Anti-diabetic Medication - Comparison

Comparison

The following table compares some common anti-diabetic agents, generalizing classes, although there may be substantial variation in individual drugs of each class. When the table makes a comparison such as "lower risk" or "more convenient" the comparison is with the other drugs on the table.

Comparison of anti-diabetic medication
agent mechanism advantages disadvantages
Sulfonylurea (glyburide, glimepiride, glipizide) Stimulating insulin production in pancreatic beta cells by inhibiting the KATP channel
  • Fast onset of action
  • No effect on blood pressure
  • No effect on low-density lipoprotein
  • inexpensive
  • lower risk of gastrointestinal problems than with metformin
  • more convenient dosing
  • causes an average of 5-10 pounds weight gain
  • Increased risk of hypoglycemia
  • Glyburide has increases risk of hypoglycemia slightly more as compared with glimepiride and glipizide
  • Higher risk of death compared with metformin
Metformin Acts on liver to cause decrease in insulin resistance
  • not associated with weight gain
  • low risk of hypoglycemia as compared to alternatives
  • Good effect on LDL cholesterol
  • Decreases triglycerides
  • no effect on blood pressure
  • inexpensive
  • increased risk of gastrointestinal problems
  • Contraindicated for people with moderate or severe kidney disease or heart failure because of risk of lactic acidosis
  • increased risk of Vitamin B12 deficiency
  • less convenient dosing
  • Metallic taste
Alpha-glucosidase inhibitor (acarbose, miglitol) Reduces glucose absorbance by acting on small intestine to cause decrease in production of enzymes needed to digest carbohydrates
  • slightly decreased risk of hypoglycemia as compared to sulfonylurea
  • not associated with weight gain
  • decreases triglycerides
  • no effect on cholesterol
  • less effective than most other diabetes pills in decreasing glycated hemoglobin
  • increased risk of GI problems than other diabetes pills except metformin
  • inconvenient dosing
  • expensive
thiazolidinediones (Actos, Avandia) Reduce insulin resistance by activating PPAR-γ in fat and muscle
  • Lower risk of hypoglycemia
  • Slight increase in high-density lipoprotein
  • Actos linked to decreased triglycerides
  • Convenient dosing
  • increased risk of heart failure
  • causes an average of 5-10 pounds weight gain
  • associated with higher risk of edema
  • lassociated with higher risk of anemia
  • increases low-density lipoprotein
  • Avandia linked to increased triglycerides and risk of heart attack
  • Actos linked to increased risk of bladder cancer
  • slower onset of action
  • requires monitoring for hepatoxicity
  • associated with increased risk of limb fractures
  • expensive

Most anti-diabetic agents are contraindicated in pregnancy, in which insulin is preferred.

Read more about this topic:  Anti-diabetic Medication

Famous quotes containing the word comparison:

    “In everyone’s youthful dreams, philosophy is still vaguely but inseparably, and with singular truth, associated with the East, nor do after years discover its local habitation in the Western world. In comparison with the philosophers of the East, we may say that modern Europe has yet given birth to none.”
    —Henry David Thoreau (1817–1862)

    “Envy and jealousy are the private parts of the human soul. Perhaps the comparison can be extended.”
    —Friedrich Nietzsche (1844–1900)

    “Most parents aren’t even aware of how often they compare their children. . . . Comparisons carry the suggestion that specific conditions exist for parental love and acceptance. Thus, even when one child comes out on top in a comparison she is left feeling uneasy about the tenuousness of her position and the possibility of faring less well in the next comparison.”
    —Marianne E. Neifert (20th century)