Fast Five Quiz: Metformin

Mary L. Windle, PharmD


December 22, 2020

In January 2020, the ADA released a guideline update which continues to recommend the use of metformin as a first-line treatment for type 2 diabetes. The update also recommended considering the addition of a drug from one of the following classes — sulfonylureas, thiazolidinediones, dipeptidyl peptidase 4 inhibitors, or selective SGLT2 inhibitors — to metformin when a second oral therapy is thought to be needed to aid glycemic control. For patients with coexisting heart failure, adding an SGLT-2 inhibitor reduces hospitalization for heart failure in adults with type 2 diabetes and cardiovascular risk.

Bromocriptine is a centrally acting dopamine D2 receptor agonist. Quick-release bromocriptine may be considered for obese patients who do not tolerate other diabetes medications or who need only a minimal reduction in A1c to reach their glycemic goal.

Bile acid sequestrants were developed as lipid-lowering agents for the treatment of hypercholesterolemia but were subsequently found to have a glucose-lowering effect. The bile acid sequestrant colesevelam is FDA-approved as an adjunctive therapy to improve glycemic control.

Pramlintide acetate is an amylin analogue that mimics the effects of endogenous amylin, which is secreted by pancreatic beta cells. This agent delays gastric emptying, decreases postprandial glucagon release, and modulates appetite.

Read more about the treatment of type 2 diabetes.

This Fast Five Quiz was excerpted and adapted from the Medscape Drugs & Diseases articles Type 2 Diabetes Mellitus and metformin (Rx).

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