Managing Diabetes Medication Side Effects

By Jenilee Matz, MPH


Taking medication can sometimes seem like a double-edged sword. Your diabetes medicine may do its job and keep your blood sugar levels stable, but it may come at the cost of undesirable side effects. Thankfully, most side effects from diabetes drugs are minor and manageable.


Why Do Side Effects Happen?

All medications carry the risk of side effects, and diabetes drugs are no exception. Since no two people respond the same way to a given medication or dosage, it’s impossible to know if you’ll experience side effects from a certain drug. It depends on how your body reacts to a medication. Know that most side effects are minor, like nausea or a headache, for example. Serious side effects, like low blood sugar or heart problems, are possible, but occur much more infrequently.


Diabetes Drugs Side Effects

Whenever you’re prescribed a new medication, ask your doctor or pharmacist what side effects to watch for. They will let you know what side effects are normal and which symptoms warrant a call to the doctor or a trip to the emergency room. Never stop taking any medication unless directed by your doctor.



All people with type 1 diabetes and some people with type 2 diabetes will need to take insulin. Insulin must be taken by an injection, either through a syringe, insulin pen or an insulin pump that’s connected to your body. Common side effects of insulin include:

  • A reaction at the injection site. It’s important to give insulin injections in the same general area of the body each time (for example, the abdomen or upper arm), but you must rotate the specific injection site (for example, injecting at different spots on your abdomen) unless you’re using an insulin pump. 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 (hypoglycemia). Insulin is needed to bring high blood sugar levels down, but taking too much insulin can cause your blood sugar levels to drop too low, making you hungry, jittery, and sweaty, and causing your heart to race. Hypoglycemia is dangerous and requires prompt treatment. If you have a low blood sugar reaction, follow your hypoglycemia treatment plan as prescribed by your doctor.


Oral Diabetes Drugs

Many people with type 2 diabetes will need to take diabetes pills to keep blood sugar levels under control. Possible side effects include:


Drug class
Drug name
Possible side effects
Chlorpropamide (Diabinese), glipizide (Glucotrol), glyburide (Micronase, Glynase and Diabeta), glimepiride (Amaryl)
Hypoglycemia, weight gain, nausea, skin rash
Repaglinide (Prandin), nateglinide (Starlix)
Hypoglycemia, weight gain, nausea, back pain, headache
Metformin (Glucophage)
Nausea, diarrhea, lactic acidosis (the buildup of lactic acid)
Pioglitazone (ACTOS), rosiglitazone (Avandia)
Heart failure or heart attack, stroke, liver disease. Note that doctors prescribe this drug only to people who cannot control their diabetes with other medications
Alpha-glucosidase inhibitors
Acarbose (Precose), meglitol (Glyset)
Stomach pain, gas, diarrhea
Dipeptidyl Peptidase-4 (DPP-4) inhibitors
Sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta)
Upper respiratory infection, sore throat, headache, inflammation of the pancreas (sitagliptin)



Other Injectable Medicines

Some people with type 1 or type 2 diabetes will need to take injectable drugs other than insulin to keep blood sugar from rising too high after eating. Side effects of these drugs include:


Drug class
Drug name
Possible side effects
Amylin mimetics
Pramlintide (Symlin)
Hypoglycemia, nausea, vomiting, headache, redness or soreness at the injection site
Incretin mimetics
Exenatide (Byetta), liraglutide (Victoza)
Nausea, vomiting, headache, dizziness, kidney damage or failure



Coping With Side Effects

If you suspect you’re experiencing side effects from your medication, tell your doctor. Your doctor will let you know if the side effect is normal, give you tips for how to deal with it or possibly adjust your medicine.

Luckily, many drugs exist to help manage diabetes. If your body doesn’t react well to one medication, your doctor will often be able to prescribe a new drug. Don’t be afraid to speak up and tell your doctor about your side effects.


Minor Side Effects

Taking all medications exactly as directed can lower the risk of side effects. For example, some medications need to be taken with food or else you may experience an upset stomach. Following these tips can help you manage common side effects:

  • Nausea or an upset stomach. Chew ginger gum or sip ginger tea, and avoid heavy meals and spicy foods. Your doctor may also recommend some over-the-counter medicines (OTC) to ease stomach discomfort.
  • Diarrhea. Steer clear of caffeine, acidic foods, spicy foods and foods high in fiber. If that’s not enough, ask your doctor if any OTC drugs can help relieve your diarrhea.
  • Headache. There are many OTC drugs that can help relieve a headache. Your doctor can let you know which headache medications are safe for you to take.
  • Weight gain. If you gain weight from taking diabetes medications, it’s usually only a small amount. Following the other parts of your diabetes treatment plan—like eating a healthy diet and exercising regularly—can keep weight in check. If not, your doctor may switch your medication to one that doesn’t carry the risk of weight gain.
  • Hypoglycemia. Always take the correct dose of insulin and other medications. Fluctuations in blood sugar levels are normal to an extent, but if you’re having fairly frequent bouts of low blood sugar, alert your doctor. If you have a low blood sugar reaction, follow your hypoglycemia treatment plan as prescribed by your doctor.
  • Injection site reactions. Rotate the injection site often. Showing your doctor how you give yourself insulin can also help. He or she can give you tips on how to reduce your chance of an injection site reaction.

Serious Side Effects

Though rare, dangerous side effects can occur from taking any medication. Keep in mind that your doctor only prescribes medicine when he or she feels the benefit of taking a drug outweighs the risk of not taking the medicine. If you’re on a medication where a serious side effect is a risk, your doctor will monitor you closely.



Jenilee Matz is a medical writer, health educator and triathlete based in Charlotte, N.C.

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