Summary of Medications for Type 2 Diabetes DIABETES MEDICATIONS

Summary of Medications for Type 2 Diabetes

Class of Medication Common Name Actions Potential for Hypoglycemia

Reduces the amount of glucose released by the liver and Biguanides Metformin (Glucophage) Not when used as monotherapy. decreases insulin resistance by muscle cells.

Increased risk when used in Acarbose (Precose) Slows digestion and absorption combination with insulin or Alpha-glucosidase inhibitors Miglitol (Glyset) of dietary carbohydrate. sulfonylurea agents. Must treat hypoglycemia with dextrose.

Increases insulin sensitivity, Increased risk when used in Pioglitazone (Actos) decreases liver glucose output. Thiazolidinediones combination with insulin or Rosiglitazone (Avandia) Takes 12 or more weeks to insulin secretagogues. achieve maximal effectiveness.

Slows the inactivation of Sitagliptin (Januvia) glucagonlike peptide-1 (GLP-1) by the degradation enzyme May increase risk with insulin Dipeptidyl peptidase 4 (DPP-4) Saxagliptin (Onglyza) DPP-4. Prolongs the action of secretagogues; not studied inhibitors Linagliptin (Tradjenta) GLP-1, thus increasing insulin with insulin. Alogliptin (Nesina) secretion and decreasing glucagon secretion.

Canagliflozin (Invokana) Sodium-glucose Inhibits glucose reabsorption Low risk when used Dapagliflozin (Farxiga) cotransporter-2 inhibitors in the kidneys. as monotherapy. Empagliflozin (Jardiance)

Glimepiride (Amaryl) Glipizide Stimulates the beta cells of the Sulfonylureas (Glucotrol) Glyburide pancreas to increase insulin Yes (Micronase, Glynase) production.

Stimulates the beta cells of the Repaglinide (Prandin) pancreas to increase insulin Meglitinides Yes Nateglinide (Starlix) production. They are shorter acting than sulfonylureas.

Mimics the effect of incretin hormones to increase insulin Exenatide (Byetta) secretion in the presence of Often used in combination Incretin mimetics Exenatide LAR (Bydureon) elevated blood glucose levels, with insulin or sulfonylureas, Liraglutide (Victoza) decreases glucagon production, (injectable) which may result in slows gastric emptying, and Dulaglutide (Trulicity) hypoglycemia. improves first-phase insulin response.

Slows gastric emptying Amylin analogues (injectable, (therefore delays glucose from taken with mealtime insulin but Pramlintide (Symlin) Yes entering the bloodstream), as a separate injection) suppresses glucagon.

Long-acting insulin: Glargine (Lantus) Detemir (Levemir) Intermediate-acting insulin: NPH Yes (Humulin R, Novolin R) Increases the passage of glucose Insulin from the bloodstream into the Understanding when the insulin Short-acting insulin: peaks as well as its onset and (injectable) cells and decreases the Regular (Humulin N, Novolin N) production of glucose by the liver. duration of action can help Rapid-acting insulin: prevent hypoglycemic episodes. Lispro (Humalog) Aspart (NovoLog) Glulisine (Apidra)

* Not a complete list RESOURCES 1. MENSING CE. THE ART & SCIENCE OF DIABETES SELF-MANAGEMENT EDUCATION DESK REFERENCE. 3RD ED. CHICAGO: IL: AMERICAN ASSOCIATION OF DIABETES EDUCATORS; 2014. 2. NAUCK MA. UPDATE ON DEVELOPMENTS WITH SGLT2 INHIBITORS IN THE MANAGEMENT OF TYPE 2 DIABETES. DRUG DES DEVEL THER. 2014;8:1335-1380.