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Table 3 Therapeutic considerations of selected US FDA-approved antidiabetes agents [20, 21, 25, 3035]

From: Therapies for type 2 diabetes: lowering HbA1c and associated cardiovascular risk factors

Intervention HbA1c Reduction (%) Effect on Weight Effect on Lipids Effect on Blood Pressure Safety
Oral      
SFUs 0.9-2.5 Increased Small improvements; mainly in TG Poorly quantified Increased risk of hypoglycemia
Metformin 1.1-3.0 Neutral or slightly decreased Improved Neutral Contraindicated in patients with renal insufficiency
Glinides 0.4-0.6 Neutral (poorly quantified) Poorly quantified Poorly quantified Caution in patients with hepatic or renal impairment (nateglinide)
TZDs 1.5-1.6 Increased Improved HDL and TG Small improvements Fluid retention, CHF, bone fractures, potential increase in MI (rosiglitazone)
DPP-4 inhibitors 0.8 Neutral Poorly quantified Small improvements in non-diabetics Long-term safety not established
α-Glucosidase inhibitors 0.5-1.0 Suggested decrease Poorly quantified Poorly quantified Frequent flatulence
Parenteral      
Insulin Up to 4.9 Increased Improved Neutral Increased risk of hypoglycemia
GLP-1 receptor agonists 0.8-1.5 Decreased Improved Lowered Nausea and vomiting; hypoglycemia with sulfonylureas; rare pancreatitis and renal dysfunction; thyroid C-cell tumors in rodents
Amylin analog 0.4-0.6 Slightly decreased Small improvements Small improvements Contraindicated in patients with gastroparesis
  1. BID, twice daily; CHF, congestive heart failure; DPP-4, dipeptidyl peptidase-4; GLP-1, glucagon like peptide-1; HbA1c, glycated hemoglobin; HDL, high-density lipoprotein; MI, myocardial infarction; SFUs, sulfonylureas; TG, triglyceride; TZDs, thiazolidinediones; US FDA, United States Food and Drug Administration.