role

Every medicine has side effects. People have different side effects from the same medicine.

The side effects of Dapagliflozin are:

• urinating (peeing) more often
• dehydration (your body does not have enough water)
• low blood pressure
• infection on your groin
• risk of breaking bones (fractures)
• higher LDL (bad) cholesterol levels
• urinary or genital infections
• rash
• back pain

Your Role

• Tell your doctor if you or your family had bladder cancer. Dapagliflozin affects your bladder.
• Stop this medicine if you are ill (with a cold or infection) to prevent a very serious health problem called ketoacidosis.
• Tell your doctor if you take insulin. If you use this medicine along with insulin, you may require less insulin
• Take this medicine with or without food. Try not to take Dapagliflozin with high-fat meals. 
• Tell your doctor if you start feeling fatigued, dizzy, or lightheaded. You may get dehydrated while taking this medicine and will need to start taking your blood pressure.
• Tell your doctor if you ever had diabetic ketoacidosis. If you did, Dapagliflozin might not be the right medicine for you. If you start feeling increased thirst, pee more often, nausea, drowsiness, dry skin or mouth, or a sweet (acetone) smell on your breath, go to the Emergency Department right away.
• Talk to your doctor right way if you start feeling pain, tenderness, redness, or swelling in your genital area (vagina or scrotum) or perineal area (the space between your genitals and your anus), along with a fever or a feeling of discomfort.
• Ask your doctor on how to have proper foot care. 
• Talk to your doctor if you are lactose intolerant or if you have hereditary galactose problems because the tablets contain lactose.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Levemir™

​This medicine is part of the Insulin class. Detemir is a “long-acting” form of insulin meaning your medicine works slowly. Detemir will take effect in 3 to 4 hours and keep working for 24 hours or longer.

Detemir provides extra insulin to your body when your pancreas cannot make enough. Detemir helps lower your blood sugar by, 1) lowering the amount of sugar released from your liver, and 2) helping your body store sugar from your blood.

Detemir is expected to lower your A1c by 0.9 to 1.1 percent (%).

Side Effects and Your Role

Every medicine has side effects. People have different side effects from the same medicine.

The most common side effects of Detemir are:

• low blood sugar (hypoglycemia)
• weight gain
• low potassium (a mineral in your body)

When you start using insulin you might get temporary symptoms (symptoms that don’t last). These include:

• swollen legs
• problems with your eyes (visual disturbances)
• changes at the injection site (where the medicine went in) such as redness, pain, bruising, and itching

If these symptoms don’t go away, call your doctor right away.

Your Role

• Avoid low blood sugar by:
  • checking your blood sugar often.
  • checking your blood sugar before you drive.
  • checking your blood sugar before and after you exercise.
  • always carrying a fast acting carbohydrate with you (such as sugar tablets, juice, or pop). Fast-acting carbohydrates raise your blood sugar quickly. Eat a fast-acting carbohydrate if your blood sugar is low.
• Follow the instructions on storing insulin:
  • Store all insulins in the fridge.
  • Store insulins with the outer carton to protect them from the light.
• Rotate the site of injection. You may get complications with your skin and skin tissues if you always inject the same site of your body. These complications include damage to your fat tissues and a condition called skin amyloidosis, which may impair insulin absorption.
• If you have diseases in the kidneys, liver, thyroid, pituitary gland, or adrenal gland, may require changes to your insulin doses.
• Talk to your doctor before you stop taking insulin or if your insulin needs to be increased. Not having enough insulin can lead to a complication called “ketoacidosis”. The symptoms of ketoacidosis develop slowly over hours or days. These symptoms include thirst, peeing more often, nausea, drowsiness, dry skin or mouth, and a sweet (acetone) smell on your breath. You can die from ketoacidosis. Contact your doctor if you experience any of these symptoms. 
• Skipping a meal or doing unplanned, hard exercise can lead to low blood sugar. Consider this if you use insulin.
• Talk to your doctor if you are also taking pioglitazone, especially if you start gaining weight or retaining fluids.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Jardiance™

​This medicine is part of the SGLT-2 Inhibitor (Gliflozins) class. This class of medicine tells your kidneys to release more sugar in your urine (pee). As a result, Empagliflozin lowers your blood sugar level.

Empagliflozin lowers your A1c level. This medicine is expected to lower your A1c by 0.5 to 1 percent (%).

Side Effects and Your Role

Every medicine h​as side effects. People have diverse side effects from the same medicine.

