[NRSKarenRN]

Found at Physician's News Digest:

Older, cheaper diabetes drugs are as safe and effective as newer ones, concludes an analysis that is good news for diabetics and may further hurt sales of GlaxoSmithKline PLC's Avandia, a blockbuster pill recently tied to heart problems, reported the Associated Press.

According to an analysis published online in the Annals of Internal Medicine, Metformin, sold as Glucophage and generically for about $100 a year, works as well as other diabetes pills but doesn't cause weight gain or too-low blood sugar, while it also lowers LDL, reported the Associated Press. The federal Agency for Healthcare Research and Quality commissioned the analysis of diabetes drugs in 2005, long before a study published in May suggested Avandia raised the risk of heart attacks, while the new analysis says that evidence is insufficient to settle this issue, the Associated Press added. The report didn't evaluate insulin or other injected diabetes drugs.
Associated Press, July 17, 2007
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[Myxel67]

They may be as safe and effective, but that doesn't mean that newer drugs don't have significant advantages. All of the sulfanylureas (glyburide, glipizide, glimeperide, chlorpropamide) may cause low BG and weight gain.

Starlix and Prandin work similarly to sulfanylureas, but don't stay in the bloodstream as long (1 dose covers 1 meal) so there is less chance of low BG. Actos attacks the cause of type 2 DM by increasing insulin sensitivity. It also has a beneficial impact on the lipid profile.

Januvia (oral) and Byetta (sub Q) may help preserve beta cell function. Byetta also helps the user to lose weight.

My own insurer (Humana HMO) sent me a letter naming GENERIC ALTERNATIVES for my diabetes meds. Notice they are not GENERIC EQUIVALENT. Of course this information was not included in the letter. Many recipients may have assumed they were the same.