<prompt> HbA1c reduction is maximum with use ofMetforminAnagliptinVogliboseRosiglitazone  <response>: Mechanism of ActionExamplesHbA Reduction Agent-Specific AdvantagesAgent-Specific DisadvantagesContraindicationsOralBiguanidesHepatic glucose productionMetformin1-2Weight neutral, do not cause hypoglycemia, inexpensive, extensive experience, CV eventsDiarrhea, nausea, lactic acidosisSerum creatinine 15 mgdL men1.4 mgdL womensee text, CHF, radio graphic contrast studies,hospitalized patients,acidosisRenalliver diseasea-Glucosidase inhibitorsGI glucose absorptionAcarbose, miglitol, voglibose0.5-0.8Reduce postprandial glycemiaGI flatulence, liver function testsRenalliver diseaseDipeptidyl peptidase IV inhibitorsProlong endogenous GLP-1 actionAlogliptin, Linagliptin, Gemigliptin, linagliptin, saxagliptin,sitagliptin, teneligliptin, vildagliptin0.5-0.8Well tolerated, donot cause hypoglycemia Reduced dose with renal disease; one associated with increase hea fail pure risk; possible association with ACE inhibitor-induced angioedemaInsulin secretagogues:SulfonylureasInsulin secretionGlibornuride, gliclazide, glimepiride,glipizide, gliquidone,glyburide,glyclopyramide1-2Sho onset of action, lower postprandial glucose, inexpensiveHypoglycemia, weight gainRenalliver diseaseInsulin secretagogues:NonsulfonylureasInsulin secretionNateglinide, repaglinide, mitiglinide0.5-1.0Sho onset of action, lower postprandial glucoseHypoglycemiaRenalliver diseaseSodium-glucose cotranspoer 2 inhibitorsUrinary glucose excretionCanagliflozin,dapagliflozin,empagliflozin0.5-1.0Insulin secretion and action independentUrinary and vaginal infections, dehydration, exacerbate tendency to hyperkalemiaLimited clinical experience; moderate renal insufficiencyThiazolidinedionesInsulin resistance,glucose utilizationRosiglitazone, pioglitazone0.5-1.4Lower insulin requirementsPeripheral edema,CHF, weight gain,fractures, macularedemaCHF, liver disease Ref: Harrison 19e pg: 2414 