The most common side effects of Empaglifozin are:

• urinating (peeing) more often
• dehydration (your body does not have enough water)
• low blood pressure
• infection on your groin
• risk of breaking bones (fractures)
• higher LDL (bad) cholesterol levels
• urinary or genital infections
• constipation

Your Role

• Stop this medicine if you are ill (with a cold or infection) to prevent a very serious health problem called ketoacidosis.
• Tell your doctor if you take insulin. If you use this medicine along with insulin, you may require less insulin.
• Take this medicine with or without food.
• Tell your doctor if you start feeling fatigued, dizzy, or lightheaded. You may get dehydrated while taking this medicine and will need to start taking your blood pressure.
• Tell your doctor if you ever had diabetic ketoacidosis. If you did, Empagliflozin might not be the right medicine for you. If you start feeling increased thirst, pee more often, nausea, drowsiness, dry skin or mouth, or a sweet (acetone) smell on your breath, go to the Emergency Department right away.
• Talk to your doctor right way if you start feeling pain, tenderness, redness, or swelling in your genital area (vagina or scrotum) or perineal area (the space between your genitals and your anus), along with a fever or a feeling of discomfort.
• Ask your doctor on how to have proper foot care. 
• Talk to your doctor if you are lactose intolerant or if you have hereditary galactose problems because the tablets contain lactose.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Byetta™

This medicine is part of the GLP-1 class (Incretin Agent). This class of medicine makes your pancreas produce more insulin when you eat. It also slows down your stomach from emptying food into your intestine when you digest. As a result, it helps you feel full longer. You may notice weight loss with this medicine. Exenatide helps your liver make less sugar too.

You will inject yourself with a needle to take Exenatide. (Exenatide is not an insulin.)

Exenatide is expected to lower your A1c by 0.7 percent (%).

Side Effects and Your Role

All medicines have side effects. People have different side effects from the same medicine.

The common side effects of Exenatide are:

• nausea (feeling dizzy)
• feeling full when you eat
• irritation (inflammation) of your pancreas, (known as pancreatitis)
• headache
• burping
• passing gas (farting)
• excess sweating
• itchiness
• loss of appetite or decreased appetite
• nausea, vomiting, diarrhea (when you first start taking the medicine)

Your Role

• Talk to your doctor if you have kidney problems.
• Do not take Exenatide if you or your family have a history of:
  • thyroid cancer
  • glandular tumours
  • pancreatitis
• Talk to your doctor if nausea, vomiting, or diarrhea don’t go away.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Lantus™

This medicine is part of the Insulin class. Glargine is a “long-acting” form of insulin. “Long-acting” means your medicine works slowly. Glargine will take effect in 3 to 4 hours. This medicine will continue to work for 24 hours or longer.

When taken, Glargine provides extra insulin to your body. This is needed when your pancreas cannot make enough. Glargine helps lower sugar released from your liver. This medicine also helps your body store sugar from your blood. As a result, Glargine helps lower your blood sugar.

Glargine lowers your A1c level. This medicine is expected to lower your A1c by 0.9 to 1.1 percent (%).

Side Effects and Your Role

Every medicine has side effects. People have diverse side effects from the same medicine.

The most common side effects of Glargine are:

• low blood sugar (hypoglycemia)
• weight gain
• low potassium (a mineral in your body)

When you start using insulin you might get temporary symptoms (symptoms that don’t last). These include:

• swollen legs
• problems with your eyes (visual disturbances)
• changes at the injection site (where the medicine went in) such as redness, pain, bruising, and itching

If these symptoms don’t go away, call your doctor right away.

Your Role

• Avoid low blood sugar by:
  • checking your blood sugar often.
  • checking your blood sugar before you drive.
  • checking your blood sugar before and after you exercise.
  • always carry a fast acting carbohydrate with you (such as sugar tablets, juice or pop). Fast acting carbohydrates raise your blood sugar quickly. Eat a fast-acting carbohydrate if your blood sugar is low.
• Follow the instructions on storing insulin:
  • Store all insulins in the fridge.
  • Store insulins with the outer carton to protect them from the light.
• Rotate the site of injection. You may get complications with your skin and skin tissues if you always inject the same site of your body. These complications include damage to your fat tissues and a condition called skin amyloidosis, which may impair insulin absorption.
• If you have diseases in the kidneys, liver, thyroid, pituitary gland, or adrenal gland, may require changes to your insulin doses.
• Talk to your doctor before you stop taking insulin or if your insulin needs to be increased. Not having enough insulin can lead to a complication called “ketoacidosis”. The symptoms of ketoacidosis develop slowly over hours or days. These symptoms include thirst, peeing more often, nausea, drowsiness, dry skin or mouth, and a sweet (acetone) smell on your breath. You can die from ketoacidosis. Contact your doctor if you experience any of these symptoms. 
• Skipping a meal or doing unplanned, hard exercise can lead to low blood sugar. Consider this if you use insulin.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Apidra™

This medicine is part of the Insulin class. Glulisine is a “rapid-acting” form of insulin meaning it works quickly to give you insulin. Glulisine will take effect in 15 to 30 minutes. This medicine is most effective between 30 minutes and 2.5 hours.

