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diabetes-drug-class-comparison.pdf

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diabetes-drug-class-comparison.pdf

  1. 1. Mechanism Route Cost A1C Lowering Hypoglycemia Risk Weight Effect Thiazolidinediones Increases insulin sensitivity in muscle fat and liver cells; increases glucose entry into cells ↓ 0.5 to 1.4% Weight gain Oral No Sulfonylureas Stimulates insulin secretion from pancreatic beta cells ↓ 1 to 2% Weight gain Oral Yes Insulin Analogs Human Insulin Stimulates peripheral glucose uptake by skeletal muscle and fat tissue; inhibits hepatic glucose production Titrate to response Weight gain SQ SQ/Inhaled Yes T2DM Drug Class ® 2020 Cosmas Health LLC and/or its affiliates More clinical pearls at pyrls.com Biguanides (Metformin) Decreases hepatic production of glucose; increases insulin sensitivity ↓ 1 to 2% Potential weight loss Oral No SGLT-2 Inhibitors Increases urinary glucose excretion ↓ 0.7 to 1% Weight loss Oral No GLP-1 Receptor Agonists Increases glucose-dependent insulin release; decreases glucagon secretion; slows gastric emptying ↓ 0.5 to 1.8% Weight loss SQ/Oral No DPP-4 Inhibitors Increases glucose-dependent insulin release; decreases glucagon secretion ↓ 0.5 to 0.8% Neutral * Oral No Type 2 Diabetes Drug Class Comparison *Pioglitazone is generic and has low cost; however, rosiglitazone (Avandia®) is currently not available generically and is high cost. References: American Diabetes Association. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes-2021. Diabetes Care. 2021 Jan;44(Suppl 1):S111-S124. doi: 10.2337/dc21-S009.; Chaudhury A, Duvoor C, Reddy Dendi VS, et al. Clinical Review of Antidiabetic Drugs: Implications for Type 2 Diabetes Mellitus Management. Front Endocrinol (Lausanne). 2017 Jan 24;8:6. doi: 10.3389/fendo.2017.00006. eCollection 2017; Cheng V, Kashyap SR. Weight considerations in pharmacotherapy for type 2 diabetes. J Obes. 2011;2011:984245. doi: 10.1155/2011/984245. Epub 2010 Sep 19. PMID: 20885921; PMCID: PMC2946585; Individual manufacturer product labels, and NLM National Center for Biotechnology Information.

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