Oral Agents That Lower Blood Glucose*
| Class of Drug | Activity | Adverse Features |
|---|
| Alpha-glucosidase inhibitors, e.g., acarbose | Delay absorption of glucose from intestinal tract | Flatulence and other abdominal side effects | | Biguanides, e.g., metformin | Improve sensitivity to insulin; decrease glucose production by the liver | Less weight gain than with other agents; avoid in patients with renal failure | | Sulfonylureas, 1st generation, e.g., tolazamide | Cause beta cells to release insulin | Resistance to drug may develop over time | | Sulfonylureas, 2nd generation, e.g., glipizide, glyburide, others | Same as 1st generation; also increase sensitivity to insulin | Same as 1st generation | | Thiazolidinediones, e.g., pioglitazone | Improve sensitivity to insulin; improve lipid profile | Monthly monitoring of liver functions needed for some drugs in this class due to risk of toxicity. Heart failure and other heart diseases. |
|
* Combinations of these drugs, either with each other or with insulin, may be used in patients with poorly controlled diabetes mellitus.