Active ingredients
Insulins substitute for endogenous insulin:
- Human insulin
- Insulin analogues
Biguanides reduce hepatic glucose formation:
Sulfonylureas promote insulin secretion from beta cells:
- Glibenclamide (Daonil, generic).
- Glibornuride (Glutril, off label).
- Gliclazide (Diamicron, generic).
- Glimepiride (Amaryl, generics)
Glinides promote insulin secretion from beta cells:
- Repaglinide (NovoNorm, generic).
- Nateglinide (Starlix)
Glitazones decrease peripheral insulin resistance:
- Pioglitazone (Actos)
- Rosiglitazone (Avandia, off label).
Alpha-glucosidase inhibitors inhibit the digestion of carbohydrates:
- Acarbose (Glucobay)
- Miglitol (Diastabol, out of commerce).
Gliptins (dipeptidyl peptidase-4 inhibitors) increase insulin secretion, decrease glucagon secretion, and increase satiety:
- Alogliptin (Vipidia).
- Linagliptin (Trajenta)
- Saxagliptin (Onglyza)
- Sitagliptin (Januvia)
- Vildagliptin (Galvus)
GLP-1 receptor agonists increase insulin secretion, decrease glucagon secretion, and increase satiety:
- Albiglutide (Eperzan).
- Dulaglutide (Trulicity)
- Exenatide (Byetta, Bydureon)
- Liraglutide (Victoza, Saxenda)
- Lixisenatide (Lyxumia)
SGLT2 inhibitors promote renal excretion of glucose by inhibiting reabsorption via the SGLT2 transporter:
- Canagliflozin (Invokana).
- Dapagliflozin (Forxiga)
- Empagliflozin (Jardiance)
- Ipragliflozin (Suglat, first approved in 2014 in Japan).
- Tofogliflozin (Apleway, Deberza, initial approval 2014 in Japan).
Amylinomimetics decrease glucagon secretion:
- Pramlintide (not commercially available in many countries).
Concomitant medication for diabetes:
- Antihypertensives
- Antiplatelet agents: acetylsalicylic acid
- Lipid-lowering agents
- Antiadiposita
Herbal antidiabetics:
- Goat’s rue (controversial)
- Guar
- Cinnamon (controversial)
- Bilberry (retinopathy, microangiopathy).
- Bitter melon (controversial)