Drugs for Diabetes

1. Physiology
   1. Pancreas
      1. islets of Langerhans
         1. a cells - produce glucagon
         2. b cells - produce insulin
   2. Insulin
2. Disease = Diabetes mellitus
   1. hyperglycemia
   1. Clinical classifications
      1. type 1
      2. type 2
      3. gestational diabetes
      4. other
   2. Effects
   3. Treatment goal
3. Type 1 Diabetes Treatment
   1. Regular insulin
      1. Humunin R
      2. Novolin R
   2. Analogs
      1. rapid & short
         1. insulin lispro (Humalog)
         2. insulin aspart (Novolog)
         3. insulin glulisine (Apidra)
      2. intermediate
         1. NPH
         2. Humulin N
         3. Novolin N
      3. long acting
         1. insulin glargine (Lantus & Basaglar)
         2. insulin detemir (Levemir)
      4. combinations
         1. Huminlin R
   3. Synthetic amylin analog
      1. pramlintide (Symlin)
4. Type 2 Diabetes Medications
   1. Strategies
   2.  insulin production
      1. sulfonlyureas
         1. glyburide (Diabeta & Glynase)
         2. glipizide (Glucotrol)
         3. glimepiride (Amaryl)
      2. glinides
         1. repaglinide (Prandin)
         2. nateglinide (Starlix)
      3. GLP-1 & GIP receptor agonists
         1. incretins
            1. GLP-1
            2. GIP
            3. dipeptidyl peptidase-4
         2. HbA1cexenatide (Byetta)
         1. liraglutide (Victoza)
         2. dulaglutide (Trulicity)
         3. semaglutide (Ozempic)
            1. (Rybelsus)
               1. SNAC
         4. weight loss
            1. (Saxenda)
            2. (Wegovy)
      4. block incretin breakdown
         1. DPP-4 inhibitors
            1. alogliptin (Nesina)
            2. linagliptin (Tradjenta)
            3. saxagliptin (Onglyza)
            4. sitagliptin (Januvia)
   3.  insulin sensitivity
      1. metformin (Fortamet & Glucophage)
      2. TZDs
         1. pioglitazone (Actos)
         2. rosiglitazone (Avandia)
   4.  glucose excretion
      1. SGLT2 Inhibitors
         1. canagliflozin (Invokana)
         2. dapagliflozin (Farxiga)
         3. empagliflozin (Jardince)
   5. Other
      1. a-Glucosidase inhibitors
      2. acarbose (Precose)
      3. miglitol (Glyset)