I definitely get some questions from students and pharmacists preparing for certification exams. I wanted to put together this Diabetes Medication Comparison Table that highlights really important stuff that you need to remember.
|Drug/Class||Primary Mechanism of Action||Advantages||Disadvantages|
|Metformin (Biguanides)||Reduces liver glucose production||Weight loss
Low risk of hypoglycemia
|Avoid in significant CKD
GI side effects
frequent dosing (non-IR)
|Sulfonylureas||Stimulates insulin release from the pancreas||Inexpensive
XL products so can dose many once daily
|DPP-4 Inhibitors||Increases endogenous incretin activity||Weight neutral/wt loss
once daily dosing in most situations
low risk of hypoglycemia
Slight pancreatitis risk
|TZD’s||Increases glucose transport into muscle
|Once daily dosing
CHF exacerbation risk
Potential association with bladder cancer, osteoporosis
|SGLT-2||Increases urinary excretion of glucose||Wt. loss
Slightly lower BP (good or bad)
Reduction in CVD risk (empagliflozin)
Increase risk of Urinary Tract Infections
|GLP-1||Incretin mimetic (promotes fullness, potentiates weight loss)||Weight loss
CVD risk reduction (Liraglutide)
Avoid in thyroid tumor history
Hopefully this diabetes comparison table is helpful for you. This isn’t all inclusive, but I think gives you a good sense of what to think about clinically when selecting medications for Type 2 diabetes.
If you have any additions you feel should be added/altered, please feel free to leave a comment, we’re all in this together!
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