Table 1.

The HbA_1c-Lowering Capacities of Antidiabetic Medications and Their Advantages and Disadvantages

Interventions	Expected Decrease in HbA1c (%)	Advantages	Disadvantages
Lifestyle modifications	1–2	Low cost, many benefits	Most patients fail within 1 year
Insulin	≥ 2.5	No dose limit, inexpensive, improved lipids	Hypoglycemia, weight gain
Inhaled insulin	1.5	No injection	Risk for pulmonary complications
Metformin	1.5	Weight neutral, inexpensive	GI distress, lactic acidosis
Sulfonylureas	1.5	Inexpensive	Hypoglycemia, weight gain
Thiazolidinediones(glitazones)	0.8–1.0	Improved lipid profile	Weight gain, edema, anemia, possible CV risks, expensive
GLP mimetic/analogs	0.6	Weight loss	GI side effects, injection, expensive
DPP-4 inhibitors	0.5–0.9	No need for dose adjustment	Limited HbA1c lowering
Alpha-glucosidase inhibitors	0.5–0.8	Weight neutral	Frequent GI side effects, three-times daily dosing, expensive

Table adapted from Nathan et al, 2006[43] and Nathan, 2007.[49]

CV = cardiovascular; DPP-4 = dipeptidyl-peptidase-4; GI = gastrointestinal; GLP = glucagon-like-peptide 1; HbA_1c = glycosylated hemoglobin