American Diabetes Association GUIDELINES Apps - Institutional

Hyperglycemia 2012 ADA v2_eViewer

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Treatment Table 1. Properties Of Currently Available Glucose-Lowering Agents that may Guide Treatment Choice in Individual Patients With T2DM (continued) Cellular Mechanism Primary Physiological Action(s) Class Compound(s) Dopamine-2 agonistsa •  Bromocriptine (quick-release)c Activates dopaminergic receptors •  Modulates hypothalamic regulation of metabolism •  ↑ Insulin sensitivity GLP-1 receptor agonists •  Exenatide •  Exenatide extended release •  Liraglutide Activates GLP-1 receptors Amylin mimeticsa •  Pramlintidec Activates amylin receptors •  ↑ Insulin secretion (glucosedependent) •  ↓ Glucagon secretion (glucosedependent) •  Slows gastric emptying •  ↑ Satiety Insulins •  Human NPH •  Human regular •  Lispro •  Aspart •  Glulisine •  Glargine •  Detemir •  Premixed (several types) Activates insulin receptors a b c d e 10 •  ↓ Glucagon secretion •  Slows gastric emptying •  ↑ Satiety •  ↑ Glucose disposal •  ↓ Hepatic glucose production Limited use in the U.S./Europe. Prescribing highly restricted in the U.S.; withdrawn in Europe. Not licensed in Europe. To be available as a generic product in 2012, with expected significant reductions in cost. Depends on type (analogs > human insulins) and dosage.

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