Glulisine provides extra insulin to your body when your pancreas cannot make enough. Glulisine helps lower your blood sugar by, 1) lowering the amount of sugar released from your liver, and 2) helping your body store sugar from your blood.

Glulisine is expected to lower your A1c by 0.9 to 1.1 percent (%).

Side Effects and Your Role

Every medicine has side effects. People have different side effects from the same medicine.

The most common side effects of Glulisine are:

• low blood sugar (hypoglycemia)
• weight gain
• low potassium (a mineral in your body)

When you start using insulin you might get temporary symptoms (symptoms that don’t last). These include:

• swollen legs
• problems with your eyes (visual disturbances)
• changes at the injection site (where the medicine went in) such as redness, pain, bruising, and itching

If these symptoms don’t go away, call your doctor right away.

Your Role

• Avoid low blood sugar by:
  • checking your blood sugar often.
  • checking your blood sugar before you drive.
  • checking your blood sugar before and after you exercise.
  • always carrying a fast acting carbohydrate with you (such as sugar tablets, juice, or pop). Fast-acting carbohydrates raise your blood sugar quickly. Eat a fast-acting carbohydrate if your blood sugar is low.
• Follow the instructions on storing insulin:
  • Store all insulins in the fridge.
  • Store insulins with the outer carton to protect them from the light.
• Rotate the site of injection. You may get complications with your skin and skin tissues if you always inject the same site of your body. These complications include damage to your fat tissues and a condition called skin amyloidosis, which may impair insulin absorption.
• If you have diseases in the kidneys, liver, thyroid, pituitary gland, or adrenal gland, may require changes to your insulin doses.
• Talk to your doctor before you stop taking insulin or if your insulin needs to be increased. Not having enough insulin can lead to a complication called “ketoacidosis”. The symptoms of ketoacidosis develop slowly over hours or days. These symptoms include thirst, peeing more often, nausea, drowsiness, dry skin or mouth, and a sweet (acetone) smell on your breath. You can die from ketoacidosis. Contact your doctor if you experience any of these symptoms. 
• Skipping a meal or doing unplanned, hard exercise can lead to low blood sugar. Consider this if you use insulin.
• Talk to your doctor if you have questions about this medicine.

Brand Names: Humalog Mix 25™, Mix 50™

This medicine is part of the Insulin class. Insulin Lispro is a “premixed” form of insulin. Premixed means this medicine works fast and slow at the same time. The insulin starts acting quickly (within 15 minutes) and has an early peak which means it can be taken closer to meals. The long acting effect of Insulin Lispro can last up to 15 hours.

When taken, Insulin Lispro provides extra insulin to your body. Extra insulin is needed when your pancreas cannot make enough. Insulin Lispro helps lower sugar released from your liver. This medicine also helps your body store sugar from your blood. As a result, Insulin Lispro helps lower your blood sugar.

Insulin Lispro is expected to lower your A1c by 0.9 to 1.1 percent (%).

Side Effects and Your Role

Every medicine has side effects. People have diverse side effects from the same medicine.

The most common side effects of Insulin Lispro are:

• low blood sugar (hypoglycemia)
• weight gain
• low potassium (a mineral in your body)

When you start using insulin you might get temporary symptoms (symptoms that don’t last). These include:

• swollen legs
• problems with your eyes (visual disturbances)
• changes at the injection site (where the medicine went in) such as redness, pain, bruising, and itching

If these symptoms don’t go away, call your doctor right away.

