Table 1.

Common glucose-lowering agents. Data derived from meta-analyses and British National Formulary

Drug class (example)Glycated haemoglobin reductionEffect on weightSide effectsCardiovascular benefitRenal benefitMonthly cost
Biguanide (metformina)0.8–1.0% (9–12 mmol/mol)NeutralGastrointestinalYesN/A£3.20 or £4.26 modified release
Sulphonylurea (gliclazide, glibenclamide)0.8–1.1% (9–22 mmol/mol)Weight gainHypoglycaemiaN/AN/A£1.63 or £3.27 modified release
Thiazolidinedione (pioglitazone)0.5–0.7% (6–8 mmol/mol)Weight gainFluid retention
Osteoporosis
Bladder cancer
NoN/A£1.84
Dipeptidyl peptidase-4 inhibitors (vildagliptin, sitagliptin, saxagliptin, linagliptin)0.4% (5 mmol/mol)NeutralCough
Nasopharyngitis
Pancreatitis
N/ANo£26.60–£33.26
Sodium-glucose co-transporter-2 inhibitor (canagliflozin, a dapagliflozin, a empagliflozin, a ertugliflozin)0.4% (5 mmol/mol)LossUrinary tract infections
Genital candidiasis
YesYes£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)LossGastrointestinal
Pancreatitis
YesYes£73.25
  • a = evidence of cardiovascular benefit; b = evidence of renal benefit.