Diabetes Medication Comparison Table

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

Inexpensive

First line

Low risk of hypoglycemia

Avoid in significant CKD

GI side effects

Low B12

frequent dosing (non-IR)

Sulfonylureas Stimulates insulin release from the pancreas Inexpensive

XL products so can dose many once daily

Hypoglycemia risk

Weight gain

DPP-4 Inhibitors Increases endogenous incretin activity Weight neutral/wt loss

once daily dosing in most situations

low risk of hypoglycemia

Cost

Slight pancreatitis risk

TZD’s Increases glucose transport into muscle

 

Once daily dosing

Relatively inexpensive

Weight gain

Edema

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)

Cost

Increase risk of Urinary Tract Infections

Electrolyte imbalances

GLP-1 Incretin mimetic (promotes fullness, potentiates weight loss) Weight loss

CVD risk reduction (Liraglutide)

Cost

Injection

Avoid in thyroid tumor history

Nausea

Pancreatitis

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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Written By Eric Christianson

January 17, 2018

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