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b Prescribing highly restricted in the U.S.; withdrawn in Europe.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