Your Role

• Avoid low blood sugar by:
  • checking your blood sugar often.
  • checking your blood sugar before you drive.
  • checking your blood sugar before and after you exercise.
  • always carry a fast acting carbohydrate with you (such as sugar tablets, juice, or pop). Fast acting carbohydrates raise your blood sugar quickly. Eat a fast-acting carbohydrate if your blood sugar is low.
• Follow the instructions on storing insulin:
  • Store all insulins in the fridge.
  • Store insulins with the outer carton to protect them from the light.
• Rotate the site of injection. You may get complications with your skin and skin tissues if you always inject the same site of your body. These complications include damage to your fat tissues and a condition called skin amyloidosis, which may impair insulin absorption.
• If you have diseases in the kidneys, liver, thyroid, pituitary gland, or adrenal gland, may require changes to your insulin doses.
• Talk to your doctor before you stop taking insulin or if your insulin needs to be increased. Not having enough insulin can lead to a complication called “ketoacidosis”. The symptoms of ketoacidosis develop slowly over hours or days. These symptoms include thirst, peeing more often, nausea, drowsiness, dry skin or mouth, and a sweet (acetone) smell on your breath. You can die from ketoacidosis. Contact your doctor if you experience any of these symptoms. 
• Skipping a meal or doing unplanned, hard exercise can lead to low blood sugar. Consider this if you use insulin.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Humulin N™, Novolin NPH™

This medicine is part of the Insulin class. Insulin NPH and Humulin are an “intermediate-acting” form of insulin meaning the medicine will take effect in 1 to 2 hours. These medicines are most effective between 4 and 12 hours.

Insulin NPH and Humulin provide extra insulin to your body when your pancreas cannot make enough. Insulin NPH and Humulin helps lower your blood sugar by, 1) lowering the amount of sugar released from your liver, and 2) helping your body store sugar from your blood.

Insulin NPH and Humulin are expected to lower your A1c by 0.9 to 1.1 percent (%).

Side Effects and Your Role

Every medicine has side effects. People have different side effects from the same medicine.

The most common side effects of Insulin NPH and Humulin are:

• low blood sugar (hypoglycemia)
• weight gain
• low potassium (a mineral in your body)

When you start using insulin you might get temporary symptoms (symptoms that don’t last). These include:

• swollen legs
• problems with your eyes (visual disturbances)
• changes at the injection site (where the medicine went in) such as redness, pain, bruising, and itching

If these symptoms don’t go away, call your doctor right away.

Your Role

• Avoid low blood sugar by:
  • checking your blood sugar often.
  • checking your blood sugar before you drive.
  • checking your blood sugar before and after you exercise.
  • always carry a fast acting carbohydrate with you (such as sugar tablets, juice or pop). Fast acting carbohydrates raise your blood sugar quickly. Eat a fast-acting carbohydrate if your blood sugar is low.
• Follow the instructions on storing insulin:
  • Store all insulins in the fridge.
  • Store insulins with the outer carton to protect them from the light.
• Rotate the site of injection. You may get complications with your skin and skin tissues if you always inject the same site of your body. These complications include damage to your fat tissues and a condition called skin amyloidosis, which may impair insulin absorption.
• If you have diseases in the kidneys, liver, thyroid, pituitary gland, or adrenal gland, may require changes to your insulin doses.
• Talk to your doctor before you stop taking insulin or if your insulin needs to be increased. Not having enough insulin can lead to a complication called “ketoacidosis”. The symptoms of ketoacidosis develop slowly over hours or days. These symptoms include thirst, peeing more often, nausea, drowsiness, dry skin or mouth, and a sweet (acetone) smell on your breath. You can die from ketoacidosis. Contact your doctor if you experience any of these symptoms. 
• Skipping a meal or doing unplanned, hard exercise can lead to low blood sugar. Consider this if you use insulin.
• Talk to your doctor if you are also taking pioglitazone, especially if you start gaining weight or retaining fluids.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Trajenta™

This medicine is part of the DPP-4 Inhibitors class. DPP-4 is a hormone that destroys incretine, a hormone that helps your body produce insulin. By blocking (or inhibiting) DPP-4, incretine is not destroyed. As a result, this class of medicine helps raise your insulin after you eat. Linagliptin also helps lower the sugar made by your liver to help you manage your blood sugar.

Linagliptin can be used with other medicines to help their effects. Medicines like Exenatide (Byetta) or Liraglutide (Victoza) can be used with Linagliptin. Linagliptin will make the effects of the other medicines last longer.

Linagliptin lowers your A1c level by 0.5 to 0.8 percent (%).

Side Effects and Your Role

Every medicine has side effects. People have diverse side effects from the same medicine.

The common side effects of Linagliptin are:

• chest infection
• stuffy or runny nose
• sore throat
• headache

Your Role

• Choose a time of day to take your medicine then take it at the same time every day.
• Take these medicines with or without food.
• Tell your doctor if you have liver problems.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Victoza™

This medicine is part of the GLP-1 class (Incretin Agent). This class of medicine makes your pancreas produce more insulin when you eat. It also slows down your stomach from emptying food into your intestine when you digest. As a result, it helps you feel full longer. You may notice weight loss with this medicine. Liraglutide helps your liver make less sugar too.

