Table 3.

Effects of antidiabetic drugs on the insulin:glucagon bipolar axis

Antidiabetic drugs	Insulin	Glucagon	IGR
Glimepiride	↑	No change	↑
DPP4i	↑	↓	↑
Liraglutide	↑	↓/No change	No change/↑
Dulaglutide	↑	↓	↑
Exenatide	↑	↓	↑
Lixisenatide	↓	↓	↓
Dapagliflozin	↑	↑	↓
Metformin	↓	No change	↓
Pioglitazone	↓	–	↓
Acarbose	↓	No change	↓

Based upon [11–14, 16, 18–22, 24–27]

↓ = reduction; ↑ = increase

DPP4i dipeptidyl peptidase-4 inhibitor, IGR insulin:glucagon ratio