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Oral DM Classes

Oral diabetic medication classes

ClassMOAMed PearlsGenericsA1C reductions
Biguanide decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity * B12 Deficiency, GI Upset, Black Box warning: Lactic acidosis Metformin 1.5%
Alpha-Glucosidase Inhibitor Inhibit pancreatic alpha-amylase and alpha-glucosidase, block carbohydrate hydrolysis to glucose, to decrease postprandial blood glucose Administer with food, Contraindicated in cirrhosis, IBD, and intestinal obstruction Acarbose, Miglitol 0.5-0.8%
Thiazolidinediones Peroxisome proliferator-activated receptor gamma activator, which improves insulin sensitivity Increased risk for bladder cancer, Contraindicated in Heart Failure Rosiglitazone, Pioglitazone 0.5-1.5%
DiPeptidyl Peptidase4 Inhibitor (DPP-4) Prolong the active incretin levels of GLP-1 and GIP (decreases glucagon release, increase insulin release, and slow gastric emptying) May cause Pancreatitis, FDA warning for Saxagliptin and Alogliptin for increase risk of heart failure Sitagliptin, Saxagliptin, Linagliptin, Alogliptin 0.5-1%
Sodium-Glucose Co-transporter 2 inhibitor (SGLT 2) Decreases reabsorption of filtered glucose from proximal tubule, increasing glucose excretion in urine UTI’s common with this class, FDA warning of increased risk for AKI and Euglycemic DKA Canagliflozin, Dapagliflozin, Empagliflozin 0.5-0.8%
Sulfonylureas Stimulate insulin release for pancreatic beta cells Don’t use in Sulfa Allergy, Watch for Hypoglycemia Glyburide, Glipizide, Glimepiride 1-2%
Meglitinides In presence of glucose, stimulate insulin release from pancreatic beta cells Administer 15 to 30 minutes before meals, May cause weight gain Repaglinide, Nateglinide 0.5-1.5%
Created by: cbisel8901