You will inject yourself with a needle to take Liraglutide. (Liraglutide is not an insulin.)

Liraglutide is expected to lower your A1c by 0.7 percent (%).

Side Effects and Your Role

All medicines have side effects. People have different side effects from the same medicine.

The most common side effects of Liraglutide are:

• nausea
• feeling full when you eat
• irritation (inflammation) of your pancreas (known as pancreatitis)
• headache
• burping
• passing gas (farting)
• excess sweating
• itchiness
• loss of appetite or decreased appetite
• nausea, vomiting, diarrhea (when you first start taking the medicine)
• respiratory infections

Your Role

• Talk to your doctor if you have kidney problems.
• Do not take Liraglutide if you or your family have a history of:
  • thyroid cancer
  • glandular tumours
  • pancreatitis
• Talk to your doctor if nausea, vomiting, or diarrhea don’t go away.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Humalog™

This medicine is part of the Insulin class. Lispro is a “rapid-acting” form of insulin meaning it works quickly to give you insulin. The medicine will take effect in 15 to 30 minutes and is most effective between 30 minutes and 2.5 hours. Lispro’s effect lasts up to 5 hours.

Lispro provides extra insulin to your body when your pancreas cannot make enough. Lispro helps lower your blood sugar by, 1) lowering the amount of sugar released from your liver, and 2) helping your body store sugar from your blood.

Lispro is expected to lower your A1c level by 0.9 to 1.1 percent (%).

Side Effects and Your Role

Every medicine has side effects. People have diverse side effects from the same medicine.

The most common side effects of Lispro are:

• low blood sugar (hypoglycemia)
• weight gain
• low potassium (a mineral in your body)

When you start using insulin you might get temporary symptoms (symptoms that don’t last). These include:

• swollen legs
• problems with your eyes (visual disturbances)
• changes at the injection site (where the medicine went in) such as redness, pain, bruising, and itching

If these symptoms don’t go away, call your doctor right away.

Your Role

• Avoid low blood sugar by:
  • checking your blood sugar often.
  • checking your blood sugar before you drive.
  • checking your blood sugar before and after you exercise.
  • always carry a fast acting carbohydrate with you (such as sugar tablets, juice or pop). Fast acting carbohydrates raise your blood sugar quickly. Eat a fast-acting carbohydrate if your blood sugar is low.
• Follow the instructions on storing insulin:
  • Store all insulins in the fridge.
  • Store insulins with the outer carton to protect them from the light.
• Rotate the site of injection. You may get complications with your skin and skin tissues if you always inject the same site of your body. These complications include damage to your fat tissues and a condition called skin amyloidosis, which may impair insulin absorption.
• If you have diseases in the kidneys, liver, thyroid, pituitary gland, or adrenal gland, may require changes to your insulin doses.
• Talk to your doctor before you stop taking insulin or if your insulin needs to be increased. Not having enough insulin can lead to a complication called “ketoacidosis”. The symptoms of ketoacidosis develop slowly over hours or days. These symptoms include thirst, peeing more often, nausea, drowsiness, dry skin or mouth, and a sweet (acetone) smell on your breath. You can die from ketoacidosis. Contact your doctor if you experience any of these symptoms. 
• Skipping a meal or doing unplanned, hard exercise can lead to low blood sugar. Consider this if you use insulin.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Glucophage™, Glumetza™

This medicine is from the Biguanides class of medicines. This class of medicine helps your liver make less sugar. Metformin lowers your blood sugar level. It also decreases the amount of sugar your intestines absorb. Metformin helps your body respond better to insulin by a process called peripheral insulin sensitivity.

Metformin is expected to lower your A1c by 1 to 1.5 percent (%).

Side Effects and Your Role

Every medicine has side effects. People tend to react in different ways to the same medicine. Side effects of Metformin often start within the first few weeks.

The most common side effects of Metformin are:

• upset stomach
• nausea
• diarrhea
• gas
• bloating
• metal taste in your mouth
• vitamin B12 deficiency (not enough vitamin B12)

Your Role

• Take metformin with food. Taking metformin with food will lower your chance of side effects.
• Tell your doctor if you have kidney or liver problems.
• Ask your healthcare team if you should stop taking Metformin for medical tests or surgeries. Metformin may be a safety risk for imaging tests using dyes (contrast agents), such as a CT Scan.
• Limit how much alcohol you drink when you are taking Metformin. Drinking a lot of alcohol while taking this medicine can lead to complications that you can die from.
• Tell your doctor is you eat a vegetarian or vegan diet. Metformin can lower vitamin B12 levels and you will need a plan to maintain a healthy level.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Actos™

This medicine is part of the Thiazolidinediones class (TZDs). This class of medicine makes your body more sensitive to insulin. Pioglitazone also helps your liver make less sugar.

