Podcast Beta
Questions and Answers
What is a benefit of metformin hydrochloride compared to sulfonylureas?
What is a characteristic of meglitinides?
What is a concern with the use of pioglitazone?
What is a benefit of DPP-4 inhibitors compared to sulfonylureas?
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What is a benefit of SGLT2 inhibitors?
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Which of the following is not associated with hypoglycaemia?
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What is a characteristic of acarbose?
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Which of the following is associated with weight gain?
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Which of the following SGLT2 inhibitors has more uncertainty around its cardiovascular benefits?
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What is a risk associated with SGLT2 inhibitors?
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When should GLP-1 receptor agonists be used?
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What is a benefit of GLP-1 receptor agonists for some patients?
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What is the alternative to GLP-1 receptor agonists in combination with other drugs when other treatments have failed?
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Study Notes
Non-Insulin Antidiabetic Drugs
- Metformin hydrochloride lowers both basal and postprandial blood-glucose concentrations without causing weight gain or hypoglycaemia.
- Sulfonylureas (e.g., gliclazide, glimepiride) may cause hypoglycaemia, especially with long-acting agents like glimepiride, and are associated with modest weight gain.
- Acarbose has a poorer anti-hyperglycaemic effect compared to many other antidiabetic drugs.
Meglitinides and Thiazolidinediones
- Meglitinides (e.g., repaglinide) have a rapid onset of action and short duration of activity, allowing flexible dosing around mealtimes.
- Thiazolidinediones (e.g., pioglitazone) are associated with weight gain and long-term risks, requiring regular review of ongoing benefit.
DPP-4 Inhibitors and SGLT2 Inhibitors
- DPP-4 inhibitors (e.g., alogliptin, linagliptin) do not appear to cause weight gain and have a lower incidence of hypoglycaemia compared to sulfonylureas.
- SGLT2 inhibitors (e.g., canagliflozin, dapagliflozin) lower blood-glucose, promote weight loss, and improve cardiovascular outcomes in certain patients, but are associated with a risk of diabetic ketoacidosis.
GLP-1 Receptor Agonists and GIP/GLP-1 Receptor Agonists
- GLP-1 receptor agonists (e.g., dulaglutide, liraglutide) promote weight loss and may improve cardiovascular outcomes in some patients, and are reserved for combination therapy when other options have failed.
- Dual GIP/GLP-1 receptor agonists (e.g., tirzepatide) promote weight loss and can be used as an alternative to GLP-1 receptor agonists in combination therapy.
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Description
Learn about non-insulin antidiabetic drugs used to treat type 2 diabetes, including metformin hydrochloride and sulfonylureas. Understand their effects on blood glucose levels and insulin secretion.
