<prompt> Mechanism of action of metformin isDecreases hepatic glucose productionIncreases GI glucose absorptionIncrease insulin secretionProlong endogenous GLP-1 action  <response>: Agents Used for Treatment of Type 1 or Type 2 Diabetes Mechanism of Action Examples HbA Reduction Agent-Specific Advantages Agent-Specific Disadvantages Contraindications Oral Biguanides Hepatic glucose production Metformin 1-2 Weight neutral, do not cause hypoglycemia, inexpensive, extensive experience, CV events Diarrhea, nausea, lactic acidosis Serum creatinine 15 mgdL men 1.4 mgdL women see text, CHF, radio graphic contrast studies, hospitalized patients, acidosis Renalliver disease a-Glucosidase inhibitors GI glucose absorption Acarbose, miglitol, voglibose 0.5-0.8 Reduce postprandial glycemia GI flatulence, liver function tests Renalliver disease Dipeptidyl peptidase IV inhibitors Prolong endogenous GLP-1 action Alogliptin, Linagliptin, Gemigliptin, linagliptin, saxagliptin, sitagliptin, teneligliptin, vildagliptin 0.5-0.8 Well tolerated, do not cause hypoglycemia Reduced dose with renal disease; one associated with increase hea fail pure risk; possible association with ACE inhibitor-induced angioedema Insulin secretagogues: Sulfonylureas Insulin secretion Glibornuride, gliclazide, glimepiride, glipizide, gliquidone, glyburide, glyclopyramide 1-2 Sho onset of action, lower postprandial glucose, inexpensive Hypoglycemia, weight gain Renalliver disease Insulin secretagogues: Nonsulfonylureas Insulin secretion Nateglinide, repaglinide, mitiglinide 0.5-1.0 Sho onset of action, lower postprandial glucose Hypoglycemia Renalliver disease Sodium-glucose cotranspoer 2 inhibitors Urinary glucose excretion Canagliflozin, dapagliflozin, empagliflozin 0.5-1.0 Insulin secretion and action indepentant Urinary and vaginal infections, dehydration, exacerbate tendency to hyperkalemia Limited clinical experience; moderate renal insufficiency Thiazolidinediones Insulin resistance, glucose utilization Rosiglitazone, pioglitazone 0.5-1.4 Lower insulin requirements Peripheral edema, CHF, weight gain, fractures, macular edema CHF, liver disease Ref: Harrison 19e pg: 2414 