Pioglitazone is expected to lower your A1c by 0.8 percent (%).

Side Effects and Your Role

Every medicine has side effects. People tend to react in different ways to the same medicine.

The common side effects of Pioglitazone are:

• fluid collects in your body (known as fluid retention)
• swelling
• weight gain
• shortness of breath
• respiratory infections, especially if this medicine is taken with other diabetes medicines
• loss of feeling in a part of your body

Your Role

• Talk to your doctor if you have liver problems. This medicine may impact your liver.
• Do not take this medicine if you:
  • have heart failure
  • have or had bladder cancer
  • have a high risk of breaking bones (fractures)
  • are a person who can become pregnant (about ages 14 to 55)
• Take this medicine with or without meals. 
• Tell your doctor if your pee (urine) changes colour to pink or red. 
• Talk to your doctor if your weight increases. This medicine can increase your weight and make you retain fluids. 
• Talk to your doctor if you develop problems focusing with your eyes.
• Tell your doctor if you are lactose intolerant or if you have hereditary galactose problems. Actos tablets contain lactose.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Humulin 30/70™, Novolin ge 30/70™, 40/60™, 50/50™

This medicine is part of the Insulin class. Premix Regular-NPH is a “premixed” form of insulin meaning it works fast and slow at the same time.

Premix Regular-NPH provides extra insulin to your body when your pancreas cannot make enough. Premix Insulin-NPH helps lower your blood sugar by, 1) lowering the amount of sugar released from your liver, and 2) helping your body store sugar from your blood.

Premix Insulin-NPH is expected to lower your A1c by 0.9 to 1.1 percent (%).

Side Effects and Your Role

Every medic​ine has side effects. People have different side effects from the same medicine.

The most common side effects of Premix Insulin-NPH are:

• low blood sugar (hypoglycemia)
• weight gain
• low potassium (a mineral in your body)

When you start using insulin you might get temporary symptoms (symptoms that don’t last). These include:

• swollen legs
• problems with your eyes (visual disturbances)
• changes at the injection site (where the medicine went in) such as redness, pain, bruising, and itching

If these symptoms don’t go away, call your doctor right away.

Your Role

• Avoid low blood sugar by:
  • checking your blood sugar often.
  • checking your blood sugar before you drive.
  • checking your blood sugar before and after you exercise.
  • always carrying a fast-acting carbohydrate with you (such as sugar tablets, juice, or pop). Fast-acting carbohydrates raise your blood sugar quickly. Eat a fast-acting carbohydrate if your blood sugar is low.
• Follow the instructions on storing insulin:
  • Store all insulins in the fridge.
  • Store insulins with the outer carton to protect them from the light.
• Rotate the site of injection. You may get complications with your skin and skin tissues if you always inject the same site of your body. These complications include damage to your fat tissues and a condition called skin amyloidosis, which may impair insulin absorption.
• If you have diseases in the kidneys, liver, thyroid, pituitary gland, or adrenal gland, may require changes to your insulin doses.
• Talk to your doctor before you stop taking insulin or if your insulin needs to be increased. Not having enough insulin can lead to a complication called “ketoacidosis”. The symptoms of ketoacidosis develop slowly over hours or days. These symptoms include thirst, peeing more often, nausea, drowsiness, dry skin or mouth, and a sweet (acetone) smell on your breath. You can die from ketoacidosis. Contact your doctor if you experience any of these symptoms. 
• Skipping a meal or doing unplanned, hard exercise can lead to low blood sugar. Consider this if you use insulin.
• Talk to your doctor if you are also taking pioglitazone, especially if you start gaining weight or retaining fluids.
• Talk to you doctor if you have any questions about your medicine.

Brand Names: Gluconorm™

This medicine is part of the Secretagogue class. This class of medicine tells your pancreas to produce insulin for hours after your meals.

Repaglinide is expected to lower your A1c by 0.7 to 0.9 percent (%).

Side Effects and Your Role

Every medicine has side effects. People have different side effects from the same medicine.

