Cardiovascular safety of non-insulin pharmacotherapy for type 2 diabetes

Table 1 Comparison of the various pharmacotherapy for type 2 diabetes mellitus

	Metformin	Sulfonylureas		Meglitinides	TZDs		DPP-4 inhibitors	GLP-1 agonists	SGLT-2 inhibitors	AGIs
	Metformin	1st generation	2nd and 3rd generation	Meglitinides	Rosiglitazone	Pioglitazone	DPP-4 inhibitors	GLP-1 agonists	SGLT-2 inhibitors
Relative glycemic efficacy	+++	+++		+	+++		++	+++	++	++
Effect on weight	Loss/neutral	Gain	Gain	Gain	Gain	Gain	Neutral	Loss	Loss	Neutral
Overall CV safety	Benefit	Caution	Neutral	No data	Caution	Likely benefit	Neutral	Benefit	Benefit	No data
Significant side effects	Lactic acidosis	Profound hypoglycemia, secondary failure		Hypoglycemia	Association with increased fracture risk, bladder cancer^a		GI effects, acute pancreatitis^a	GI effects	Ketoacidosis, UTI	Flatulence, diarrhea

TZDs thiazolidinediones, DPP-4 dipeptidyl peptidase-4, GLP-1 glucagon-like peptide-1, SGLT-2 sodium glucose cotransporter 2, AGIs alpha-glucosidase inhibitors, CV cardiovascular, GI gastrointestinal, UTI urinary tract infection
^aCausative relationship not established

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