DPP4 | GLP1 | INS/B | SGLT2 | SFU | TZD | |
First on market | 2006 | 2005 | NPH (isophane insulin)1982; Lantus 2000 | March 2013 | 1950s | 1997 |
Route | Oral | Injection | Injection | Oral | Oral | Oral |
Mean A1c-lowering* | 0.25%–1.0% | 0.8%–1.5% | No limit | 0.5%–1.0% | 1.0%–1.5% | 0.5%–1.5% |
Hypoglycemia | No | No | Yes | No | Yes | No |
Cost† | $428–$436 | $527–$831 | $165–$355 | $470 | $50–$94 | $349–$355 |
Body weight | Neutral/loss | Loss | Gain | Loss | Gain | Gain |
Other cautions | Kidney disease; ketoacidosis; pancreatitis | Pancreatitis; thyroid cancer; gastrointestinal upset | Urine and vaginal infection; kidney disease; fractures; caution elderly ketoacidosis | Caution elderly | congestive heart failure; liver disease; edema; fractures |
*Range of mean A1c reductions from synthesis of multiple trials.9
†Range of median wholesale prices for monthly supply.10
DPP4, dipeptidyl peptidase-4 inhibitors; GLP1, glucagon-like peptide-1 receptor agonists; INS/B, long-acting or intermediate-acting insulin given as a basal (rather than mealtime) injection; SGLT2, sodium-glucose cotransporter 2 inhibitors; SFU, sulfonylurea or meglitinides; TZD, thiazolidinediones.