Selecting a Treatment Regimen
Table 10. Diabetes Drug Properties (continued)
Agent
Durability
Mechanism
Advantages
TZDs
The duration
of glycemic
control
with TZDs
appears to be
maintained
over periods
up to 5 to 6
years.
Improve
insulin
sensitivity in
adipose tissue
and muscle.
TZDs increase HDL-C and lower
triglycerides, lower blood pressure,
reduce markers of inflammation,
reduce hepatic steatosis, decrease
carotid and coronary artery
thickening and prevent restenosis
after percutaneous transluminal
coronary angioplasty.
α-Glucosidase
Inhibitors
Impair
breakdown
of starches
in GI tract,
reducing PPG
excursions.
Not systemically absorbed.
Bile Acid
Sequestrants
(colesevelam)
Unknown
Not systemically absorbed.
Lowers LDL-C.
Dopamine
Agonists
Bromocriptine
is a potent
agonist at
dopamine
D2 receptors
and various
serotonin
receptors. It
also inhibits
the release
of glutamate
by reversing
the glutamate
GLT-1
transporter.
No hypoglycemia, no weight
gain, potential CV safety.
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