Table 2. Common antidiabetic agents used in managing diabetes mellitus.

GLP-1, glucagon-like peptide 1; SGLT2, sodium-glucose cotransporter-2; SUR1, sulfonylurea receptor 1; DPP-4, dipeptidyl peptidase-4

Class of medication	Examples	Mechanism of action	Risk of hypoglycemia
Biguanides	Metformin	Activates adenosine monophosphate-activated protein kinase in the liver, causing hepatic glucose uptake and inhibiting gluconeogenesis through complex effects on the mitochondrial enzymes.	Low
Sulfonylureas	Glimepiride, glipizide, glyburide	Sulfonylureas lower blood glucose levels by increasing insulin secretion in the pancreas by binding to SUR1 receptors, which leads to the blockage of ATP-sensitive potassium (KATP) channels.	High
Thiazolidinediones	Pioglitazone, rosiglitazone	Mechanisms of actions include diminution of free fatty acid accumulation, reduction in inflammatory cytokines, rising adiponectin levels, and preservation of β-cell integrity and function, all leading to improvement of insulin resistance and β-cell exhaustion.	Low
Alpha-glucosidase inhibitors	Acarbose, miglitol	Reduce intestinal glucose absorption	Low
GLP-1 receptor agonists	Exenatide, dulaglutide, semaglutide, liraglutide, lixisenatide	Activating GLP-1 receptors in the pancreas leads to enhanced insulin release and reduced glucagon release responses.	Low
DPP-4 inhibitors	Alogliptin, saxagliptin, linagliptin, repaglinide	Inhibit GLP-1 degradation → promote glucose-dependent insulin secretion.	Low
SGLT2 inhibitors	Ertuglifozin, dapagliflozin, canagliflozin, empagliflozin	GLT2 inhibitors provide insulin-independent glucose lowering by blocking glucose reabsorption in the proximal renal tubule by inhibiting SGLT2	Low
Meglitinides	Nateglinide, repaglinide	They bind to the SUR1 receptor on the β-cell, although with lower affinity than sulfonylureas, and stimulate insulin release similarly.	High
Insulin	Lispro, aspart human insulin, NPH/regular, glargine	Bind to insulin receptors and produce similar effects to endogenous insulin.	High