Adverse Effects of Glycemia-Lowering Medications in Type 2 Diabetes

Purpose of Review Treatment of patients with type 2 diabetes mellitus is focused on preventing the occurrence and delaying the development of macro- and micro-vascular complications. Glycemic control can help prevent these complications, but there is concern about the adverse effects of glycemia-lowering medications. A rational approach is to balance the desired low risk of adverse events against the unwanted higher risk of major complications resulting from suboptimal glucose control. Recent Findings Using the above approach, approved glucose-lowering agents have favorable benefit-to-risk profiles for use in most patients with type 2 diabetes. We first briefly review the mechanism of actions and benefits of the different commonly used classes of glycemia-lowering medications and then discuss adverse effects and safety concern associated with their use. Summary Our overall assessment is that if used appropriately, the different classes of glycemia-lowering medications offer beneficial outcomes with relatively modest and, in some instances, preventable adverse events.