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Prescribing highly restricted in the U.S.; withdrawn in Europe.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.
