Table 2.

List of current drugs that are used in the management of diabetes mellitus.

Medication	Mechanism of Action
Biguanides (metformin)	Improve hepatic insulin resistance via decreasing the hepatic glucose output
Second-generation sulfonylureas Glyburide, glipizide, glimepiride	Stimulate endogenous insulin secretion through inhibition of potassium channels in pancreatic cells; most effective in early stages of diabetes when insulin secretion is still working
Meglitinides Repaglinide, nateglinide	Insulin secretagogues that stimulate insulin release by inhibiting potassium channels in the pancreas on a different site from sulfonylureas; work much faster than other secretagogues and can be taken more effectively before meals
Thiazolidinediones Rosiglitazone, pioglitazone	Activate PPARG and improve metabolic control in type 2 diabetes through the improvement of insulin sensitivity in adipose tissue, muscle, and the liver
Glucosidase inhibitors Acarbose, miglitol, voglibose	Inhibit α-glucosidase at the brush border of the small intestine and affect the digestion of complex carbohydrates, resulting in lower postprandial blood glucose
Bromocriptine mesylate	A sympatholytic dopamine D2 receptor agonist that exerts inhibitory effects on serotonin turnover in the central nervous system
GLP-1 agonists Exenatide, liraglutide, lixisenatide, dulaglutide, semaglutide	Bind to GLP-1 receptors to restore pancreatic β-cell sensitivity to glucose and to increase β-cell mass
DPP-4 inhibitors (gliptins) Sitagliptin, saxagliptin, linagliptin, vildagliptin, alogliptin	Block GLP-1 degradation
SGLT-2 inhibitors Empagliflozin, canagliflozin, dapagliflozin, ertugliflozin	SGLT2 is expressed in the proximal renal tubules and mediates glucose reabsorption; SGLT2 inhibitors promote the renal excretion of glucose and thereby reduce the serum glucose level
Amylinomimetics Pramlintide	Regulate postprandial spikes in blood glucose by slowing gastric emptying and digestion, promoting satiety, and inhibiting glucagon secretion
Insulin/insulin analogs	Similarly to endogenous insulin, exogenous insulin increases the uptake of glucose into cells, stimulates glycogen synthesis, and inhibits glucagon

DPP-4, dipeptidyl peptidase-4; GLP-1, glucagon-like peptide 1; PPARG, peroxisome proliferator-activated receptor gamma; SGLT-2, sodium glucose transporter-2.