Best Buy Drugs for diabetes

If you’re one of the 24 million people in the U.S. with type 2 diabetes, exercise, a healthful diet, and weight loss (if needed) are essential to help keep your blood sugar levels in check. If medication is required, three older, inexpensive drugs are your best first options. They’re just as effective as newer, high-priced medications and in some cases are better and safer.

The best first option is generic metformin. If that doesn’t drop your blood sugar levels enough, you might need to add glimepiride or glipizide. (If you also have heart failure or kidney disease, your doctor might start with one of those drugs instead.)

If the older drugs still don’t do the trick, a newer medication called Actos (pioglitazone) might make sense. But it can be expensive. It’s also linked to a higher risk of heart failure, so we advise that you consider it only if other medications have not been effective or if you can’t tolerate them.

CR Best Buys

• Metformin
• Glimepiride
• Glipizide and Glipizide Sustained Release (They are available as low-cost generics.)

Less impressive

• Rosiglitazone (Avandia). Linked to a higher risk of heart attack and stroke. Last year, the FDA restricted use of this drug to people for whom other drugs were ineffective.
• Pioglitazone (Actos). Linked to higher risk of heart failure. Only consider if other treatments have not worked.
• Sitagliptin (Januvia). Expensive brand-name drug that’s no more effective than metformin and might induce hypoglycemia (low blood sugar) when used with other drugs.

Actos vs. Metformin

Older drugs work just as well as newer drugs and are safer in some cases. They could also save you a lot of money.