Table 1.

Current anti-diabetic treatment for T2DM (excluding insulin therapy).

Drug class	Drugs	Treatment	Action	Side effects	Reference
Biguanide	Metformin	1st line	Increase hepatic insulin sensitivity Increase uptake of glucose into peripheral cells	lactic acidosis, gastric discomfort, chest pain, allergic reactions	[8]
			Reduce hepatic glucose production
Sulfonylureas	1st generation: acetohexamide, carbutamide, chlorpropamide, glycyclamide, metahexamide, tolazamide, tolbutamide	1st/2nd line	Induce glucose independent insulin release from pancreatic beta-cells	Hypoglycemia, hyponatremia, water retention	[9]
	2nd generation: glibemclamide, glibornuride, gliclazide, glipizide, gliquidone, glisoxepide, glyclopyramide
	3rd generation: glimepiride
Thiazolidiediones	Pioglitazone, Rosiglitazone, Lobeglitazone	2nd/3rd line	Activate PPARs – decrease insulin resistance	Water retention, heart failure	[10]
Incretin mimetics/ analogs	Exetatide, Lixisenatide, Dulaglutide, Liraglutide	2nd line	Activate GLP-1 receptors on pancreatic beta-cells Enhance insulin secretion and synthesis	Mild to moderate transient nausea and vomiting, headache, upper respiratory infection	[11]
DDP4 inhibitors	Sitagliptin, Saxagliptin, Vildagliptin, Linagliptin, Algogliptin	2nd/3rd line	Stimulate insulin release	Nausea, diarrhoea, stomach pain, headache, sore throat, runny nose, skin reactions	[12]
SGLT2	Canagliflozin, Dapagliflozin, Empagliflozin	1st/2nd/3rd line	Increase glucose excretion	Diabetic ketoacidosis, genital and urinary tract infection, cancer, bone fracture and foot and leg amputation	[13]