1. Hypoglycemic agents
   1. insulin
      1. general
         1. secreted by beta cells in pancreas
      2. fast-acting
         1. insulin analog
         2. aspart
         3. lispro
      3. short-acting
         1. regular insulin
         2. humulin
      4. intermediate-acting
         1. regular insulin with protamine
         2. NPH
      5. long-acting
         1. regular insulin with zinc
         2. ultralente
      6. basal-acting
         1. insulin analog
         2. glargine
         3. detemir
   2. sulfonylureas
      1. secretagogue
         1. act on ATP-associated K channels in beta cells
         2. increase insulin secretion
         3. for type II or gestational only
      2. First generation
         1. tolbutamide
         2. acetohexamide
         3. tolzamide
         4. chlorpropamide
      3. Second generation
         1. glipizide (Glucotrol)
         2. glyburide (Diabeta, Micronase)
         3. glimepiride (Amaryl)
         4. gliclazide (Diamicron)
   3. meglitinides
      1. secretagogue
         1. short-acting
         2. close potassium channels and open calcium channels
         3. increase insulin secretion
         4. for type II or gestational only
      2. First generation
         1. repaglinide (Prandin)
         2. nateglinide (Starlix)
2. Sensitizers
   1. biguanides
      1. general
         1. reduce hepatic glucose output
         2. increase glucose uptake in periphery
         3. commonly used in type II
         4. can cause lactic acidosis
      2. First generation
         1. phenformin
         2. buformin
      3. Second generation
         1. metformin
   2. thiazolidinediones
      1. general
         1. bind to PPAR-gamma
         2. influence insulin-sensitive genes
         3. better use of glucose by cells
      2. First generation
         1. rosiglitazone (Avandia)
         2. pioglitazone (Actos)
         3. troglitazone (Rezulin)
3. Digestion modifiers
   1. alpha-glucosidase inhibitor
      1. general
         1. slow starch digestion in SI
         2. useful as adjunct in type II
         3. AE: flatulence and bloating
      2. First generation
         1. miglitol (Glyset)
         2. acarbose (Precose)
4. Incretin mimetics
   1. GLP-1 analogs
      1. glucagon-like peptide 1
         1. general
            1. secreted by L cell in SI
            2. stimulated by food in SI
            3. rapidly degraded by DPP-4 (few minutes)
         2. actions
            1. increases insulin secretion
            2. decreases glucagon secretion
            3. increases beta-cell mass
            4. increases insulin gene expression
            5. inhibits acid secretion
            6. inhibits gastric emptying
            7. increases satiety
      2. First generation
         1. exenatide (Byetta)
         2. liraglutide (Victoza)
         3. taspoglatide
   2. GIP analogs
      1. general
         1. glucose-dependent insulinotropic peptide
         2. secreted by K cells in duodenum/jejunum
         3. stimulated by hyperosmolarity of glucose in duodenum
      2. actions
         1. increase insulin secretion in pancreas
         2. increase lipoprotein lipase activity in adipocytes
   3. DPP-4 inhibitors
      1. general
         1. inhibits dipeptidyl peptidase-4 (DPP-4)
         2. allows endogenous GLP-1 levels to increase
      2. First generation
         1. vildagliptin (Galvus)
         2. sitagliptin (Januvia)
5. Amylin analogues
   1. amylin
      1. general
         1. synergistic with insulin
         2. co-secreted with insulin by beta cells
         3. works largely on area postrema of brain
      2. actions
         1. inhibits digestive secretions
         2. slows gastric emptying
         3. inhibits glucagon
   2. First generation
      1. pramlintide (Symlin)