Table 2.

Effects of hypoglycemic drugs on endothelial function.

Drug category	Primary effect	Mechanism of action	Effectiveness	References
GLP-1R agonists	Anti-inflammatory, blood glucose reduction	Activates AMPK-eNOS pathway, promotes NO production, reduces inflammatory factors	High	(93–105)
Metformin	Enhances insulin sensitivity, reduces oxidative stress	Activates AMPK, inhibits NF-κB, reduces free radical production	High	(129–137)
Sulfonylureas	Increases insulin secretion	Stimulates insulin secretion, indirectly improves endothelial function	Moderate	(106–108)
α-Glucosidase inhibitors	Reduces glucose fluctuation, lowers oxidative stress	Inhibits carbohydrate breakdown, alleviates postprandial hyperglycemia-induced endothelial damage	Moderate	(123–125)
SGLT2 inhibitors	Improves glucose fluctuation and metabolic parameters	Protects endothelial function by reducing oxidative stress and inflammation	High	(112–122)
TZDs (Thiazolidinediones)	Reduces insulin resistance	Activates PPARγ pathway, decreases inflammation and oxidative stress	Moderate	(126–128)
DPP-4 inhibitors	Improves postprandial glucose fluctuation, partial anti-inflammatory effect	Inhibits DPP-4 enzyme activity, extends endogenous GLP-1 action duration	Low	(99–109)