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Type 2 Diabetes Medications - Coggle Diagram
Type 2 Diabetes Medications
Metformin (biguanide)
Titrated initally from 500mg
Increases insulin sensitivity and decreases liver production of glucose
Weight neutral
Side effects
Diarrhoea and abdominal pain
Dose dependent (reducing dose often resolves symptoms)
Lactic acidosis
Does NOT typically cause hypoglycaemia
Pioglitazone (thiazolidinedione)
Increases insulin sensitivity and decreases liver production of glucose
Side effects
Weight gain
Fluid retention
Anaemia
Heart failure
Extended use may increase risk of bladder cancer
Does NOT typically cause hypoglycaemia
Gliclazide (sulfonylurea)
Stimulate insulin release from the pancreas
Side effects
Hypoglycaemia
Weight gain
Increased risk of cardiovascular disease and myocardial infarction when used as monotherapy
Sitagliptin (DPP-4 inhibitor)
Inhibits DPP-4 enzyme and therefore increases GLP-1 activity
Increases insulin secretions
Inhibit glucagon production
Slow absorption by the GI tract
Side effects
GI tract upset
Symptoms of URTI
Pancreatitis
Weight neutral
Exenatide/ liraglutide (GLP-1 mimetics)
Mimic action of incretin GLP-1 which are secreted in response to large meals and act to reduce blood sugar
Increase insulin secretions
Inhibit glucagon production
Slow absorption by the GI tract
Exenatide given as SC injection BD by patient or once weekly in modifiable-release form; liraglutide given OD SC
Sometimes used in combination with metformin and sulfonylurea in overweight patients
Side effects
GI tract upset
Weight loss
Dizziness
Low risk hypoglycaemia
-Gliflozins (SGLT-2 inhibitors)
Empagliflozin
Reduces risk of cardiovascular disease, hospitalisation with heart failure and all cause mortality
SGLT-2 responsible for reabsorbing glucose from urine into blood
Inhibitors block this and cause glucose excretion in urine
Canagliflozin
Reduces risk of cardiovascular events, stroke, death, hospitalisation with heart failure
Side effects
Glucoseuria (glucose in urine)
UTIs
Weight loss
Diabetic ketoacidosis
Lower limb amputation (canagliflozin)