Pros/Cons DM-II Drugs

Question 1

GLP-1

Answer 1

+No hypoglycemia
+decreased weight
+decreases postpran glucose excursions
+decreases some CV risk factors

• GI SE
• increases HR
• injectable, needs training
• med thyroid tumors in animals
• ?acute panc

Question 2

SGLT-2 inhibitors

Answer 2

\+No hypoglycemia
\+?decrease CVD events
-GU infections
-polyuria
-hypotension
-increase LDL-C
-transient creatinine increase

Question 3

TZDs

Answer 3

\+no hypoglycemia
\+durability
\+increases HDL-C
\+pioglit decreases TG
\+decreases CVD events? (pio)

• increased weight
• edema/HF
• increases LDL-C (rosig)
• ? Increase MI (rosig)

Question 4

DPP4

Answer 4

+no hypoglycemia
+well tolerated

• angioedema/urticaria
• ?acute panc
• ?HF hospitalization increase
• modest A1C efficacy
• Increase TG
• Constipation
• decreases abs of other meds

Question 5

SUs

Answer 5

+decreases microvasc risk

• hypoglycemia
• increases weight
• ?blunts myocardial ischemic preconditioning

Question 6

Metformin

Answer 6

+no hypoglycemia
+decreases CVD events

• GI SE
• Lactic Acidosis risk (rare)
• Vit b12 deff
• multiple c/i (dehydration, CKD)

Question 7

a-glucosidase inhib

Answer 7

+no hypoglycemia
+decreased LDL-C

• Modest A1c
• GI side effects
• frequent dosing schedule