Drug Therapies for Diabetes
Abstract
:1. Introduction
2. Metformin
3. Thiazolidinediones
4. Dipeptidyl Peptidase-4 Inhibitors
5. Sulfonylureas
6. Glinides
7. Alpha-Glucosidase Inhibitors
8. Glucagon-like Peptide-1 Receptor Agonists—GLP 1 RA
9. Sodium-Glucose Cotransporter Inhibitors (SGLT-2i)
10. Is the Combination of SGLT-2i and GLP-1 RA Synergistic?
11. Pharmacotherapy in Pregnancy
12. Breakthrough Research and Future Drugs
13. Innovation in the Therapeutic Approach
- Early diagnosis of abnormal glucose metabolism.
- Early treatment with combination therapy.
- Giving preference to medications that simultaneously lower weight and blood glucose levels in those who are overweight or obese, do not cause hypoglycemia, and protect against possible damage to target organs like the heart, the macro- and microvascular systems, the kidneys, the liver, and the brain.
- Aiming to normalize blood glucose levels using the new drugs and adding the old ones for patients who do not achieve the target HbA1c.
Author Contributions
Funding
Conflicts of Interest
References
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Drug Group | Specific Drug | Effects | Adverse Effects | Safety |
---|---|---|---|---|
Biguanides | Metformin | HbA1c ↓ Body weight ↓→ Cancer ↓? Cardiovascular↓? | Gastrointestinal disorders ↑ Reversible vitamin B12 deficiency↑ Lactic Acidosis ↑ | None |
Glinides | Repaglinide Nateglinide | HbA1c ↓ Body weight ↑ | Hypoglycemia ↑ Headache ↑ Upper respiratory tract infection ↑ | None |
Alpha-Glucosidase inhibitors | Acarbose | HbA1c ↓ Body weight ↓ → | Gastrointestinal disorders ↑ Serum transaminases (AST, ALT) ↑ | None |
SGLT2-I | Empagliflozin Dapagliflozin Canagliflozin | HbA1c ↓ Body weight ↓ BP ↓ MACE ↓ Hospitalization for HF ↓ Progression of renal disease ↓ | Diabetic ketoacidosis ↑ Genital infection ↑ Urinary tract infection ↑ Hypovolemia ↑ Acute kidney injury ↑ (related to hypovolemia) Canagliflozin: Amputation ↑ Bone fracture ↑ | None |
Thiazolidineidiones | Pioglitazone | HbA1c ↓ BP ↓ NAFLD ↓ MACE ↓ | Body weight ↑ Peripheral edema ↑ Anemia ↑ Hospitalization for HF ↑ Bone fracture in women ↑ | Cancer? |
DPP-4 | Sitagliotin Saxagliptin Alogliptin | HbA1c ↓ | Saxagliptin: Hospitalization for HF? | |
Sulfonylureas | Glimepiride Gliclazide Glibenclamide Glipizide | HbA1c ↓ | Body weight ↑ Hypoglycemia ↑ Lack of durable effect | Glibenclamide Glipizide: Cardio-vascular events? |
GLP-1 RA Combination therapy | Liraglutide Dulaglutide Semaglutide Orforglipron Tirzepatide Retatrutide | HbA1c ↓↓ Body weight ↓ Systolic BP ↓ MACE ↓ HF ? Quality of life for patients with HF (KCCQ-CSS) ↑ NAFLD ↓ → | Gastrointestinal disorders ↑ Semaglutide: Macular edema | Pancreatitis Bile stones Thyroid carcinoma |
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Weinberg Sibony, R.; Segev, O.; Dor, S.; Raz, I. Drug Therapies for Diabetes. Int. J. Mol. Sci. 2023, 24, 17147. https://doi.org/10.3390/ijms242417147
Weinberg Sibony R, Segev O, Dor S, Raz I. Drug Therapies for Diabetes. International Journal of Molecular Sciences. 2023; 24(24):17147. https://doi.org/10.3390/ijms242417147
Chicago/Turabian StyleWeinberg Sibony, Roni, Omri Segev, Saar Dor, and Itamar Raz. 2023. "Drug Therapies for Diabetes" International Journal of Molecular Sciences 24, no. 24: 17147. https://doi.org/10.3390/ijms242417147