Nathan DM, Buse JB, Davidson MB, et al. Medical Management of Hyperglycemia in Type 2 Diabetes: A Consensus Algorithm for the Initiation and Adjustment of Therapy. Diabetes Care. 2008;32(1):193 LP-203. http://care.diabetesjournals.org/content/32/1/193.abstract.
Lifestyle - 1.0-2.0
Advantages Broad benefits
Disadvantages Insufficient for most within 1st year
Metformin - 1.0-2.0
Advantages Weight neutral
Disadvantages GI side effects, contraindicated with renal insufficiency
Insulin - 1.5-3.5
Advantages No dose limit, rapidly effective, improved lipid profile
Disadvantages 1-4 injections daily, monitoring, weight gain, hypoglycemia, analogues are expensive (e.g. glargine)
Sulfonylurea - 1.0-2.0
Advantages
Disadvantages
TZDs - 0.5-1.4
Advantages
Disadvantages
GLP-1 agonist - 0.5-1.0
Advantages
Disadvantages
alpha-Glucosidase inhibitor - 0.5-0.8
Advantages
Disadvantages
Glinide - 0.5-1.5
Advantages
Disadvantages
Pramlintide - 0.5-1.0
Advantages
Disadvantages
DPP-4 inhibitor - 0.5-0.8
Advantages
Disadvantages