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Table 1 Important characteristics of main glucose-lowering agents

From: Personalizing guidelines for diabetes management: twilight or dawn of the expert?

 

HbA1C reduction (%)

Hypoglycemia

Weight

Use in heart failure

Use in renal failure

Stimulation of insulin secretion

Increase of insulin sensitivity

Durability of action

Main side effects

Outcome benefit

Relevant references

Metformin

1.0 to 1.5

-

-

+/-

-

-

+

~↑

Gastrointestinal

+

[1, 2, 10, 12, 32, 37, 54, 55],[60, 65]

Lactic acidosis

Sulfonylureas

1.0 to 1.5

+

↑

-

+/-

+

-

↓

Hypoglycemia

+/-

[1, 2, 10, 12, 32, 37, 47, 76]

Weight gain

Meglitinides

0.5 to 1.0

+

↑

-

+

+

-

↓

Hypoglycemia

 

[1, 2, 10, 12, 46, 76]

Weight gain

Thiazolidinediones

1.0 to 1.5

-

↑

-

+

-

+

~↑

Weight gain

 

[1, 2, 10, 12, 37, 58–60, 63, 64]

Oedema/Heart failure

GLP-1 receptor agonists

1.0 to 1.5

-

↓

+

+/-

+

-

?

Gastrointestinal

?

[10–18, 72, 73, 75, 76]

? Pancreatitis

DPP-4 inhibitors

0.5 to 1.0

-

-

+

+/-

+

-

?

? Pancreatitis

?

[10–12, 61, 64, 73, 75, 76]

Insulin therapy

>1.0

+

↑

+/-

+

  

↑

Hypoglycemia

+

[6, 7, 10, 20–22, 32, 50–52]

Weight gain

?Mitogenic effects

  1. DDP-4 dipeptidyl peptidase-4, GLP-1 glucagon-like peptide-1, HbA1C glycated haemoglobin, ~ approximately.