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Diabetes Drugs: Summary of Recommendations
Six types of oral medicines (and 11 individual drugs) are now available to help the 24 million people in the U.S. with type 2 diabetes control their blood sugar when diet and lifestyle changes are not enough. Our evaluation of these medicines found the following:
  • Newer drugs are no better. Two drugs from a class called the sulfonylureas and a drug named metformin have been around for more than a decade and work just as well as newer medicines. Indeed, several of the newer drugs are less effective than the older ones.
  • Newer drugs are no safer. All diabetes pills have the potential to cause adverse effects, both minor and serious. The drugs' safety and side effect "profiles" may be the most important factor in your choice.
  • The newer drugs are more expensive. The newer diabetes medicines cost many times more than the older ones.
  • Taking more than one diabetes drug is sometimes necessary. Many people with diabetes do not get enough blood sugar control from one medicine. Two or more may be necessary. However, taking more than one diabetes drug raises the risk of adverse effects and increases costs.
Taking effectiveness, safety, adverse effects, dosing, and cost into consideration, we have chosen the following as Consumer Reports Best Buy Drugs if your doctor and you have decided that you need medicine to control your diabetes:
  • Metformin - alone or with glipizide or glimepiride
  • Glipizide and Glipizide Sustained Release - alone or with metformin
  • Glimepiride - alone or with metformin

These medicines are available as low-cost generics, costing from $10 to $60 a month. If you have been diagnosed with diabetes, we recommend that you try metformin first unless your health status prevents it.

If metformin fails to bring your blood sugar into normal range, we recommend you add glipizide or glimepiride. Should either of those cause problems, Actos (pioglitizone) may be an option you and your doctor will want to consider. Be aware that Actos has been linked to a higher risk of heart failure.

This information was updated in February 2009.
Diabetes Drugs: Drug Comparison
Recommendations: Diabetes Drugs
CR Best Buy Generic Name and Dose Brand Name (or Generic) Number of Pills (Per day)1 Total Daily Dose1 Average Monthly Cost2 Compare Prices
  Glyburide 5mg Generic One 5mg $6
  Glyburide 5mg Micronase One 5mg $47
  Glyburide 5mg Diabeta One 5mg $38
  Glyburide 5mg Generic Two 10mg $12
  Glyburide 5 mg Micronase Two 10mg $94
  Glyburide 5 mg Diabeta Two 10mg $76
  Glyburide micronized 6mg Glynase One 6mg $68
  Glyburide micronized 6mg Generic One 6mg $7
  Glipizide 10mg Glucotrol One-Two 10-20mg $42-$84
Glipizide 10mg Generic One-Two 10-20mg $4-$8
  Glipizide 5mg, sustained release Glucotrol XL One 5 mg $25
Glipizide 5mg, sustained release Generic One 5 mg $13
  Glipizide 10mg, sustained release Glucotrol XL One-Two 10-20mg $45-$90
Glipizide 10mg, sustained release Generic One-Two 10-20mg $23-$46
  Glimepiride 1mg Amaryl One 1mg $22
Glimepiride 1mg Generic One 1mg $6
  Glimepiride 2mg Amaryl One 2mg $35
Glimepiride 2mg Generic One 2mg $7
  Metformin 500mg Glucophage Three 1500mg $117
Metformin 500mg Generic Three 1500mg $18
  Metformin 1000mg Glucophage Two 2000mg $154
Metformin 1000mg Generic Two 2000mg $18
  Sitagliptin 100mg Januvia One 100mg $225
  Sitagliptin 50mg Januvia One 50mg $232
  Pioglitazone 15mg Actos One 15mg $164
  Pioglitazone 30mg Actos One 30mg $241
  Rosiglitazone 2mg Avandia Two 4mg $190
  Rosiglitazone 4mg Avandia One-Two 4 mg-8mg $137-$274
  Repaglinide 1mg Prandin Three 3mg $195
  Repaglinide 2mg Prandin Three 6mg $186
  Nateglinide 60mg Starlix Three 180mg $174
  Nateglinide 120mg Starlix Three 360mg $174
  Acarbose 50mg Precose Three 150mg $114
  Acarbose 100mg Precose Three 300mg $129
  Miglitol 50mg Glyset Three 150mg $111
  Miglitol 100mg Glyset Three 300mg $132
  Metformin+glipizide 250 mg/2.5mg Metaglip Two 250mg/2.5mg-500mg/5mg $74
  Metformin+glipizide 250 mg/2.5 mg Generic Two 500mg/5mg $50
  Metformin+glipizide 500 mg/2.5 mg Metaglip Two 1000mg/5mg $86
  Metformin+glipizide 500 mg/2.5 mg Generic Two 1000mg/5mg $56
  Metformin+glyburide 250 mg/1.25 mg Glucovance Two 500mg/2.5mg $88
  Metformin+glyburide 250 mg/1.25 mg Generic Two 500mg/2.5mg $44
  Metformin+glyburide 500 mg/2.5 mg Glucovance Two 1000mg/5 mg $94
  Metformin+glyburide 500 mg/2.5 mg Generic Two 1000mg/5mg $50
  Pioglitazone+metformin 15 mg/850 Actoplus Met One 850mg/15mg $123
  Pioglitazone+metformin 15 mg/500mg Actoplus Met Two 1000mg/30mg $250
  Rosiglitazone+glimepiride 4mg/1mg Avandaryl One 4mg/1mg $157
  Rosiglitazone+glimepiride 4mg/2mg Avandaryl One 4mg/2mg $154
  Rosiglitazone+metformin 2 mg/500mg Avandamet Two 4mg/1000mg $162
  Rosiglitazone+metformin 2 mg/1000mg Avandamet Two 4mg/2000mg $168
  Sitagliptin + metformin 50 mg/500mg Janumet Two 100mg/1000mg $232
  Sitagliptin + metformin 50 mg/1000mg Janumet Two 100mg/2000mg $228
* For space reasons, not all doses are listed.

1. As commonly or usually recommended.

2. Prices reflect nationwide retail average for September 2008, rounded to the nearest dollar. Information derived by Consumer Reports Best Buy Drugs from data provided by Wolters Kluwer Health, Pharmaceutical Audit Suite®. Wolters Kluwer Health is not involved in our analysis or recommendations.

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