While its blood glucose-lowering effects in laboratory animals were known by the late 1920s, its importance as a potential treatment for diabetes was obscured by the high-profile nature of insulin, which was relatively inexpensive, more understood than the biguanides
, easily obtained and known to be effective.
There are seven pharmacologic subclasses of oral antidiabetic agents: alpha-glucosidase inhibitors, biguanides
, dipeptidyl peptidase-4 inhibitors, meglitinides, sulfonylureas, sodium-glucose cotransporter-2 inhibitors, and thiazolidinediones.
TYPES AND NAMES OF DIABETES MEDICATIONS* CLASS BRAND NAMES Biguanides
Glucophage, Fortamet GLP-1 receptor agonists Trulicity, Tanzeum, Bydureon, Victoza DPP-IV inhibitors Januvia, Onglyza, Nesina SGLT-2 inhibitors Invokana, Farxiga, Jardiance Sulfonylureas Amaryl, Glucotrol, DiaBeta, Glynase Insulin Tresiba, Toujeo, Afrezza, Levemir, Lantus Combination drugs Janumet, Jentadueto, Kombiglyze, Tradjenta, Kazano, Oseni * This chart provides examples of some, but not all, medications used to treat diabetes.
The global diabetes drugs and devices market report estimates the market size (Revenue USD million - 2013 to 2020) for key market segments based on the drug type (insulin derivatives - short-acting, intermediate-acting, long-acting, premixed, and rapid-acting insulin; oral anti-diabetes drugs - alpha-glucosidase inhibitors, biguanides
, DPP-4 inhibitors, meglitinides, SGLT-2 inhibitors, sulphonylureas, thiazolidinediones; and non-insulin injectable anti-diabetes drugs - GLP-1 analogs), device type (diabetes monitoring and diagnostic devices - analog glucose meter, continuous glucose monitoring devices, glucose test strips, lancets and lancing devices; insulin delivery devices - insulin injectors, pens, pumps, syringes, etc.
inhibits pyruvate carboxylase and dehydrogenase and causes more lactate accumulation.
Metformin and other biguanides
in oncology: Advancing the research agenda.
The longitudinal retrospective analysis of a large administrative claims database found a 10% incidence of fracture on sulfonylureas and 11% on thiazolidinediones, compared with 7% on biguanides
(metformin), 8% on dipeptidyl peptidase-4 (DPP-4) inhibitors, 11% on meglitinide analogues, and 6% on incretin mimetic agents.
The discussion of biguanides
, such as metformin (Glucophage[R]), on page 88, also contains incorrect information.
1920s Derivatives of goat's rue called biguanides
are shown to lower blood sugar in rabbits.
This article will discuss the following classes of drugs: biguanides
, thiazolidinedione agents (TZDs), sulfonylureas, meglinitides, glucagon-like peptide-1 (GLP-1) agonists, dipeptyl peptidase 4 (DDP-4) inhibitors, alpha-glucosidase inhibitors, amylin analogues, and insulin.
That led Shaw and his team to a class of drugs called biguanides
, which lower cellular energy levels by attacking the power stations of the cell, called mitochondria.
The known toxic effect of biguanides
is lactic acidosis in acute and chronic use.