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- Table 1.
Common glucose-lowering agents. Data derived from meta-analyses and British National Formulary
Drug class (example) Glycated haemoglobin reduction Effect on weight Side effects Cardiovascular benefit Renal benefit Monthly cost Biguanide (metformina) 0.8–1.0% (9–12 mmol/mol) Neutral Gastrointestinal Yes N/A £3.20 or £4.26 modified release Sulphonylurea (gliclazide, glibenclamide) 0.8–1.1% (9–22 mmol/mol) Weight gain Hypoglycaemia N/A N/A £1.63 or £3.27 modified release Thiazolidinedione (pioglitazone) 0.5–0.7% (6–8 mmol/mol) Weight gain Fluid retention
Osteoporosis
Bladder cancerNo N/A £1.84 Dipeptidyl peptidase-4 inhibitors (vildagliptin, sitagliptin, saxagliptin, linagliptin) 0.4% (5 mmol/mol) Neutral Cough
Nasopharyngitis
PancreatitisN/A No £26.60–£33.26 Sodium-glucose co-transporter-2 inhibitor (canagliflozin, a dapagliflozin, a empagliflozin, a ertugliflozin) 0.4% (5 mmol/mol) Loss Urinary tract infections
Genital candidiasisYes Yes £36.59–£39.20 Glucagon-like peptide-1 receptor agonists (dulaglutide, a exenatide, liraglutide, ab lixisenatide, semaglutide ab) 0.5–0.7% (6–8 mmol/mol) Loss Gastrointestinal
PancreatitisYes Yes £73.25 ↵a = evidence of cardiovascular benefit; b = evidence of renal benefit.
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