Drugs for treating type 2 diabetes in adults (not including insulin or insulin analogs) but not yet approved in youth except for metformin
Drug class | Available drugs in this class | Mechanism of action | Significant adverse effects | Approved in patients <18 years old |
---|---|---|---|---|
Biguanides |
| Decreases insulin resistance; reduces hepatic glucose production; increases peripheral glucose uptake; decreases gastrointestinal absorption of glucose |
| Yes |
Sulfonylureas |
| Stimulates secretion of insulin from the β-cell |
| No |
Meglitinides |
| Stimulates glucose-dependent secretion of insulin from the β-cell |
| No |
α-Glucosidase inhibitors |
| Delays absorption of glucose by intestines by inhibiting breakdown of complex sugars |
| No |
GLP-1 agonists |
| Incretin effect; slows gastric emptying; enhances postprandial insulin biosynthesis; improves β-cell function; decreases appetite |
| No |
DPP-4 inhibitors |
| Inhibits DPP-4 enzyme, reducing endogenous GLP-1 breakdown |
| No |
Amylin analog |
| Inhibits postprandial glucagon secretion; delays gastric emptying; improves satiety |
| No |
Thiazolidinediones |
| PPAR-γ inhibitor; increases insulin sensitivity in liver, muscle, and adipose tissue; decreases hepatic glucose output |
| No |
SGLT-2 inhibitors |
| Allows more glucose to be excreted in the urine and hence lowers blood glucose |
| No |
Bile acid sequestrant |
| Mechanism for glucose lowering is unknown |
| No |
Dopamine-2 agonist |
| Modulates hypothalamic regulation of metabolism; increases insulin sensitivity |
| No |
DPP-4, dipeptidyl peptidase 4; GLP-1, glucagon-like peptide 1; PPAR, peroxisome proliferator–activated receptor; SGLT2, sodium–glucose cotransporter 2; URI, upper respiratory infection; UTI, urinary tract infection.