This article aims to help clear your doubts about the common questions asked regarding diabetes medication. “When to take diabetes medicines?”, “Should they be taken before or after meals?” Go through this article to find answers.
| Anti diabetic drugs (tablets) | Time of administration |
|---|---|
| Glimepiride* | 30 min before meals |
| Gliclazide IR | 30 min before meals |
| Gliclazide XR | After meals |
| Glipizide IR | 30 min before meals |
| Glipizide XR | After meals |
| Metformin IR/XR** | After meals |
| Acarbose/Voglibose*** | Before meals |
| Pioglitazone | No regard to meals |
| Sitagliptin/Linagliptin/Vildagliptin/Teneligliptin | No regard to meals |
| Repaglinide# | Before meals |
| Empagliflozin/Dapagliflozin/Remogliflozin | No regard to meals |
| Canagliflozin## | 30 min before meals |
* Glimepiride efficacy reduced by 10% if taken after meals
** Metformin is given after meals to reduce stomach upset
*** these drugs lose their efficacy drastically if taken after meals as their mechanism is to reduce intestinal glucose absorption from ingested food.
# short acting insulin secretory agents and always recommended to be taken before meals.
## has an added effect of slowing gastric emptying thereby reducing postprandial glucose levels in addition to their classic urinary glucose excretion.
note: efficacy meaning – the ability to produce a desired or intended result.
| Subcutaneous Injections | Time of administration |
|---|---|
| Inj Liraglutide * | No regard to meals, same time of day |
| Inj Dulaglutide** | No regard to meals, once weekly, same time of time |
| Inj Exenatide*** | Before meals, once daily |
| Inj Degludec## | No regard to meals, once daily, 8h – 40hrs flexible with time of dosing |
| Inj Lispro/Aspart/Glulisine Insulins | 15 min prior to meals to 5 min after meals |
| Inj FiASP# insulin | 5 min prior to meals to 20 min after meals |
| Inj Glargine Insulin U100/U300### | No regard to meals, same time of the day |
| Inj Regular Insulin | 30 – 60 min before meals |
| Inj NPH Insulin | No regard to meals, twice daily per day equally spaced |
| In NPH-Regular premix Insulin | 30 – 60 min before meals, once or twice daily |
| Inj NPH-Aspart/Lispro premix Insulin ####(30/70, 50/50, 25/75, 70/30) |
15 min prior to meals to 5 min after meals, once or twice daily |
| Inj NPH Insulin | No regard to meals, twice daily per day equally spaced |
| Inj Degludec – Aspart Co-formulation Insulin | 15 min prior to meals to 5 min after meals, once or twice daily |
| Inj Degludec – Liraglutide Co-formulation Insulin | No regard to meals, once daily, same time of the day |
* Liraglutide is once daily GLP-1 agonist with predominant effect on fasting BG
** Dulaglutide is once weekly GLP-1 agonist with predominant effect on FPG
*** Exenatide is once daily GLP-1 agonist with primary effect on postprandial BG
# More flexible in children and elderly as can be given upto 20 min post meals
## Basal insulin with most flexibility and least glucose variability
### U300 Glargine can be taken upto 3hrs before/after the previous day dose timing
#### can be given thrice daily in some patients who deny basal bolus therapy, efficacy almost similar to basal bolus therapy (4 injections per day)
note: efficacy meaning – the ability to produce a desired or intended result.
