Open Access

Table 4

Pharmacological treatment for T2D.

Mechanisms Type Drugs Reference
Increase insulin secretion from pancreatic β-cells. Sulfonylureas (First generation) Tolbutamide Chlorpropamide Acetohexamide Tolazamide [149158]
Sulfonylureas (Second generation) Glibenclamide (Euglucon ®) Glipizide (Glidiab®) Gliclazide (Diamicron ®) Glimepiride (Amaryl®) [149158]
Meglitinide Repaglinide (Novonorm®) Nateglinide (Starlix®) [159162]
Enhances insulin sensitivity in liver and peripheral tissues by activation of AMP activated protein kinase. Glycogen hydrolysis and Gluco- neogenesis inhibition. Biguanide Metformin [163167]
Absorption of glucose is delayed. α-Glucosidase inhibitor Acarbose [168170]
Enhances insulin sensitivity in peripheral tissues and liver by activation of peroxisome proliferator-activated receptor-gamma receptors. Thiazolidinedione (TZD) Rosiglitazone (Avandia®) Pioglitazone (Actos) [171174]
Amplifies incretin pathway activation by inhibition of enzymatic breakdown of endogenous GLP-1 and GIP. DPP-4 inhibitor Sitagliptin (Januvia) Saxagliptin (Onglyza) Linagliptin (Trajenta) [150, 175178]
Activates incretin pathway by utilizing DPP-4 resistant analogue to GLP-1. GLP-1 receptor agonist Exenatide (Byetta) Liraglutide (Victoza) [179185]
Activates insulin receptors to regulate metabolism of carbohydrate, fat and protein. Insulin Bolus (prandial) insulins Basal insulins Premixed insulins Aspart (NovoRapid) Glulisine (Apidra) Lispro (Humalog) Detemir (Levemir) Glargine (Lantus) NPH (Humulin-N, Novolin ge NPH) Biphasic insulin aspart (NovoMix 30) Insulin lispro/lispro protamine suspension (Humalog Mix25, Mix50) Premixed Regular-NPH (Humulin 30/70; Novolin ge 30/70, 40/60, 50/50) [111, 186-191]