Diabetes Mellitus Medications

Remember the key points easily with the tips to remember at the bottom.

ClassExamplesMechanismImportant points
Biguanides Metformin[Glucophage]Activates AMP-kinaseDecreases hepatic glucose prod’n
No weight gain-Good for obese pts
No hypoglycemia
GI side effects-continue for a week and reassess.
Acidosis
B12 deficiency
SulfonylureasGlyburide
Glipizide[Glucotrol]
Gliclazide
Glimepiride[Amaryl]
Closes KATP channels
on ß-cell plasma
mem branes
Insulin secretion
Hypoglycemia
Weight gain
Avoid in Obese
Mortality in elderly
Meglitinides/glinidesRepaglinide
Nateglinide
Closes KATI’ channels
on ß-cell plasma
membranes
Increases Insulin secretion
Repaglinide for Renal pts
ThiazolidinedionesPioglitazone
Rosiglitazone
Activates the nuclear
transcription factor
PPAR-Y
Increases Insulin sensitivity
Avoid in CHF NYHA II pts.
Thigh high edema.
a-Glucosidase
inhibitors
Acarbose
Miglitol
Voglibose
Inhibits intestinal
a-glucosidase
Slows intestinal
carbohydrate
digestion/absorption
Give Dextrose for hypoglycemia not orange juice
DPP-4 inhibitorsSitagliptin[Januvia]
Vildagliptin
Saxagliptin
Linagliptin[Tradjenta]
Alogliptin
Inhibits DPP-4 activity,
increasing postprandial
active incretin (GLP-I ,
GIP) concentrations
Increases Insulin secretion
Decreases Glucagon secretion
GLP-I receptor
agonists
Dulaglutide[Trulicity]
Exenatide [Byetta]
Liraglutide[Victoza]
Activates GLP-I
receptors
Increases Insulin secretion
Decreases Glucagon secretion
Slows gastric emptying->nausea
Early satiety
Wt loss->Good for obese
SGLT2 inhibitors/
Gliflozins
CanaGliflozin [Invokana]
Dapa ” [Farxiga]
Empa ”[Jardiance]
Block reabsorption of glu by kidney, urine glucose goes up–>genital fungal inf’ns, fournier gangrene.Dapa-reduces HF hospitalizations in DM pts.
Cana and Empa-reduce ESRD and hospitalizations for HF pts. Decreased CV death and all-cause mortality.
DKA with normal blood sugars.
Amylin mimetics PramlintideActivates amylin
receptors
Decreases Glucagon secretion
Slows gastric emptying
Increases satiety
InsulinsHuman NPH
Human Regular
Lispro
Aspart
Glulisine
Glarglne
Detemir
Premixed
Activates insulin
receptors
Hypoglycemia
Weight gain

Tips to Remember:

Empagliflozin=Jardiance —>EmptyJar.

Canagliflozin=Invokana—>Cana Invokana.

DPP4 inhibitors=gliptins—>Glip Dipp

Glutides will Gulp the Gluteus maximus causing wt loss. [Glutides are GLP1 agonists which help in wt loss]

SGLT2 inhibitors—>Sugar in urine

Exenetide=Byetta —>Bye Ex-girl/boyfriend

Liraglutide =Victoza is used for weight loss—>Lira got Victory in Weight loss

Dulaglutide=Trulicity—>Truly Dull.

Some important points:

Repaglinide and Linagliptin can be used for renal patients.

—–

1 unit Lispro covers 20gm glucose control

1% HBA1C =29gm Glucose

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