Diabetic medications

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DPP Mechanisms

Inhibit DPP, Increases GLP-1 and GIP

DPP advantages

No hypoglycemia, well tolerated

DPP Disadvantages

Modest A1C decrease, uticaria, possible pancreatitis

GLP-1 Mechanisms

Increased insulin, increased satiety, decreased glucagon, decreased gastric emptying

GLP-1 Advantages

No hypoglycemia, wt loss, CV protection

GLP-1 Disadvantages

GI, pancreatitis, medullary CA, injectable

Amylin Mechanisms

Increase satiety, increased insulin, decreased gastric emptying and decreased glucagon

Amylin Advantages

Wt loss, decreased PPG

Amylin Disadvantages

GI, modest decrease A1C, injectable, hypo, dosing frequency

Bile acid sequestrants Mechanisms

Bind bile acids, decrease hepatic glucose production

Bile acid sequestrant Advantages

No hypo, decreased post prandial glucose, decreased CVD events

Bile acid sequestrant Disadvantages

GI, modest decreased A1C, dosing frequency

Dopamine-2 agonist Advantages

No hypoglycemia, decreased CVD events

Dopamine-2 agonist Disadvantages

Modest A1C decrease, dizziness/syncope, nausea, fatigue

Biguanides Advantages

No hypoglycemia, wt neutral, decreased CVD

Biguanides Disadvantages

GI, Lactic acidosis, B-12 deficiency, contraindications

SUs/Meglitinides Disadvantages

Hypoglycemia, wt gain, low durability, ischemic predisposing

TZDs Advantages

No hypoglycemia, durability, increased HDL, decreased CVD

TZDs Disadvantages

Wt gain, edema/heart failure, bone fx, increased MI, bladder CA

SUs/Meglitinides Mechanism

Increase insulin secretion