7 terms

Available Agents for Type 2 Diabetes Management

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Metformin
Activates AMP-Kinase

A1c Reduction - 1% to 2%
Weight Effect - Neutral or reduction
Side Effects - GI; Lactic acidosis
Evidence of CDV reduction - Yes
Costs - Low
Sulfonylurea ( Glipizide, glimeperide )
Stimulates insulin secretion

A1c Reduction - 1% to 2%
Weight Effect - Gain
Side Effects - Hypoglycemia
Evidence of CDV reduction - No
Costs - Low
Sulfonylurea ( Glipizide, glimeperide )
Stimulates insulin secretion in the pancreas

A1c Reduction - 1% to 2%
Weight Effect - Gain
Side Effects - Hypoglycemia, bloating
Evidence of CDV reduction - No
Costs - Low
Contraindication- Type 1 Diabetes, advance liver/kidney disease
DPP-4 Inhibitor ( Sitigliptin (Januvia), saxagliptin (Onglyzide )
Inhibits DPP-4, increases incretin secretion

A1c Reduction - 0.5% to 1%
Weight Effect - Neutral
Side Effects - Rare
Evidence of CDV reduction - No
Costs - High
SGLT2 Inhibitor ( Canagliflozin (Invokana), empagliflozin (Jardiance)
Inhibits SGLT2 in the kidney

A1c Reduction - 0.5% to 1%
Weight Effect - Reduction
Side Effects - GU symptoms, dehydration
Evidence of CDV reduction - Yes
Costs - High
GLP-1 Agonist ( Exenatide, liraglutide )
Activates GLP-1 receptors, mimics incretin

A1c Reduction - 1% to 2%
Weight Effect - Reduction
Side Effects - GI, pancreatitis, medullary thyroid cancer
Evidence of CDV reduction - Yes
Costs - High
Insulin ( Glargine, lispro )
Overcomes insulin resistance

A1c Reduction - > 2%
Weight Effect - Gain
Side Effects - Hypoglycemia
Evidence of CDV reduction
Costs - Intermediate