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Diabetes: Difference between revisions
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! colspan="3"|Comparison of type 1 and 2 diabetes<cite>4</cite> | |||
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!Feature | !Feature | ||
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! colspan="2"|The following is a comprehensive list of other causes of diabetes:<cite>16</cite> | |||
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*'''Infections''' | *'''Infections''' | ||
**Cytomegalovirus infection | **Cytomegalovirus infection | ||
**Coxsackie B4 virus | **Coxsackie B4 virus | ||
*'''Drugs''' | *'''Drugs''' | ||
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The following table compares some common anti-diabetic agents, generalizing classes, although there may be substantial variation in individual drugs of each class. When the table makes a comparison such as "lower risk" or "more convenient" the comparison is with the other drugs on the table. | The following table compares some common anti-diabetic agents, generalizing classes, although there may be substantial variation in individual drugs of each class. When the table makes a comparison such as "lower risk" or "more convenient" the comparison is with the other drugs on the table. | ||
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! colspan="4 | ! colspan="4"|Comparison of anti-diabetic medication<cite>62</cite><cite>63</cite> | ||
|- | |- | ||
! | !Agent<cite>63</cite> | ||
! | !Mechanism<cite>64</cite> | ||
! | !Advantages<cite>63</cite> | ||
! | !Disadvantages<cite>63</cite> | ||
|- | |- | ||
| Sulfonylurea(glyburide, glimepiride, glipizide) | |Sulfonylurea (glyburide, glimepiride, glipizide) | ||
| Stimulating insulin release by pancreatic beta cells by inhibiting the K<sub>ATP</sub> channel | |Stimulating insulin release by pancreatic beta cells by inhibiting the K<sub>ATP</sub> channel | ||
| | | | ||
*Fast onset of action | *Fast onset of action | ||
*No effect on blood pressure | *No effect on blood pressure | ||
*No effect on low-density lipoprotein | *No effect on low-density lipoprotein | ||
* | *Inexpensive | ||
*lower risk of Human gastrointestinal tract|gastrointestinal problems than with metformin | *lower risk of Human gastrointestinal tract|gastrointestinal problems than with metformin | ||
* | *More convenient dosing | ||
| | | | ||
* | *Causes an average of 5-10 pounds weight gain | ||
*Increased risk of hypoglycemia | *Increased risk of hypoglycemia | ||
*Glyburide has increases risk of hypoglycemia slightly more as compared with glimepiride and glipizide | *Glyburide has increases risk of hypoglycemia slightly more as compared with glimepiride and glipizide | ||
*Higher risk of death compared with metformin<cite>64</cite> | *Higher risk of death compared with metformin<cite>64</cite> | ||
|- | |- | ||
| Metformin | |Metformin | ||
| Acts on liver to cause decrease in insulin resistance | |Acts on liver to cause decrease in insulin resistance | ||
| | | | ||
* | *Not associated with weight gain | ||
* | *Low risk of hypoglycemia as compared to alternatives | ||
*Good effect on LDL cholesterol | *Good effect on LDL cholesterol | ||
*Decreases triglycerides | *Decreases triglycerides | ||
* | *No effect on blood pressure | ||
* | *Inexpensive | ||
| | | | ||
* | *Increased risk of Human gastrointestinal tract|gastrointestinal problems | ||
*Contraindicated for people with moderate or severe kidney disease or heart failure because of risk of lactic acidosis | *Contraindicated for people with moderate or severe kidney disease or heart failure because of risk of lactic acidosis | ||
* | *Increased risk of Vitamin B12 deficiency<cite>63</cite> | ||
* | *Less convenient dosing | ||
*Metallic taste<cite>63</cite> | *Metallic taste<cite>63</cite> | ||
|- | |- | ||
| Alpha-glucosidase inhibitor (acarbose, miglitol) | |Alpha-glucosidase inhibitor (acarbose, miglitol) | ||
| Reduces glucose absorbance by acting on small intestine to cause decrease in production of enzymes needed to digest carbohydrates | |Reduces glucose absorbance by acting on small intestine to cause decrease in production of enzymes needed to digest carbohydrates | ||
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* | *Slightly decreased risk of hypoglycemia as compared to sulfonylurea | ||
* | *Not associated with weight gain | ||
* | *Decreases triglycerides | ||
* | *No effect on cholesterol | ||
| | | | ||
* | *Less effective than most other diabetes pills in decreasing glycated hemoglobin | ||
* | *Increased risk of GI problems than other diabetes pills except metformin | ||
* | *Inconvenient dosing | ||
* | *Expensive | ||
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| | |Thiazolidinediones (Actos, Avandia) | ||
| Reduce insulin resistance by activating (Peroxisome proliferator-activated receptor gamma) PPAR-γ in fat and muscle | |Reduce insulin resistance by activating (Peroxisome proliferator-activated receptor gamma) PPAR-γ in fat and muscle | ||
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*Lower risk of hypoglycemia | *Lower risk of hypoglycemia | ||
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*Convenient dosing | *Convenient dosing | ||
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* | *Increased risk of heart failure | ||
* | *Causes an average of 5-10 pounds weight gain | ||
* | *Associated with higher risk of edema | ||
* | *Associated with higher risk of anemia | ||
* | *Increases low-density lipoprotein | ||
*Avandia linked to increased triglycerides and risk of heart attack | *Avandia linked to increased triglycerides and risk of heart attack | ||
*Actos linked to increased risk of bladder cancer | *Actos linked to increased risk of bladder cancer | ||
* | *Slower onset of action | ||
* | *Requires monitoring for hepatoxicity | ||
* | *Associated with increased risk of limb fractures | ||
* | *Expensive | ||
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