The most common side effects of Repaglinide are:

• low blood sugar (hypoglycemia), especially if you have kidney disease
• weight gain
• abdominal pain
• diarrhea

Your Role

• Take this medicine 15 to 30 minutes before you eat. Do not take this medicine without food. Taking it without food will increase your risk of a low blood sugar (hypoglycemia). Ask your doctor how to skip or add a dose if you skip a meal or have an extra meal.
• Talk to your doctor if you have liver problems.
• Talk to your doctor if you take gemfibrozil (a lipid-lowering drug).
• Avoid low blood sugar by:
  • checking your blood sugar often
  • checking your blood sugar before you drive
  • checking your blood sugar before and after you exercise
  • always carrying a fast-acting carbohydrate with you (such as sugar tablets, juice or pop). Fast-acting carbohydrates raise your blood sugar quickly. Eat a fast-acting carbohydrate if your blood sugar is low.
• Talk to your doctor if you are taking sulfa-antibiotics or Plavix (Clopidogrel). Meglitinide medicine can cause low blood sugar if you are also taking sulfa-antibiotics or Plavix (Clopidogrel).
• Talk to your doctor if you have kidney problems.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Avandia™

This medicine is part of the Thiazolidinediones class (TZDs). This class of medicine makes your body more sensitive to insulin. Rosiglitazone also helps your liver make less sugar.

Rosiglitazone is expected to lower your A1c by 0.8 percent (%).

Side Effects and Your Role

Every medicine has side effects. People have different side effects from the same medicine.

The common side effects of Rosiglitazone are:

• buildup of fluid in your body (known as fluid retention)
• swelling
• weight gain
• shortness of breath
• respiratory infections, especially if taken with other diabetes medicines
• loss of sensation (feeling) in a part of your body

Rosiglitazone (Avandia) increases your risk of serious heart problems. These include:

• heart failure (fluid collects in your lungs, ankles, lower legs, and belly as a result of heart failure)
• angina (chest pain)
• heart attack

Talk to your doctor about other diabetes medicines you can take.

Your Role

• Talk to your doctor if you have liver problems.
• Do not take this medicine if you
  • have heart failure
  • have bladder cancer
  • have a high risk of breaking bones (fractures)
  • are a person who can become pregnant (about ages 14 to 55)
• Take this medicine with or without meals.
• Tell your doctor if your pee (urine) changes colour to pink or red.
• Tell your doctor if you develop problems getting your eyes to focus (visual acuity).
• Talk to your doctor if you have questions about your medicine.

Brand Names: Onglyza™

This medicine is part of the DPP-4 Inhibitors class. DDP-4 is a hormone that destroys incretine, a hormone that helps your body produce insulin. By blocking (or inhibiting) DDP-4, incretine is not destroyed. As a result, this class of medicine helps raise your insulin after you eat. Saxagliptin also helps lower the sugar made by your liver to help you manage your blood sugar.

Saxagliptin can be used with other medicines to help their effects. Medicines like Exenatide (Byetta) or Liraglutide (Victoza) can be used with Saxagliptin. Saxagliptin will make the effects of the other medicines last longer.

Saxagliptin is expected to lower your A1c by 0.5 to 0.8 percent (%).​

Side Effects and Your Role

Every medicine has side effects. People have different side effects from the same medicine.

The common side effects of Saxagliptin are:

• chest infection
• stuffy or runny nose
• sore throat
• headache
• joint pain
• urinary infections
• respiratory infections
• dizziness
• abdominal pain
• diarrhea
• fatigue

Your Role

• Choose a time of day to take your medicine and take your medicine at the same time every day.
• Take your medicine with or without food.
• Tell your doctor if you are lactose intolerant or if you have hereditary galactose problems. These tablets contain lactose.
• Check your skin often for blisters or rashes.
• Tell your doctor if you have kidney or liver problems.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Januvia™

This medicine is part of the DPP-4 Inhibitors class. DDP-4 is a hormone that destroys incretine, a hormone that helps your body produce insulin. By blocking (or inhibiting) DDP-4, incretine is not destroyed. As a result, this class of medicine helps raise your insulin after you eat. Sitagliptin also helps lower the sugar made by your liver to help you manage your blood sugar.

Sitagliptin can be used with other medicines [such as Exenatide (Byetta) or Liraglutide (Victoza)] to make the effects of the other medicines last longer.

Sitagliptin is expected to lower your A1c by 0.5 to 0.8 percent (%).

Side Effects and Your Role

Every medicine has side effects. People have different side effects from the same medicine.

