Overview Goals of diabetes treatment login to view 5 more bullets Modalities of diabetes treatment login to view 8 more bullets Diabetic Drugs Class Example ↑ Insulin secretion ↑ Insulin sensitivity ↓ Glucose production ↓ Glucose absorption Weight Hypoglycemia Insulin Insulin ↑ ++ Sulfonylureas Glyburide ++ + + ↑ ++ Meglitinides Nateglinide ++ + + ↑ ++ Biguanides Metformin + ++ None Glitazones (thiazolidinediones) Pioglitazone ++ +/- ↑↓ + α-glucosidase inhibitors Acarbose ++ None GLP-1 mimetics (incretin mimetics) Exenatide ++ + ↓ + Amylin analog Pramlintide + + + Insulin Insulin is only given parenterally (subcutaneous or IV) Various preparations have different durations of action Other preparations include aspart (rapid), detemir (long) Preparation Onset (hrs) Peak (hrs) Duration (hrs) Lispro (rapid-acting) 15 min 0.5-1.5 3-4 Regular (short-acting) 0.5-1 2-4 5-7 NPH (intermediate) 1-2 6-12 18-24 Glargine (long-acting) 1 None >24 Mechanism login to view 11 more bullets Clinical use login to view 5 more bullets Toxicity login to view 2 more bullets Insulin Synthesis login to view 2 more bullets Sulfonylureas Drugs login to view 7 more bullets Mechanism login to view 7 more bullets Clinical use login to view 3 more bullets Toxicity login to view 6 more bullets Megltinides Drugs login to view 2 more bullets Mechanism login to view 2 more bullets Clinical use login to view 2 more bullets Toxicity login to view 3 more bullets Biguanides Drugs login to view 1 more bullet Mechanism login to view 8 more bullets Clinical use login to view 1 more bullet Toxicity login to view 4 more bullets Glitazones (thiazolidinediones) Thiazolidinediones, also known as the "-glitazones" Drugs login to view 2 more bullets Mechanism login to view 6 more bullets Clinical use login to view 4 more bullets Toxicity login to view 7 more bullets α-glucosidase inhibitors Drugs login to view 2 more bullets Mechanism login to view 5 more bullets Clinical use login to view 2 more bullets Toxicity login to view 2 more bullets Amylin mimetics Drugs login to view 1 more bullet Mechanism login to view 3 more bullets Clinical use login to view 1 more bullet Toxicity login to view 4 more bullets GLP-1 analogs Drugs login to view 1 more bullet Mechanism login to view 7 more bullets Clinical use login to view 1 more bullet Toxicity login to view 4 more bullets DPP-4 inhibitors Drugs login to view 2 more bullets Mechanism login to view 1 more bullet Clinical use login to view 1 more bullet Toxicity login to view 2 more bullets SGLT-2 Inhibitors Drugs login to view 2 more bullets Mechanism login to view 3 more bullets Clinical use login to view 1 more bullet Toxicity login to view 2 more bullets