Type 2 Diabetes Non-Insulin Agents
Metformin: 1st ...

Type 2 Diabetes Non-Insulin Agents

Metformin: 1st line anti-diabetic medication; many effects, primary mechanism is decreasing hepatic glucose production

Insulin Secretagogues: stimulate release of insulin from pancreatic beta cells, thus only effective in pts who still have beta cell function

 • Sulfonylureas:

    - Glipizide 2.5-20mg QD

    - Glimepiride 1-8mg QD

 • Meglinitides:

    - Repaglinide (Prandin) 0.25-4mg QAC

GLP-1 Receptor Agonists: stimulate glucose-dependent insulin release from beta cells, therefore lower risk of hypoglycemia

 • Exenatide (Byetta) 5-10mg BID

 • Liraglutide (Victoza) 0.6-1.8 QD

 • Dulaglutide (Trulicity) 0.75-1.5 Qwk

DPP-4 Inhibitors: inhibit degradation of DPP4, increasing glucose-dependent insulin secretion and decreasing glucagon secretion

 • Sitagliptin (Januvia) 25mg-100mg QD

 • Saxagliptin (Onglyza) 2.5-5mg QD

 • Linagliptin (Tradjenta) 5mg QD

SGLT-2 Inhibitors: block renal glucose reabsorption, increasing glucosuria

 • Canagliflozin (Invokana) 100-300mg QD

 • Empagliflozin (Jardiance) 5-10 mg QD

 • Dapagliflozin (Farxiga) 5-10 mg QD

Thiazolidinediones: increase insulin sensitivity by acting on adipose, muscle, and liver to ↑glucose uptake, ↓ectopic lipid deposition

 • Pioglitizone (Actos) 15-30mg QD

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MGH White Book Manual
Account created for the MGH Internal Medicine Housestaff Manual "White Book" - https://stk10.github.io/MGH-Docs/WhiteBook-2019-2020.pdf

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