Division of Endocrinology and Metabolism, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
© 2025 Korean Society of Cardiovascular Disease Prevention; Korean Society of Cardiovascular Pharmacotherapy.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Conflicts of interest
Junghyun Noh is the editor-in-chief of this journal, but was not involved in the peer reviewer selection, evaluation, or decision process of this article. The author has no other conflicts of interest to declare.
Funding
The author received no financial support for this study.
Medication | Advantages | Disadvantages |
---|---|---|
Metformin | Low risk of hypoglycemia | Gastrointestinal adverse effects |
No weight gain | Vitamin B12 deficiency | |
Lactic acidosis (rare) | ||
Thiazolidinedione | Low risk of hypoglycemia | Weight gain |
Good glycemic durability | Edema | |
Exacerbation of heart failure | ||
Increased risk of fractures | ||
Concerns regarding bladder cancer | ||
Sulfonylurea | Good initial efficacy | Risk of hypoglycemia |
Weight gain | ||
Meglitinide | Rapid onset of action | Risk of hypoglycemia |
Flexibility with meal timing | Weight gain | |
Effectiveness in postprandial glucose control | Frequent dosing | |
Can be used in renal impairment (repaglinide) | ||
DPP4 inhibitor | Low risk of hypoglycemia | Potential risk of pancreatitis (rare) |
Well tolerated | Potential joint pain (rare) | |
Once-daily dosing | ||
Weight-neutral | ||
GLP-1 receptor agonist | Low risk of hypoglycemia | Injectable |
Weight loss | Gastrointestinal adverse effects | |
Cardiovascular benefits (liraglutide, dulaglutide, semaglutide) | ||
Αlpha-glucosidase inhibitor | Low risk of hypoglycemia | Gastrointestinal adverse effects |
Effectiveness in postprandial glucose control | Frequent dosing | |
Weight-neutral | ||
SGLT2 inhibitor | Low risk of hypoglycemia | Increased risk of genital and urinary infection |
Weight loss | Polyuria | |
Decreased blood pressure | Dehydration | |
Cardiovascular benefit | Risk of euglycemic ketoacidosis | |
Renal protection | Bone fracture risk | |
Insulin | Effective glycemic control | Injectable |
Risk of hypoglycemia | ||
Weight gain | ||
Requires visual, manual, and cognitive skills |
DPP4, dipeptidyl peptidase-4; GLP-1, glucagon-like peptide-1; SGLT2, sodium-glucose cotransporter 2.