| Class |
A1c dcr |
Drug & Dose |
Brand |
Comments |
| cf. Lifestyle |
1-2% |
+:++; -:fails<1yr |
|
|
| Biguanide |
1-2% |
+: wt neutral;
-: GI, lact acid
|
Metformin 500-3000
[±MR: 500-2000od] |
Glucophage® |
| Sulphonylureas |
1-2% |
+:inexp;
-:wt gain, hypos |
Gliclazide 40-160[od-bd]
[±MR: 30-120od] |
Diamicron® |
| Glimepiride 1-4[-6] |
Amaryl® |
| Glipizide 2.5-15od [-10bd] |
Glibenese® Minodiab® |
|
Thiazolidinediones
=Glitazones
=PPARgamma-Ag
|
0.5-1.4% |
+:improved lipid profile[Pio], ?dcrd MI risk[Pio];-:fluid retention, 2fold risk HF, ?icrd MI risk [Rosi]; wt icr, LFTs, macul oed, atherogenic lipid profile; expensive Lipscombe'07(JAMA) |
Rosiglitazone 4-8 |
Avandia® |
| Pioglitazone 15-45 |
Actos® |
| cf. Insulin |
1.5-3.5% |
+:no dose limit, inexp, lipids;
-:sc, monitoring,
hypos |
|
|
| Secretagogues
=Glinides |
1-1.5% |
+: short duration;
-:tds, expensive |
Repaglinide
[0.5-]1-4[od-qds] |
Prandin® |
| Nateglinide 60-180tds |
Starlix® |
| α-Glucosidase-
Inhibitors |
0.5-0.8% |
+:wt neutral;
-:GI, tds, expensive |
Acarbose 50-200[od-tds] |
Glucobay® |
| DPP4-Inhibitors
=Gliptins |
0.5-0.8% |
+: wt neutral;
-: expensive |
Sitagliptin 100od
Vildagliptin 50bd |
Januvia®
Galvus®
|
| Incretin Mimetics |
0.5-1.0 |
+:wt dcr;
-:sc, GI,
expensive,
pancreatitis |
Exenatide 5-10µSC bd |
Byetta®
|
| Amylin Analog |
0.5-1.0% |
+:wt dcr;
-:sc, tds, GI,
expensive |
Pramlintide |
Symlin®[US] |
Src: Nathan'06/13 (Diabetes Care) Management of hyperglycemia in T2DM ...: pdf
- Gliquidone alpha: 1½ h
- Glipizide: 2½ h
- Tolazamide 7 h
- Tolbutamide 7 h
- Glimepiride: 6½ h
- Gliclazide: 10 h
- Glibenclamide: -10h (action > 16h)
- Gliquidone beta: 16½ h
- Chlorpropamide: 35 h
|
|