Table 3.

Therapeutic considerations of selected US FDA-approved antidiabetes agents [20,21,25,30-35]

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

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.