Complete Diabetes Medications Table

• Alpha-Glucosidase Inhibitor
• Biguanide (Metformin)
• DPP-4 Inhibitors

• GLP-1 Agonists (Incretin Mimetics)
• SGLT Inhibitors
• Secretagogues

• Thiazolidinediones -TZDs
• Combination Medications
• Insulins  

 Metformin extended release
Glumetza® (NB) $21- $41

• Monotherapy or in combination with metformin, sulfonylurea, pioglitazone or insulin.
• Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination.

• Monotherapy or in combination with metformin , sulfonylurea or with empagliflozin. 
• Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination.

• In combination with metformin, sulfonylurea, dapagliflozin or insulin. 
• Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination.

• Monotherapy or in combination with metformin, sulfonylurea, pioglitazone, dapagliflozin or insulin.
• Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination

• Monotherapy or in combination with metformin, sulfonylurea, pioglitazone, sitagliptin or insulin. 
• Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination. 

• Monotherapy or in combination with metformin, sulfonylurea, sitagliptin, saxagliptin or insulin. 
• Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination.

• Monotherapy or in combination with metformin, sulfonylurea, pioglitazone or insulin (or with linagliptin as in the combination drug Glyxambi). 
• Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination.

• Monotherapy or in combination with metformin or metformin and sitagliptin.
• Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination.

•  Not yet approved by Health Canada
•  Indications are expected to be with type 1 diabetes first. (Consideration for type 2 diabetes requires completion of cardiovascular outcome trials.)
• Use of DPP-4 inhibitors with SGLT-2 inhibitors may not be outlined in the product monograph(s), but is an acceptable combination.

1 unit of Xultophy contains 1 unit of degludec and 0.04 mg liraglutide (fixed ratio)

Starting dose: 16 units
Maximum dose: 50 units

• Type 2 diabetes in combination with metformin, with or without sulfonylurea, when these combined with basal insulin (< 50 units daily) or liraglutide (less than or equal to 1.8 mg daily), do not provide adequate glycemic control.

• Type 2 diabetes on basal insulin (< 60 units daily and > 15 units per day) alone or in combination with metformin
• Taken before the first meal.
• Starting Doses: 15 units Soliqua  (if current glargine dose < 30 units); 30 units Soliqua (if current glargine dose 30 to <60 units.)
• Take oral contraceptives at least 1 hour before or at least 11 hours after the dose of SOLIQUA.
• Suggested adjustments by fasting glucose of past 3 days:
  > 7.8 mmol/L add 4 units
  > 5.6 to < 7.8 mmol/L add 2 units
  4.4 to 5.6 mmol/L, no change
  < 4.4 mmol/L subtract 2 units

• Bolus
• Basal
• Mixed

10-20 min / 1-3 hrs / 3-5 hrs

• May inject up to 10 minutes before a meal 

5-15 min / 1-3 hrs / 3-5 hrs

• May inject 2 mins before meal and up to 20 mins after starting meal
• Should not be mixed with other insulins
• Onset is 5 mins earlier than insulin aspart
• Time to peak is 11mins faster than insulin aspart
• Offset of effect occurs 12-14 mins earlier than insuilin aspart

30-45 min / 1-3 hr / 3-5 hrs

Same as Lispro 100 u/mL 

30-45 min / 1-3 hr / 3-5 hrs

• Reserved for patients using > 20 units per day of rapid insulin.
• Not to be mixed with other insulins
• Not to be administered via SC infusion pump (not tested)

10-15 min / 1-1.5 hrs / 3-5 hrs

• Must not be refrigerated once opened

Refer to "regular insulin" line in the image Pharmacodynamic Action Profiles of Bolus Insulins 

30-60 min / 2-4 hrs / 6-8 hrs 

Refer to "regular insulin" line in the image Pharmacodynamic Action Profiles of Bolus Insulins 

30-60 min / 2-4 hrs / 6-8 hrs

1 hr / no peak / 42 hrs

• Doses dialed are per one "normal" unit; e,g,  80 units u100 = 80 units u200; the latter is contained in less volume. 
• U100 pen delivers doses in 1 unit increments up to 80 unit per dose
• U200 pen delivers doses in 2 unit increments up to 160 unit increments
• Missed doses may be taken when remembered (during waking hrs). Ensure at least 8 hrs between missed dose and the next dose.
• Steady state serum concentration is reached after 3-4 days. You may wish to use the  Tresiba titration handout. 
• Reduce by 20% if patient has type 1 diabetes or if switching from bid basal
• Also available as the combination medication  Xultophy® (degludec + liraglutide). See combination medications section. 

1.5 hrs /  no peak / 16-24 hrs

15 15 min / 4-8  hrs / 17-24 hrs

• Indicated for those requiring over 200 units insulin/day
• Onset similar to U-100
• Peak slightly lower than Humulin R U100
• Time to peak is delayed (vs. Humulin R)
• Dose 30 minutes before meal
• Given 2-3 times daily
• When switching to Entuzity and HbA1c < 8% reduce TDD by 20%
• Pen delivers 5 unit increments

1-2 hrs / 5-8 hrs / 14-18 hrs

Refer to NPH line in the image Pharmacodynamic Action Profiles of Long-Acting Insulins 

1-2 hrs / 5-8 hrs / 14-18 hrs

1.5 hrs / no peak / 24 hrs

•  Reduce by 20% when switching from Toujeo to Lantus.

1.5 hrs / no peak / 24 hrs

up to 6 hrs / no peak / up to 36 hrs

• The prescribed dose of TOUJEO should always be expressed in units of insulin.
• See Toujeo dosing handout.

 regular insulin (%Toronto) / insulin (%NPH)
Novolin® ge 30/70 (B)
Novolin® ge 40/60 (B)
Novolin® ge 50/50 (B) 
cartridges $43