The most common side effects of Sitagliptin are:

• chest infection
• stuffy or runny nose
• sore throat
• headache
• severe joint pain
• irritation (inflammation) of your pancreas (known as pancreatitis)

Your Role

• Choose a time of day to take your medicine then take it at the same time every day.
• Take this medicine with or without food.
• Tell your doctor if you have kidney or liver problems.
• Talk to your doctor if you have questions about your medicine.

Brand Names: Diabeta™, Glynase™, Glucotrol™, Diamicron™, Amaryl™

This medicine is part of the Secretagogue class. This class of medicine tells your pancreas to produce insulin for hours after your meals. These medicines are amongst the oldest diabetes medicines still used today.

Sulfonylureas are expected to lower your A1c by 0.7 to 0.9 percent (%).

Side Effects and Your Role

Every medicine has side effects. People have different side effects from the same medicine.

The common side effects of Sulfonylureas are:

• low blood sugar (hypoglycemia)
• weight gain
• nausea
• diarrhea
• abdominal pain

Your Role

• Take this medicine when you eat. It is best to take it before or during a meal.
• Do not take this medicine without food. If you take this medicine without eating, your risk of a low blood sugar (hypoglycemia) is higher.
• Avoid low blood sugar by:
  • checking your blood sugar often
  • checking your blood sugar before you drive
  • checking your blood sugar before and after you exercise
  • always carrying a fast-acting carbohydrate with you (such as sugar tablets, juice, or pop). Fast-acting carbohydrates raise your blood sugar quickly. Eat a fast-acting carbohydrate if your blood sugar is low.
• Talk to your doctor if you are taking antibiotics. Sulfonylureas can cause low blood sugar if you are taking sulfa-antibiotics. Use this medicine with caution.
• Talk to your doctor if you have kidney or liver problems.
• Talk to your doctor if you are lactose intolerant or if you have hereditary galactose problems. Glimepiride and glipizide tablets contain lactose.
• Check your blood sugar if you choose to have alcohol. Drinking alcohol when you are taking these medicines can increase your risk of low blood sugar. 
• Talk to your doctor if you have questions about this medicine.

Brand Names: Humulin R™, Novolin R™

This medicine is part of the Insulin class. Toronto Insulin is a “regular short-acting” form of insulin meaning this medicine will take effect in 30 minutes. This medicine is most effective between 2.5 and 5 hours.

Toronto Insulin provides extra insulin to your body when your pancreas cannot make enough. Toronto Insulin helps lower your blood sugar by, 1) lowering the amount of sugar released from your liver, and 2) helping your body store sugar from your blood.

Toronto Insulin is expected to lower your A1c by 0.9 to 1.1 percent (%).

Side Effects and Your Role

Every medicine has side effects. People have different side effects from the same medicine. Everyone will experience different side effects from the same medicine.

The most common side effects of Toronto Insulin are:

• low blood sugar (hypoglycemia)
• weight gain
• low potassium (a mineral in your body)​

When you start using insulin you might get temporary symptoms (symptoms that don’t last). These include:

• swollen legs
• problems with your eyes (visual disturbances)
• changes at the injection site (where the medicine went in) such as redness, pain, bruising, and itching

If these symptoms don’t go away, call your doctor right away.

Your Role

• Avoid low blood sugar by
  • checking your blood sugar often
  • checking your blood sugar before you drive
  • checking your blood sugar before and after you exercise
  • always carrying a fast-acting carbohydrate with you (such as sugar tablets, juice, or pop). Fast-acting carbohydrates raise your blood sugar quickly. Eat a fast-acting carbohydrate if your blood sugar is low.
• Follow the instructions on storing insulin:
  • Store all insulins in the fridge.
  • Store insulins with the outer carton to protect them from the light.
• Rotate the site of injection. You may get complications with your skin and skin tissues if you always inject the same site of your body. These complications include damage to your fat tissues and a condition called skin amyloidosis, which may impair insulin absorption.
• If you have diseases in the kidneys, liver, thyroid, pituitary gland, or adrenal gland, may require changes to your insulin doses.
• Talk to your doctor before you stop taking insulin or if your insulin needs to be increased. Not having enough insulin can lead to a complication called “ketoacidosis”. The symptoms of ketoacidosis develop slowly over hours or days. These symptoms include thirst, peeing more often, nausea, drowsiness, dry skin or mouth, and a sweet (acetone) smell on your breath. You can die from ketoacidosis. Contact your doctor if you experience any of these symptoms. 
• Skipping a meal or doing unplanned, hard exercise can lead to low blood sugar. Consider this if you use insulin.
• Talk to your doctor if you have questions about your medicine.